Resuscitation
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Defibrillation in out-of-hospital cardiac arrest (OHCA) is increasingly performed by using an Automated External Defibrillator (AED). Therefore presence of a shockable rhythm is recurrently only documented by the AED. However, AED-information is rarely available to the treating physician. ⋯ In 11-13% of OHCAs, a shockable rhythm is only seen on the AED-ECG. Adequate transfer to the physician of vital AED-information is essential but not always accomplished.
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Bilateral absence of cortical somato-sensory evoked potentials (SSEPs) robustly predicts poor outcome after cardiac arrest (CA), but it is uncertain if SSEP amplitudes provide additional information. Here, we examined the prognostic value of cortical SSEP amplitude in comparison with other known outcome predictors. ⋯ Decreased SSEPs amplitudes are associated with poor outcome after cardiac arrest; however, adding this to a multimodal prognostic approach including EEG, clinical and blood biomarkers, improves slightly prediction of mortality, but not of poor or good outcome.
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There has been an explosive growth of ECPR within new and established ECMO programs worldwide with the concomitant need for simulation trainers. However, current commercially available ECMO simulation models are expensive and lack many standard cardiorespiratory resuscitative (CPR) features. ⋯ A novel in-house modified manikin for ECPR was developed that was cost-efficient and realistic to use from first response through to establishment of ECMO circulation.
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Multicenter Study
Association between mild hypercapnia and hospital mortality in patients admitted to the intensive care unit after cardiac arrest: A retrospective study.
Mild hypercapnia may increase cerebral oxygenation and attenuate cerebral injury in post-cardiac arrest patients. However, its association with hospital mortality has not been evaluated. ⋯ PaCO2 has a U-shaped association with odds ratio for hospital mortality, with mild hypercapnia not having a higher hospital survival probability than normocapnia in post-cardiac arrest patients.