Resuscitation
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We aimed to document how often patients received appropriate treatment of the primary cause underlying pulseless electrical activity (PEA) during cardiopulmonary resuscitation (CPR) and how it affected their outcome. ⋯ During CPR, only a fifth of patients received appropriate treatment of the primary cause underlying PEA. Those patients were more likely to be alive 30 days after IHCA, but age turned out to be the only significant individual factor for better survival.
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End tidal carbon dioxide (ETCO(2)) monitoring during advanced life support (ALS) using capnography, is recommended in the latest international guidelines. However, several factors might complicate capnography interpretation during ALS. How the cause of cardiac arrest, initial rhythm, bystander cardiopulmonary resuscitation (CPR) and time impact on the ETCO(2) values are not completely clear. Thus, we wanted to explore this in out-of-hospital cardiac arrested (OHCA) patients. ⋯ Capnography is a useful tool to optimise and individualise ALS in cardiac arrested patients. Confounding factors including cause of cardiac arrest, initial rhythm, bystander CPR and time from cardiac arrest until quantitative capnography had an impact on the ETCO(2) values, thereby complicating and limiting prognostic interpretation of capnography during ALS.
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Letter Randomized Controlled Trial Comparative Study
Video-based CPR training--the importance of quality assurance.
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To explore the molecular mechanisms by which mild hypothermia following resuscitation improves neurological function in a porcine model of cardiac arrest. ⋯ Brain protection induced by hypothermia involves inhibition of inflammatory and brain edema pathways.
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The amount of myocardial perfusion required for successful defibrillation after cardiac arrest is unknown. Coronary perfusion pressure (CPP) is a surrogate for myocardial perfusion. One limited clinical study identifies a threshold of 15 mmHg required for return of spontaneous circulation (ROSC). Our exploration of threshold and dose models of CPP during the initial bout of CPR indicates higher levels than previously demonstrated are required. CPP required for shock success throughout on-going resuscitation is unknown and other conceptual models of CPP have not been explored. ⋯ Threshold, delta, cumulative delta, dose, and cumulative dose CPP predict individual defibrillation success throughout resuscitation.