Resuscitation
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Mathematical optimization can be used to place automated external defibrillators (AEDs) in locations that maximize coverage of out-of-hospital cardiac arrests (OHCAs). We sought to determine whether optimization can improve alignment between AED locations and OHCA counts across levels of socioeconomic deprivation. ⋯ Mathematical optimization results in AED locations and suspected OHCA coverage that more closely resembles the suspected OHCA distribution and results in more equitable coverage across levels of socioeconomic deprivation.
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Bystander CPR (B-CPR) is known to be a critical action in treating out-of-hospital cardiac arrest (OHCA). Immediate CPR may double a patient's chance of survival. Only 40% of OHCA patients receive B-CPR (Cardiac Arrest Registry to Enhance Survival1). Civilians may be more comfortable performing CPR on male than female victims based on stereotyped training and the culture of cardiac disease treatment. ⋯ There was a significantly lower rate of B-CPR in women experiencing OCHA in the population sample analyzed. Continued education and research are needed on the topic to address gender-specific differences in OHCA.
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Observational Study
Expired Carbon Dioxide during Newborn Resuscitation as Predictor of Outcome.
To explore and compare expired CO2 (ECO2) and heart rate (HR), during newborn resuscitation with bag-mask ventilation, as predictors of 24-h outcome. ⋯ Higher levels and a faster rise in ECO2 and HR during newborn resuscitation were independently associated with improved survival compared to persisting low values. ECO2 increased before HR and may serve as an earlier predictor of survival.
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Cardiopulmonary resuscitation after cardiac arrest initiates a whole-body ischemia-reperfusion injury, which may activate the innate immune system, including the complement system. We hypothesized that complement activation and subsequent release of soluble endothelial activation markers were associated with cerebral outcome including death. ⋯ Complement system activation, reflected by sC5b-9 at admission, leading to subsequent endothelial cell activation, was associated with poor outcome in out-of-hospital cardiac arrest patients.