Resuscitation
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Review Meta Analysis
Mortality after In-Hospital Cardiac Arrest in Patients with COVID-19: A Systematic Review and Meta-Analysis.
To estimate the mortality rate, the rate of return of spontaneous circulation (ROSC) and survival with favorable neurological outcome in patients with COVID-19 after in-hospital cardiac arrest (IHCA) and attempted cardiopulmonary resuscitation (CPR). ⋯ Although one of three COVID-19 patients undergoing IHCA may achieve ROSC, almost 90% may not survive at 30 days or to hospital discharge.
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Randomized Controlled Trial Multicenter Study
The effect of immediate coronary angiography after cardiac arrest without ST-segment elevation on left ventricular function. A sub-study of the COACT randomised trial.
The effect of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients who are successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) on left ventricular function is currently unknown. ⋯ Netherlands Trial Register number, NTR4973.
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Multicenter Study
Barriers and Facilitators for In-hospital Resuscitation: A Prospective Clinical Study.
Guideline deviations with impact on patient outcomes frequently occur during in-hospital cardiopulmonary resuscitation (CPR). However, barriers and facilitators for preventing these guideline deviations are understudied. We aimed to characterize challenges occurring during IHCA and identify barriers and facilitators perceived by actual team members immediately following IHCA events. ⋯ Using novel, immediate after-event survey methodology of individual cardiac arrest team members, we characterized challenges and identified 24 themes within 4 domains that were barriers and facilitators for in-hospital resuscitation teams. We believe this level of detail is necessary to contextualize guidelines and training to facilitate high-quality resuscitation.
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If a patient in out-of-hospital cardiac arrest (OHCA) does not achieve return of spontaneous circulation (ROSC) despite advanced life support, emergency medical services can decide to either transport the patient with ongoing CPR or terminate resuscitation on scene. ⋯ In patients without ROSC on scene, besides known resuscitation characteristics, the decision to transport a patient is largely determined by non-protocollized factors.
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Analysis of the impact of bradycardia and hypoxemia on the course of cerebral and peripheral oxygenation parameters in preterm infants in need for respiratory support during foetal-to-neonatal transition. ⋯ Our study shows that the degree of bradycardia has a significant impact on the course of SpO2 only, but when associated with the additional presence of hypoxemia a significant impact on cerebral oxygenation parameters was seen (crStO2, cFTOE). Furthermore, the additional presence of hypoxemia has a significant impact on FiO2 delivered. Our study emphasizes the importance of HR and SpO2 during neonatal resuscitation, underlining the relevance of hypoxemia during the early transitional phase.