Resuscitation
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Multicenter Study Observational Study
EEG for good outcome prediction after cardiac arrest: a multicentre cohort study.
Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). ⋯ Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.
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Randomized Controlled Trial
Combined use of the Montreal Cognitive Assessment and Symbol Digit Modalities Test improves neurocognitive screening accuracy after cardiac arrest: A validation sub-study of the TTM2 trial.
To assess the merit of clinical assessment tools in a neurocognitive screening following out-of-hospital cardiac arrest (OHCA). ⋯ gov Identifier: NCT03543371.
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Understanding the impact of social determinants of health (SDOH) on CA, including access to care pre-cardiac arrest (CA) can improve outcomes. Large databases, such as Epic Cosmos, can help identify trends in patient demographics and SDOH that identify gaps in care. The purpose of this study was to determine the incidence of CA and subsequent mortality in a large national database across patient demographics and social determinants and characterize pre-arrest care patterns. ⋯ SDOH have a significant impact on the risk of CA, pre-arrest care patterns, and post-arrest mortality. Determining the impact that SDOH have on the CA care continuum provides can provide actionable targets to prevent CA and subsequent mortality.
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Hypoxic ischemic brain injury (HIBI) induced by cardiac arrest (CA) seems to predominate in cortical areas and to a lesser extent in the brainstem. These regions play key roles in modulating the activity of the autonomic nervous system (ANS), that can be assessed through analyses of heart rate variability (HRV). The objective was to evaluate the prognostic value of various HRV parameters to predict neurological outcome after CA. ⋯ In comatose patients after CA, some HRV markers appear to be associated with unfavorable outcome, EEG severity and PLR abolition, although the sensitivity of these HRV markers remains limited.
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Clinicians may make prognostication decisions for out-of-hospital cardiac arrest (OHCA) using historical details pertaining to non-prescription drug use. However, differences in outcomes between OHCAs with evidence of non-prescription drug use, compared to other OHCAs, have not been well described. ⋯ In unadjusted models, DA-OHCA was associated with an improved odds of survival and favourable neurological outcomes at hospital discharge, compared to other OHCA. However, we did not detect an association in adjusted analyses.