Resuscitation
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Editorial Comment
Do We Need Continuous Electroencephalography After Cardiac Arrest?
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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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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.
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Observational Study
Time to achieve desired fraction of inspired oxygen using a T-piece ventilator during resuscitation of preterm infants at birth.
To determine the time between adjustment of FiO2 at the oxygen blender and the desired FiO2 reaching the preterm infant during respiratory support at birth. ⋯ There is a clear delay before a desired FiO2 is achieved at the distal end of the T-piece resuscitator. This delay is clinically relevant as this delay could easily lead to over- and under titration of oxygen, which might result in an increased risk for both hypoxia and hyperoxia.