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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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.
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The simplified cardiac arrest hospital prognosis (sCAHP) score is a validated tool for predicting neurological outcomes after out-of-hospital cardiac arrest (OHCA). We used the sCAHP score to evaluate whether the effects of early coronary angiography (CAG) and targeted temperature management (TTM) for OHCA were modulated by immediate neuroprognosis. ⋯ Early CAG and TTM should be considered for all OHCA patients as suggested by guidelines, irrespective of the immediately predicted neuroprognosis after ROSC.
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Observational Study
Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes.
In 2016, the neonatal resuscitation guidelines suggested electronic cardiac (ECG) monitoring to assess heart rate for an infant receiving positive pressure ventilation immediately after birth. Our aim was to study the impact of ECG monitoring on delivery room resuscitation interventions and neonatal outcomes. ⋯ Introduction of ECG monitoring in the delivery room was associated with fewer endotracheal intubations, and an increase use of chest compressions with no difference in mortality.