Resuscitation
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Randomized Controlled Trial
Wireless and continuous monitoring of vital signs in patients at the general ward.
Clinical deterioration regularly occurs in hospitalized patients potentially resulting in life threatening events. Early warning scores (EWS), like the Modified Early Warning Score (MEWS), assist care givers in assessing patients' clinical situation, but cannot alert for deterioration between measurements. New devices, like the ViSi Mobile (VM) and HealthPatch (HP) allow for continuous monitoring and can alert deterioration in an earlier phase. VM and HP were tested regarding MEWS calculation compared to nurse measurements, and detection of high MEWS in periods between nurse observations. ⋯ Both VM and HP are promising for continuous vital sign monitoring and may be more accurate than nurses. High MEWS can be detected in hospitalized patients around the clock and clinical deterioration at an earlier phase during unobserved periods.
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Randomized Controlled Trial
The Effect of Intravenous Adrenaline on Electrocardiographic Changes During Resuscitation in Patients with Initial Pulseless Electrical Activity in Out of Hospital Cardiac Arrest.
Presence of electrocardiographic rhythm in the absence of palpable pulses defines pulseless electrical activity (PEA) and the electrocardiogram (ECG) may provide a source of information during resuscitation. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-hospital cardiac arrest (OHCA) with initial PEA, and to explore the potential effects of adrenaline on these characteristics. ⋯ ECG changes during ALS in cardiac arrest were associated with prognosis, and the administration of adrenaline impacted on these changes.
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Multicenter Study
Neuron-Specific-Enolase as a Predictor of the Neurologic Outcome after Cardiopulmonary Resuscitation in Patients on ECMO.
Neuron-specific-enolase (NSE) is frequently used to predict the neurologic outcome in persistently unconscious patients after cardiopulmonary resuscitation (CPR). However, its predictive value is unclear in the setting of veno-arterial extracorporeal membrane oxygenation therapy (ECMO). Aim of this project is to evaluate the predictive value of NSE in ECMO patients. ⋯ In post-CPR patients on ECMO, NSE can be used to assess the neurologic outcome. Importantly, specificity was highest if using serial NSE measurements. Further research using prospective datasets is needed to verify these findings.
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Multicenter Study Observational Study
Survival and neurological outcome with extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest caused by massive pulmonary embolism: A two center observational study.
Cardiac arrest (CA) due to pulmonary embolism (PE) is associated with low survival rates and poor neurological outcomes. We examined whether Extracorporeal Cardiopulmonary Resuscitation (ECPR) improves the outcomes of patients who suffer from CA due to massive PE. ⋯ ECPR seems a promising treatment for cardiac arrest patients due to (suspected) massive pulmonary embolism compared to conventional CPR, though outcomes remain poor.
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Sudden cardiac arrest (SCA) is a major public health challenge in the United States (US). At present, the existence of limited literature on psychological sequelae post-cardiac arrest is a challenge in providing optimal care to survivors. ⋯ Comorbid psychiatric disorders are prevalent in SCA survivors, especially younger, white, female patients. However, CAPD did not have higher all-cause mortality as compared to CANPD. It is imperative to identify, assess, treat, and monitor high-risk SCA patients for associated psychiatric comorbidities.