Resuscitation
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To evaluate volume-outcome relationship in paediatric out-of-hospital cardiac arrest (OHCA). ⋯ There may be a relationship between institutional case volume and survival outcomes in paediatric OHCA.
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Cardiac arrest related to accidental hypothermia may occur at temperatures below 32 °C. Our goal was to describe the clinical characteristics and outcomes of patients who suffered from witnessed hypothermic cardiac arrest (CA) and assess the occurrence of hypothermic CA as a function of patient body temperature. ⋯ CA that is solely caused by hypothermia did not occurs for patients with a body temperature >30 °C. Our findings provide valuable new information that can be incorporated into the international clinical management guidelines of accidental hypothermia.
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Observational Study
Ion shift index as a promising prognostic indicator in adult patients resuscitated from cardiac arrest.
Several studies reported that disturbances in cellular ion homeostasis occur following ischaemia, the magnitude of which was proportional to illness severity. The changes in serum electrolyte levels following ischaemia were minor compared with the changes in ion concentrations in the extracellular fluid. To amplify the serum electrolyte changes, we devised a new index (ion shift index), which could be calculated using commonly measured serum electrolyte levels, and explored its prognostic value in adult cardiac arrest patients. ⋯ Our results suggest that the ion shift index can be helpful in the early prognostication of adult cardiac arrest patients.
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This study evaluates differences in out-of-hospital cardiac arrest (OHCA) characteristics, interventions, and outcomes by race/ethnicity. ⋯ We identified important differences in patients with OHCA according to race/ethnicity. Such differences may have implications for interventions; for example, emphasis on bystander CPR instruction in Black and Hispanic communities.
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Screening and correcting reversible causes of cardiac arrest (CA) are an essential part of cardiopulmonary resuscitation (CPR). Point-of-care (POC) laboratory analyses are used for screening pre-arrest pathologies, such as electrolyte disorders and acid-base balance disturbances. The aims of this study were to compare the intraosseous (IO), arterial and central venous POC values during CA and CPR and to see how the CPR values reflect the pre-arrest state. ⋯ A dynamic change occurs in the common laboratory values during CA and CPR. POC analyses of lactate, pH, sodium and calcium within IO samples are not different from analyses of arterial or venous blood. Potassium values in IO, arterial and venous samples during CPR are higher than the pre-arrest arterial values.