Resuscitation
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Randomized Controlled Trial
Elimination of Glutamate using CRRT for 72 hours in patients with post-cardiac arrest syndrome: a randomized clinical pilot trial.
Glutamine and glutamate are major mediators of secondary brain cell death during post-cardiac arrest syndrome. As there is an equilibrium between brain tissue and plasma concentrations of glutamine and glutamate, their elimination from systemic circulation by extracorporeal blood purification may ultimately lead to reduced secondary cell death in the brain. We hypothesized that systemic glutamine and glutamate can be significantly reduced by continuous venovenous hemodiafiltration (CVVHDF). ⋯ In this trial, CVVHDF was not able to statistically significantly lower systemic plasma glutamine and glutamate levels. Post-cardiac arrest patients had plasma glutamine and glutamate levels within the normal range.
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Little is known about the long-term trends in the incidence and outcomes of drug overdose out-of-hospital cardiac arrests (OHCA). ⋯ Although the incidence of drug overdose OHCA remained unchanged between 2000 and 2017, the rates of survival have significantly improved.
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This study aimed to assess whether team-based cardiopulmonary resuscitation (CPR) training for emergency medical service (EMS) providers improved the pre-hospital return of spontaneous circulation (ROSC) rates of non-traumatic adult out-of-hospital cardiac arrest (OHCA) patients. ⋯ Team-based CPR training for EMS providers in a large community EMS system improved the pre-hospital ROSC rates of OHCA patients.
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Observational Study
Extracorporeal membrane oxygenation improves outcomes of accidental hypothermia without vital signs: a nationwide observational study.
Patients with accidental hypothermia without vital signs increasingly receive venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, there is limited knowledge regarding the efficacy of this advanced rewarming method. We aimed to determine whether VA-ECMO improved outcomes in patients with accidental hypothermia without vital signs, using a large nationwide inpatient database in Japan. ⋯ VA-ECMO was associated with higher survival and favourable neurological outcomes compared with conventional CPR alone in patients with accidental hypothermia without vital signs.
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Observational Study
Electroencephalographic Patterns Preceding Cardiac Arrest in Neonates Following Cardiac Surgery.
To identify EEG changes that could predict impending cardiac arrest (CA) in neonates with congenital heart disease undergoing postoperative continuous EEG monitoring. ⋯ EEG background was abnormal in 68% of neonates at EEG monitoring onset and worsened in all minutes before CA. EEG background changes may be an early sign of impending CA and indicative of developing cerebral dysfunction. Further study is needed to determine whether rapid identification of EEG changes could drive implementation of interventions to prevent CA.