Resuscitation
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Neurological impairment after resuscitated cardiac arrest (CA) remains a significant unmet medical need. Brain ischemia associated with CA and subsequent reperfusion is evident as two fundamentally different types of damage on neuropathological examination: frank necrosis (involving all cell types) and selective eosinophilic neuronal death (SEND). These types of damage are not only dissimilar in micromorphology, but also differently detectable with clinical brain imaging methods. In a previous study, SEND was reported in most patients surviving the initial CA. This study was undertaken to further characterize and map SEND in an expanded dataset. ⋯ There are regional differences in SEND distribution. Cases free of SEND in the hippocampus or basal ganglia are unlikely to have significant SEND in other regions, suggesting that these regions could be used as "sentinel sites" for global SEND in future studies.
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Review Meta Analysis
Paediatric targeted temperature management post cardiac arrest: A systematic review and meta-analysis.
The International Liaison Committee on Resuscitation prioritized the need to update the review on the use of targeted temperature management (TTM) in paediatric post cardiac arrest care. In this meta-analysis, the effectiveness of TTM at 32-36 °C was compared with no target or a different target for comatose children who achieve a return of sustained circulation after cardiac arrest. ⋯ There is currently inconclusive evidence to either support or refute the use of TTM at 32-34 °C for comatose children who achieve return of sustained circulation after cardiac arrest. Future trials should focus on children with out-of-hospital cardiac arrest.
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Large cities pose unique challenges that limit the effectiveness of system improvement interventions. Successful implementation of integrated cardiac resuscitation systems of care can serve as a model for other urban centers. ⋯ Densely populated cities with low survival rates can overcome systematic challenges and improve OHCA survival.
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Randomized Controlled Trial
Comparing bystander response to a sudden cardiac arrest using a virtual reality CPR training mobile app versus a standard CPR training mobile app.
Using a mobile virtual reality (VR) platform to heighten realism for cardiopulmonary resuscitation (CPR) training has the potential to improve bystander response. ⋯ The use of the VR mApp significantly increased the likelihood of calling 911 and asking for an AED, however, CC depth was decreased.