Resuscitation
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Cardiac arrests occurring in emergency departments (ED) represent 10-20% of all in-hospital cardiac arrests (IHCA). Yet few studies have examined the characteristics and outcomes of IHCA occurring in the ED. The aim was to describe this population in a nationwide registry covering all EDs in Sweden. ⋯ About 10% of all IHCA occurs in ED, however, from an ED perspective it is a rare event. Cardiac arrests in the ED generally occur within an hour from arrival to the ED. One in three survive to discharge from hospital and the majority of survivors have a good neurological outcome.
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This study aimed to investigate the effect of the head-up position implemented during cardiopulmonary resuscitation (CPR) on cerebral blood flow (CBF) using near-infrared spectroscopy in out-of-hospital cardiac arrest patients. ⋯ CBF increased when the head-up position was used during CPR in non-traumatic out-of-hospital cardiac arrest patients.
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To evaluate the association between bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and survival after out-of-hospital cardiac arrest (OHCA) across the urban-rural spectrum. ⋯ Bystander CPR and AED use are associated with positive clinical outcomes after OHCA in all areas along the urban-rural spectrum.
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Observational Study
Intra-Cardiac Arrest Transport and Survival from Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study.
To assess whether intra-cardiac arrest transport as compared to continued on-scene resuscitation was associated with improved clinical outcomes among out-of-hospital cardiac arrest patients in Denmark. ⋯ Among patients aged 18-65 years, intra-cardiac arrest transport was associated with a non-significant increase in survival within 20 minutes of EMS on-scene arrival. However, the results did not eliminate the potential for bias and the results should be interpreted carefully.
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Pressure reactivity index (PRx) provides a surrogate measurement of cerebrovascular autoregulation (CAR). We determined whether deviations from PRx-derived optimal mean arterial pressure (MAPopt) were associated with in-hospital mortality after adult cardiac arrest. ⋯ A greater burden of MAP below PRx-derived MAPopt-5 was associated with mortality after cardiac arrest. Non-survivors had a narrower range of intact CAR than survivors.