Resuscitation
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We evaluated the effect of chest compression fraction (CCF) on survival to hospital discharge and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients with non-shockable rhythms. ⋯ We observed an incremental benefit from higher CCF on the incidence of ROSC, but not survival, among non-shockable OHCA patients with CCF higher than 40%.
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The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. ⋯ Refractory cardiac arrest patients treated with VA-ECMO experience significant recovery of ventricular function during treatment. We postulate that this primarily occurs via reduction of LV preload.
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Observational Study
Contributing Factors to Early Recurrence of Ventricular Fibrillation during Out-of-hospital Cardiac Arrest: an Observational Retrospective Study.
In out-of-hospital cardiac arrest (OHCA), external electric shock (EES) is recommended for treating ventricular fibrillation (VF). Refibrillation commonly occurs within one minute post-shock. We aimed to investigate refibrillation times and identifyclinical and electrical factors associated with them. ⋯ In non-traumatic OHCA, most refibrillations occurred within 45-s post-shock. Age and post-shock hands-off time were the two contributing factors to time to refibrillation.
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Survival following out-of-hospital cardiac arrest (OHCA) decreases as the interval from collapse to CPR and defibrillation increases. Innovative approaches are needed to reduce response intervals, especially for private locations. ⋯ In this initial US-based experience of a smartphone program for suspected OHCA in private and public locations, Verified Responders reported a positive experience, though were only involved in a small fraction of OHCA. Studies should determine how this type of program could be enhanced to involve more OHCA events.