Resuscitation
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To describe the long-term survival of out-of-hospital cardiac arrest (OHCA) patients and to determine whether survival is improving in comparison to the general age- and sex-matched population. ⋯ Relative long-term survival prospects for initial OHCA survivors are moderately lower than that of the general population, however these differences have reduced over time and may be approaching those of the general population.
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For out-of-hospital-cardiac-arrest (OHCA) due to ventricular fibrillation (VF) guidelines recommend early defibrillation followed by chest compressions for two minutes before analyzing shock success. If rhythm analysis reveals VF again, it is obscure whether VF persisted or reoccurred within the two-minutes-cycle of chest compressions after successful defibrillation. We investigated the time of VF-recurrence in OHCA. ⋯ Although VF was terminated by defibrillation in 74.1%, VF recurred in 81% subsequent to the chest compression interval. Thus, VF reappears frequently and early. It is unclear to which extend chest compressions influence VF-relapse. Further studies need to re-evaluate the algorithm, timing of antiarrhythmic therapy or novel defibrillation strategies to minimize refibrillation during shockable OHCA.
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To determine changes over time in 30-day survival and the incidence of shockable rhythms after in-hospital cardiac arrest, from a countrywide perspective. ⋯ In an 11-year perspective, resuscitation in in-hospital cardiac arrest in Sweden was characterised by an overall increase in the adjusted 30-day survival, despite a decrease in shockable rhythms. An increased proportion, among the patients found in a shockable rhythm, who were defibrillated before the arrival of a cardiac arrest team may have contributed to the finding.