Resuscitation
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Multicenter Study Observational Study
Airway management during in hospital cardiac arrest: An international, multicentre, retrospective, observational cohort study.
To determine the type of airway devices used during in-hospital cardiac arrest (IHCA) resuscitation attempts. ⋯ There is wide variation in airway device use during resuscitation after IHCA. Only half of patients are intubated before return of spontaneous circulation and many are managed without an advanced airway. Further investigation is needed to determine optimal airway device management strategies during resuscitation following IHCA.
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Randomized Controlled Trial Multicenter Study
A pragmatic randomized trial of cardiopulmonary resuscitation training for families of cardiac patients before hospital discharge using a mobile application.
Since over 80% of sudden cardiac arrests occur in the home, cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR training may facilitate this approach, but evidence regarding its efficacy is lacking. ⋯ URL: ClinicalTrials.gov, Identifier: NCT02548793.
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We compared the outcomes between patients who experienced out-of-hospital cardiac arrest at private residences and public locations to investigate whether patient and bystander characteristics can explain the poorer outcomes of out-of-hospital cardiac arrests at private residences. ⋯ Patients with out-of-hospital cardiac arrest at private residences had poorer outcomes than those with out-of-hospital cardiac arrest at public locations, even after adjusting for patient and bystander characteristics, if the initial cardiac rhythm was non-shockable. Our results suggest that poorer patient and bystander characteristics do not completely explain the poorer outcomes of out-of-hospital cardiac arrests; there may be unknown mechanisms through which the location of cardiac arrest affect the outcomes.
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Randomized Controlled Trial Multicenter Study
DOuble Sequential External Defibrillation for Refractory Ventricular Fibrillation: The DOSE VF Pilot Randomized Controlled Trial.
The primary objective was to determine the feasibility and safety of a cluster randomized controlled trial (RCT) with crossover comparing vector change defibrillation (VC) or double sequential external defibrillation (DSED) to standard defibrillation for patients experiencing refractory ventricular fibrillation (VF). Secondary objectives were to assess the rates of VF termination (VFT) and return of spontaneous circulation (ROSC). ⋯ Our findings suggest the DOSE-VF protocol is feasible and safe. Rates of VFT and ROSC were higher in the VC and DSED than standard defibrillation. The results of this pilot trial will allow us to inform a multicenter cluster RCT with crossover to determine if alternate defibrillation strategies for refractory VF may impact clinical outcomes.
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Multicenter Study
Prognostic value of somatosensory evoked potential in cardiac arrest patients without withdrawal of life-sustaining therapy.
The reliability of somatosensory evoked potential (SSEP) to predict a poor outcome of cardiac arrest patients after targeted temperature management (TTM) has been questioned due to self-fulfilling prophecy. ⋯ Our results provide further evidence that SSEP exactly predicts poor neurological outcome in these patients and suggest that caution be taken when the brainstem reflex is used as a single test to make decisions regarding WLST.