Resuscitation
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Randomized Controlled Trial
Using a smartwatch with real-time feedback improves the delivery of high-quality cardiopulmonary resuscitation by Healthcare Professionals.
Cardiopulmonary resuscitation (CPR) quality affects survival after cardiac arrest. We aimed to investigate if a smartwatch with real-time feedback can improve CPR quality by healthcare professionals. ⋯ Without real-time feedback, chest compressions tend to be too fast and too shallow. CPR quality can be improved with the assistance of a smartwatch providing real-time feedback.
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Observational Study
Prognostic impact of the conversion to a shockable rhythm from a non-shockable rhythm for patients suffering from out-of-hospital cardiac arrest.
For patients suffering from an out-of-hospital cardiac arrest (OHCA), having an initial shockable rhythm is a marker of good prognosis. It has been suggested as one of the main prognosticating factors for the selection of patients for extracorporeal resuscitation (E-CPR). However, the prognostic implication of converting from a non-shockable to a shockable rhythm, as compared to having an initial shockable rhythm, remains uncertain, especially among patients that can otherwise be considered eligible for E-CPR. The objective of this study was to evaluate the association between the initial rhythm and its subsequent conversion and survival following an OHCA, for the general population and for E-CPR candidates. ⋯ The initial rhythm remains a much better prognostic marker than subsequent rhythms for all patients suffering from an OHCA, including in the subset of potential E-CPR candidates.
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Observational Study
External Validation of a Risk Classification at the Emergency Department of Post-cardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management.
There are no established risk classification for post-cardiac arrest syndrome (PCAS) patients at the Emergency Department (ED) undergoing targeted temperature management (TTM). The aim of this study was to externally validate a simplified version of our prognostic score, the "post-Cardiac Arrest Syndrome for Therapeutic hypothermia score" (revised CAST [rCAST]) and estimate the predictive accuracy of the risk classification based on it. ⋯ The rCAST was useful for predicting the neurological outcomes with high accuracy in PCAS patients, and the three grades was developed for a risk classification based on the rCAST.
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Paediatric traumatic out-of-hospital cardiac arrest (OHCA) is a rare event with few survivors. We examined long-term trends in the incidence and outcomes of paediatric traumatic OHCA and explored the frequency and timing of intra-arrest interventions. ⋯ The incidence and outcomes of paediatric traumatic OHCA remained unchanged over an 18 year period. Early correction of reversible causes by reducing delays to the delivery of trauma-specific interventions may yield additional survivors.
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Observational Study
Impact of first documented rhythm on cost-effectiveness of extracorporeal cardiopulmonary resuscitation.
Recommendations for extracorporeal cardiopulmonary resuscitation (ECPR) state that appropriate patient selection is important for the sake of efficacy and cost-effectiveness of ECPR. It is not known whether first documented rhythm plays a prominent role in economic outcomes of patients with cardiac arrest who received ECPR. ⋯ ECPR for patients presenting with VF/VT was found to be highly cost-effective and ECPR for patients presenting with ASY/PEA was borderline cost-effective.