Resuscitation
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Observational Study
Time course of platelet counts in relation to the neurologic outcome in patients undergoing targeted temperature management after cardiac arrest.
Thrombocytopenia is common and associated with mortality in critically ill patients. However, the time course of platelet counts and its association with the neurologic outcome after out-of-hospital cardiac arrest (OHCA) are not well known. The purpose of this study is to describe the time course of platelet counts in relation to the neurologic outcome in patients undergoing targeted temperature management (TTM) after CA. ⋯ The changes in platelet counts in OHCA patients have a biphasic pattern that is significantly different in patients with good neurologic outcomes and those with poor neurologic outcomes at 6 months. A low platelet count 7 days after CA was associated with a poor neurologic outcome and mortality at 6 months.
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Observational Study
Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan.
Our objective was to assess the characteristics such as public-access defibrillation (PAD) by laypersons and the outcomes after pediatric out-of-hospital cardiac arrest by location in the PAD era. ⋯ In Japan, where public-access automated external defibrillators are well disseminated, characteristics such as PAD and outcomes for pediatric out-of-hospital cardiac arrest before EMS arrival differed substantially by location.
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Studies suggest that hyperoxemia increases short-term mortality after cardiopulmonary resuscitation (CPR), but the effect of hyperoxemia on long-term outcomes is unclear. We determined the prevalence of early hyperoxemia after CPR and its association with long-term neurological outcome and mortality. ⋯ We found no association between early post-arrest hyperoxemia and unfavourable outcome. Subgroup analysis found no differential effect depending on arrest location, initial rhythm or time-to-ROSC.
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It is recommended globally that shocks by automated external defibrillators (AEDs) should be delivered immediately when a shockable out-of-hospital cardiac arrest (OHCA) occurs. However, the actual time-interval from collapse to first shock by public-access AED and its impact on subsequent outcome has not been extensively investigated in real-world settings. ⋯ In Japan, earlier shock by public-access AED led to better outcome after bystander-witnessed OHCA with shockable rhythm in public locations. However, the proportion of OHCA patients who received early shock was still low in public locations.
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Recent work has demonstrated low rates of layperson CPR training across the US. In an attempt to increase rates, some states passed legislation that requires CPR training before high school graduation. We hypothesized laypeople in states with required training would exhibit a greater likelihood of being currently trained in CPR when compared with laypeople in states without required CPR training. ⋯ Individuals were more likely to be currently trained in CPR in states with mandatory CPR training for high school graduation, suggesting a need for additional research on this public policy.