Resuscitation
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Observational Study
Trends in the incidence and outcome of paediatric out-of-hospital cardiac arrest: A 17-year observational study.
System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. ⋯ Survival following paediatric OHCA increased in our region over a 17 year period. This was driven, in part, by improving outcomes for initial shockable arrests.
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Observational Study
Work factors associated with return to work in out-of-hospital cardiac arrest survivors.
Although the survival rate after out-of-hospital cardiac arrest (OHCA) has increased over time, little is known about the return to work of OHCA survivors. We aim to evaluate prevalence and factors associated with return to work (RTW) in OHCA survivors. ⋯ Two thirds of OHCA survivors, in the present study, returned to work. Patients with a higher-level job, and with the arrest occurring in the workplace, were more likely to return to work. Further research should include more details of job contents, evolution, financial consequences, as well as prevention practices related to work location.
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Prognostication following out-of-hospital cardiac arrest (OHCA) remains challenging. A multimodal approach is favoured, including consideration of the biomarker neuron-specific enolase (NSE) (Sandroni et al., 2014). Our objective was to investigate the utility of serial NSE measurements and to determine an appropriate cut-off value for prediction of death before hospital discharge using data from our tertiary care center. ⋯ Serial measurement of NSE levels (at 0 and 48 h after admission) provides a useful tool to aid prognostication following out-of-hospital cardiac arrest.
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Comparative Study
Effects of head-up vs. supine CPR on cerebral oxygenation and cerebral metabolism - a prospective, randomized porcine study.
Recent studies have shown that during cardiopulmonary resuscitation (CPR) head-up position (HUP) as compared to standard supine position (SUP) decreases intracranial pressure (ICP) and increases cerebral perfusion pressure (CPP). The impact of this manoeuvre on brain oxygenation and metabolism is not clear. We therefore investigated HUP as compared to SUP during basic life support (BLS) CPR for their effect on brain oxygenation and metabolism. ⋯ In this animal model of BLS CPR, HUP as compared to SUP did not improve cerebral oxygenation or metabolism.
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Observational Study
Major traumatic complications after out-of-hospital cardiac arrest: Insights from the Parisian registry.
Due to collapse and cardiopulmonary resuscitation (CPR) maneuvers, major traumatic injuries may complicate the course of resuscitation for out-of-hospital cardiac arrest patients (OHCA). Our goals were to assess the prevalence of these injuries, to describe their characteristics and to identify predictive factors. ⋯ Major traumatic injuries are common after cardiopulmonary resuscitation. Further studies are necessary to evaluate the interest of a systematic traumatic check-up in resuscitated OHCA patients in order to detect these injuries.