Resuscitation
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Randomized Controlled Trial
Ubiquinol (reduced Coenzyme Q10) as a Metabolic Resuscitator in Post-Cardiac Arrest: A Randomized, Double-Blind, Placebo-Controlled Trial.
Ubiquinol (reduced coenzyme Q10) is essential for adequate aerobic metabolism. The objective of this trial was to determine whether ubiquinol administration in patients resuscitated from cardiac arrest could increase physiological coenzyme Q10 levels, improve oxygen consumption, and reduce neurological biomarkers of injury. ⋯ Administration of enteral ubiquinol increased plasma coenzyme Q10 levels in post-cardiac arrest patients as compared to placebo. There were no differences in neurological biomarkers and oxygen consumption between the two groups.
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Multicenter Study Observational Study
Arterial carbon dioxide tension has a non-linear association with survival after out-of-hospital cardiac arrest: a multicentre observational study.
International guidelines recommend targeting normocapnia in mechanically ventilated out-of-hospital cardiac arrest (OHCA) survivors, but the optimal arterial carbon dioxide (PaCO2) target remains controversial. We hypothesised that the relationship between PaCO2 and survival is non-linear, and targeting an intermediate level of PaCO2 compared to a low or high PaCO2 in the first 24-h of ICU admission is associated with an improved survival to hospital discharge (STHD) and at 12-months. ⋯ Normocapnia within the first 24-h of intensive care admission after OHCA was associated with an improved survival compared to patients with hypocapnia or hypercapnia.
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Sudden cardiac death (SCD) may be triggered by daily circumstances and activities such as stressful psycho-emotional events, physical exertion or substance misuse. We calculated population attributable fractions (PAFs) to estimate the public health relevance of daily life triggers of SCD and to compare their population impacts. ⋯ In addition to episodic alcohol consumption, a trigger with the greatest public health importance for SCD, episodic physical exertion, cocaine use and coffee consumption also show a considerable population impact.
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Endotracheal intubation is an import component of out-of-hospital cardiac arrest (OHCA) resuscitation. In this analysis, we evaluate the association of video laryngoscopy (VL) with first pass success and return of spontaneous circulation (ROSC) using a national OHCA cohort. ⋯ While associated with higher FPS, VL was not associated with increased rate of ROSC. The role of VL in OHCA remains unclear.
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Observational Study
Machine learning can support dispatchers to better and faster recognize out-of-hospital cardiac arrest during emergency calls: A retrospective study.
Fast recognition of out-of-hospital cardiac arrest (OHCA) by dispatchers might increase survival. The aim of this observational study of emergency calls was to (1) examine whether a machine learning framework (ML) can increase the proportion of calls recognizing OHCA within the first minute compared with dispatchers, (2) present the performance of ML with different false positive rate (FPR) settings, (3) examine call characteristics influencing OHCA recognition. ⋯ ML recognized a higher proportion of OHCA within the first minute compared with dispatchers and has the potential to be a supportive tool during emergency calls. The optimal FPR settings need to be evaluated in a prospective study.