Resuscitation
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Observational Study
Optimal timing to measure optic nerve sheath diameter as a prognostic predictor in post-cardiac arrest patients treated with targeted temperature management.
We evaluated the optimal timing of optic nerve sheath diameter (ONSD) measurement to predict neurologic outcome in post-cardiac arrest patients treated with target temperature management (TTM). ⋯ Our findings demonstrate ONSD24 as a valuable tool to predict the neurologic outcome in post-cardiac arrest patients treated with TTM. Therefore, we recommend performing ONSD measurement using ultrasonography at 24 h after ROSC, rather than immediately after ROSC, to predict neurologic outcome in post-cardiac arrest patients treated with TTM.
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Observational Study
Non-invasive continuous haemodynamic monitoring and response to intervention in haemodynamically unstable patients during rapid response team review.
During rapid response team (RRT) management of haemodynamic instability (HI), continuous non-invasive haemodynamic monitoring may provide supplemental physiological information. ⋯ Continuous non-invasive measurement of haemodynamics during RRT management for HI was possible for 20 min. Patients with hypotension rather than tachycardia had lower baseline HR, MAP and CI values. There was a statistically significant but small increase in MAP at the 15-20 min time-block and overall, for both the tachycardia and FBT groups.
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Emergency coronary angiography (CAG) and percutaneous coronary intervention (PCI) are thought to improve outcomes in cardiac arrest (CA) survivors with ST segment elevation myocardial infarction (STEMI) and those without STEMI but likely cardiac etiology (shockable rhythms). However, the role of CAG ± PCI in OHCA survivors with non-shockable rhythms and no STEMI post-resuscitation remains unclear. ⋯ There is limited data describing the prevalence of CAD and the role of CAG ± PCI in CA survivors with non-shockable rhythms and no STEMI post-resuscitation. In the two studies meeting criteria for this systematic review, 16% of patients with non-shockable rhythms underwent PCI.
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Evidence about the immediate survival from in-hospital cardiac arrest (IHCA) is well established, however, beyond discharge there is very little describing the long-term outcomes of these patients. Of the few existing studies, all have been conducted in metropolitan centres. Therefore, this study describes survival from IHCA in both the short and long-term in a large regional hospital cohort. ⋯ Both short and long-term survival following an IHCA in a regional hospital are similar to previously described rates in metropolitan hospitals. Further research is required on the post-discharge correlates of long-term survival.
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Observational Study
Growth differentiation factor-15 predicts poor survival after cardiac arrest.
Early prognostication in post-cardiac arrest (CA) patients remains challenging and biomarkers have evolved as helpful tools in risk assessment. The stress-response cytokine growth differentiation factor-15 (GDF-15) is dramatically up-regulated during various kinds of tissue injury and predicts outcome in many pathological conditions. We aimed to assess the predictive value of circulating GDF-15 in post-CA patients. ⋯ GDF-15 predicts poor survival and neurological outcome in post-CA patients. GDF-15 may reflect the extent of hypoxic injury to the brain and other organs and might help to improve early risk stratification after CA.