Resuscitation
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To summarise evidence on the clinical effectiveness of initial vascular attempts via the intraosseous route compared to the intravenous route in adult cardiac arrest. ⋯ Initial vascular access attempts via the intraosseous, compared with intravenous, route in adult cardiac arrest did not improve 30-day survival and may reduce the odds of a sustained return of spontaneous circulation.
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To evaluate the ability of blood-biomarkers, clinical examination, electrophysiology, or neuroimaging, assessed within 14 days from return of circulation to predict good neurological outcome in children following out- or in-hospital cardiac arrest. ⋯ Clinical examination, electrophysiology, neuroimaging or blood-biomarkers as individual tests can predict good neurological outcome after cardiac arrest in children. However, evidence is often low quality and studies are heterogeneous. Use of a standardised, multimodal, prognostic algorithm should be studied and is likely of added value over single modality testing.
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Acute kidney injury (AKI) is a serious complication of out-of-hospital cardiac arrest (OHCA). Post-resuscitation cardiogenic shock (CS) is a key contributing factor. Targeting a higher arterial carbon dioxide tension may affect AKI after OHCA in patients with or without CS. ⋯ AKI occurred in approximately two-thirds and RRT in approximately one in ten TAME patients without differences according to treatment allocation. CS significantly increased the prevalence of AKI but this effect was not modified by carbon dioxide allocation.
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To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery. ⋯ There are low rates of maternal survival following resuscitative hysterotomy for OHCA. There are documented neonatal survivors after extended periods of maternal resuscitation, and at extremely preterm gestations (<28 weeks). Further prospective research should assess both maternal and neonatal outcomes to better inform future clinical practice.