Resuscitation
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Multicenter Study
Early withdrawal of life support after resuscitation from cardiac arrest is common and may result in additional deaths.
"Early" withdrawal of life support therapies (eWLST) within the first 3 calendar days after resuscitation from cardiac arrest (CA) is discouraged. We evaluated a prospective multicenter registry of patients admitted to hospitals after resuscitation from CA to determine predictors of eWLST and estimate its impact on outcomes. ⋯ Early withdrawal of life support occurs frequently after cardiac arrest. Although the mortality of patients matched to those with eWLST was high, these data showed excess mortality with eWLST.
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Multicenter Study Observational Study
The Effect of Fractional Inspired Oxygen Concentration on Early Warning Score Performance: a database analysis.
To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission. ⋯ NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.
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Multicenter Study
Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest.
The use of extracorporeal membrane oxygenation (ECMO) in refractory cardiac arrest (ECPR) has increased exponentially. ECPR is a resource intensive service and its cost effectiveness has yet to be demonstrated. We sought to complete a cost analysis with modelling of cost effectiveness and quality of life outcomes. We sought to complete a cost analysis with modelling of cost effectiveness and quality of life outcomes of patients who have undergone ECPR. ⋯ ECMO support for refractory cardiac arrests is cost effective and compares favourably to accepted cost effectiveness thresholds.
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To describe one-year cognitive and neurologic outcomes among extracorporeal cardiopulmonary resuscitation (ECPR) survivors enrolled in the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial; and compare outcomes between survivors who received ECPR, later extracorporeal membrane oxygenation (ECMO), or no ECMO. ⋯ Many ECPR survivors had favourable outcomes although impairments were common. ECPR survivors had similar outcomes to other survivors who were initially comatose post-arrest.
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Post-resuscitation care of out-of-hospital cardiac arrest (OHCA) patients often involves inter-hospital transfer (IHT). We aimed to determine the association between IHT and outcomes of OHCA. ⋯ IHT should be considered when treating OHCA patients in LVEDs.