Resuscitation
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Multicenter Study
Variability in temperature control practices amongst the Influence of Cooling duration on Efficacy in Cardiac Arrest Patients (ICECAP) trial.
Temperature control is a complex bundled intervention; the synergistic impact of each individual component is ill defined and underreported. Resultantly, the influence of parameter optimization on temperature control's overall neuroprotective effect remains poorly understood. To characterize variability in temperature control parameters and barriers to short pre-induction and induction times, we surveyed sites enrolling in an ongoing multicenter clinical trial. ⋯ Amongst ICECAP trial sites, there was significant variability in resources, methods, and barriers for early temperature control initiation. Defining and standardizing high-quality temperature control must be prioritized, as it may impact the interpretation of past and current clinical trial findings.
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Comparative Study
Manual versus automatic chest compression devices for cardiopulmonary resuscitation under zero gravity (The MACCC - 0G STUDY).
Cardiopulmonary resuscitation (CPR) in microgravity requires specific methods to counteract weightlessness. Automatic chest compression devices (ACCDs) could improve CPR in microgravity. We aimed to compare ACCDs versus manual CPR in microgravity simulated through parabolic flights. ⋯ Only LUCAS 3© provided effective CPR according to international guidelines. ACCDs should implement microgravity CPR algorithms.
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This study explores the evolution of organ donation from patients treated with extracorporeal-cardiopulmonary-resuscitation (ECPR) for refractory out-of-hospital-cardiac-arrest (OHCA) and evaluates the public health benefits of a mature ECPR program. ⋯ The public health benefits of an established ECPR program extend beyond individual ECPR patient survival, forming a new, previously under-recognized source of transplant donors.
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Poor neurological outcome is common following a cardiac arrest. The use of volatile anesthetic agents has been proposed during post-resuscitation to improve outcome. ⋯ In this propensity-matched control study, isoflurane sedation during the post-resuscitation care of ICU patients was associated with a lower incidence of delirium, a shorter duration of mechanical ventilation and a reduced ICU length of stay. Prospective data are needed before its widespread use.