Resuscitation
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Extracorporeal cardiopulmonary resuscitation (ECPR) can treat cardiac arrest refractory to conventional therapies. Many institutions are interested in developing their own ECPR program. However, there may be challenges in logistics and implementation. ⋯ ECPR is an infrequent occurrence in EMS practice. Most apparently eligible patients did not get ECPR, highlighting the need for ongoing programmatic development, provider education, and qualitative work exploring barriers to implementation.
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Limited data is available on the association between low-flow time and neurologic outcome according to the initial arrest rhythm in patients underwent extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ The effect of interplay between arrest rhythm and low-flow time might be helpful for decisions about team activation and management for ECPR and could provide information for early neurologic prognosis.
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Observational Study
Improvement of Consciousness before Initiating Targeted Temperature Management.
Following cardiac arrest, return of spontaneous circulation (ROSC) in patients may be followed by spontaneous neurological recovery, which may decrease the potential adverse effects of treatments in post-cardiac arrest care, including those of Targeted Temperature Management (TTM). We investigated the percentage of post-arrest patients who experienced spontaneous neurological recovery, and the characteristics and neurological outcomes of these patients. ⋯ A significant portion of patients had spontaneous neurological recovery to GCS M6 within 3 h post ROSC, and had a favorable neurological outcome. Close monitoring of GCS and later initiation of TTM should be considered in those patients with a substantial likelihood of neurological recovery.