Resuscitation
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The use of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) is increasing. Prehospital ECPR (PH-ECPR) for out-of-hospital cardiac arrest (OHCA) may improve both equity of access and outcomes but its cost effectiveness has yet to be determined. ⋯ Initial cost analysis and modelling indicate PH-ECPR service strategies are likely to be cost effective and comparable to other medical interventions. Survival rate and service integration into non ECPR clinical tasks are key aspects contributing to cost effectiveness.
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To determine the association between institutional experience with extracorporeal cardiopulmonary resuscitation (ECPR) and outcomes after out-of-hospital cardiac arrest (OHCA). ⋯ Increasing institutional experience of ECPR did not significantly improve 30-day survival after OHCA but was associated with a shorter interval between hospital arrival and initiation of ECMO. In patients with non-shockable OHCA, increasing experience of ECPR improved 30-day survival. (246/250 words).
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Awakening from coma is crucial for survivors of cardiac arrest, though coma duration is variable. We tested the association of coma duration with short-term functional recovery and long-term survival after cardiac arrest. ⋯ Shorter coma duration was associated with better functional outcome at discharge, but not with long-term survival.
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Multicenter Study Observational Study
Plasma phosphorylated tau (p-tau231) and total tau (t-tau) as prognostic markers of neurological outcome after cardiac arrest - a multicentre study.
We studied the promising Alzheimer biomarker plasma tau phosphorylated at threonine 231 (p-tau231) in a cohort of cardiac arrest patients who survived to intensive care to predict long-term neurological outcomes. We also compared it to total tau (t-tau), which has demonstrated predictive abilities of neurological outcome post-cardiac arrest. ⋯ Although p-tau231 showed moderate neurological prognostic ability, t-tau was a stronger predictor, particularly at 48 h, even after adjusting for clinical covariates.