Resuscitation
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Extracorporeal cardiopulmonary resuscitation (ECPR) is the emerging resuscitative strategy to save refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) patients. We investigated whether the receiving hospitals' ECPR capabilities are associated with outcomes in out-of-hospital cardiac arrest (OHCA) patients who have refractory VF or pulseless VT. ⋯ Hospitals' ECPR capabilities were associated with favourable neurologic outcomes in OHCA patients who had refractory VF or pulseless VT. We should take each hospital's ECPR capability into consideration when developing a regional system of care for OHCA.
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Multicenter Study Comparative Study Observational Study
Comparison of video laryngoscopy versus direct laryngoscopy for intubation in emergency department patients with cardiac arrest: A multicentre study.
To compare the tracheal intubation performance between video laryngoscopy (VL) and direct laryngoscopy (DL) in patients with cardiac arrest in the ED. ⋯ Based on large multicentre prospective data of ED patients with cardiac arrest, the use of VL was associated with a higher first-attempt success rate compared to DL, with a better glottic visualisation and lower oesophageal intubation rate.
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Observational Study
Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients.
Several scores are available to predict mortality and neurological outcome in cardiac arrest patients admitted to the intensive care unit (ICU). The aim of the study was to externally validate the prognostic value of four previously published risk scores. ⋯ This study confirms the good prognostic performance of cardiac arrest specific scores to predict mortality and neurological outcomes in cardiac arrest patients. Routine use of OHCA or CAHP score helps to objectively risk stratify these vulnerable patients and thereby may improve therapeutic decisions.
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Review Retracted Publication
Epinephrine for out of hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials.
To evaluate the effectiveness of epinephrine, compared with control treatments, on survival at admission, ROSC, survival at discharge, and a favorable neurologic outcome in adult patients during OHCA. ⋯ In OHCA, standard or high doses of epinephrine should be used because they improved survival to hospital discharge and resulted in a meaningful clinical outcome. There was also a clear advantage of using epinephrine over a placebo or no drugs in the considered outcomes.
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Multicenter Study
Differential association of subtypes of epileptiform activity with outcome after cardiac arrest.
Epileptiform activity is common after cardiac arrest, although intensity of electroencephalographic (EEG) monitoring may affect detection rates. Prior work has grouped these patterns together as "malignant," without considering discrete subtypes. We describe the incidence of distinct patterns in the ictal-interictal spectrum at two centers and their association with outcomes. ⋯ We found high rates of epileptiform EEG findings, regardless of intensity of EEG monitoring. The association of distinct ictal-interictal EEG findings with outcome was variable.