Resuscitation
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To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery. ⋯ There are low rates of maternal survival following resuscitative hysterotomy for OHCA. There are documented neonatal survivors after extended periods of maternal resuscitation, and at extremely preterm gestations (<28 weeks). Further prospective research should assess both maternal and neonatal outcomes to better inform future clinical practice.
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Meta Analysis
Drug therapy versus placebo or usual care for comatose survivors of cardiac arrest; a systematic review with meta-analysis.
In Europe, approximately 291,000 cardiac arrests occur annually. Despite critical care therapy, hospital mortality remains high. This systematic review assessed whether, in comatose survivors of cardiac arrest, any drug therapy, compared to placebo or usual care, improves outcomes. ⋯ In comatose survivors of cardiac arrest, the majority of trials of drug therapy reported no effect on mortality. Meta-analyses of steroids, coenzyme Q10 and thiamine demonstrated no evidence of an effect on mortality. However, the low certainty of evidence warrants further research.
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Across the world, many systems have implemented extracorporeal cardiopulmonary resuscitation (ECPR) as a potential treatment strategy for patients in refractory cardiac arrest. To date, there are no universally accepted criteria for patient selection for ECPR. We conducted a systematic review to explore the variability in patient eligibility criteria for ECPR across systems. ⋯ PROSPERO (CRD42023451109).
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Across the world, many systems have implemented extracorporeal cardiopulmonary resuscitation (ECPR) as a potential treatment strategy for patients in refractory cardiac arrest. To date, there are no universally accepted criteria for patient selection for ECPR. We conducted a systematic review to explore the variability in patient eligibility criteria for ECPR across systems. ⋯ PROSPERO (CRD42023451109).
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Review
EEG reactivity in neurologic prognostication in post-cardiac arrest patients: A narrative review.
Electroencephalographic reactivity (EEG-R) is a promising early predictor of arousal in comatose patients after cardiac arrest. Despite recent guidelines advocating for the integration of EEG-R into the multimodal prognostication model, EEG-R testing methods remain heterogeneous across studies. ⋯ In this narrative review, we explore the value and possible mechanisms of EEG-R, focusing on post-cardiac arrest comatose patients. We aim to discuss the current standard of knowledge and future directions, as well as elucidate possible implications for patient care and research.