Resuscitation
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To assess survival duration and frequency of delayed neurologic improvement in patients with poor neurologic status at discharge from emergency hospitals after out-of-hospital cardiac arrest (OHCA). ⋯ Survival probability in patients with CPC 3 or 4 was 50% at 1-year and 20% at 3-year. Neurologic improvements were observed in 3.6% patients, higher in CPC 3 than in CPC 4 patients. During the first 6 months after OHCA, the neurologic status may improve in patients with CPC 3 or 4.
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The guidelines on temperature control for comatose cardiac arrest survivors were recently changed from recommending targeted temperature management (32-36 °C) to fever control (≤37.7 °C). We investigated the effect of implementing a strict fever control strategy on prevalence of fever, protocol adherence, and patient outcome in a Finnish tertiary academic hospital. ⋯ The implementation strict fever control strategy was feasible and did not result in increased prevalence of fever, poorer protocol adherence, or worse patient outcomes. Most patients in the fever control group did not require external cooling.
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A minority of out-of-hospital cardiac arrest patients have an acutely occluded coronary artery without manifesting ST-segment elevation on their post-resuscitation ECG. Identifying such patients is an issue to providing timely reperfusion therapy. We aimed to evaluate the usefulness of the initial post-resuscitation electrocardiogram in out-of-hospital-cardiac-arrest patients for selection to perform early coronary angiography. ⋯ Electrocardiogram findings cannot exclude or identify the presence of an acutely occluded coronary in out-of-hospital-cardiac-arrest patients without ST-segment elevation. An acutely occluded coronary may be present regardless of normal electrocardiogram findings.
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The aim of this study was to explore associations between comorbidities and health-related quality of life (HRQoL) among in-hospital cardiac arrest (IHCA) survivors. ⋯ Since IHCA survivors with comorbidities report worse HRQoL compared to those without comorbidities, it is important to pay directed attention to them when developing and providing post-CA care, especially in those with respiratory insufficiency and previous stroke.
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This study sought to identify Out of Hospital Cardiac Arrests (OHCA) eligible for Extracorporeal Cardiopulmonary Resuscitation (ECPR), use Geographic Information Systems (GIS) to investigate geographic patterns, and investigate if correlation between ECPR candidacy and Social Determinants of Health (SDoH) exist. ⋯ A significant proportion of OHCAs were eligible for ECPR based on prehospital criteria. Utilizing GIS to map and analyze ECPR patients provided insights into the locations of these events and the SDoH that may be driving risk in these places.