Resuscitation
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Review Meta Analysis
Tracheal suctioning of meconium at birth for non-vigorous infants: A systematic review and meta-analysis.
The International Liaison Committee on Resuscitation sought to review the initial management of non-vigorous newborns delivered through meconium stained amniotic fluid (MSAF). ⋯ PROSPERO; CRD42019122778.
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Review
Intravenous vs. Intraosseous Administration of Drugs During Cardiac Arrest: A Systematic Review.
To perform a systematic review of the literature on intravenous (IV) vs. intraosseous (IO) administration of drugs during cardiac arrest in order to inform an update of international guidelines. ⋯ We identified a limited number of studies comparing IV vs. IO administration of drugs during cardiac arrest. Pooled results from four observational studies favoured IV access with very low certainty of evidence. From the subgroup analyses of two randomized clinical trials, there was no statistically significant interaction between the route of access and study drug on outcomes.
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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.
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Adrenaline is an important component in the resuscitation of individuals experiencing out-of-hospital cardiac arrest (OHCA). The 2018 Advanced Cardiac Life Support (ACLS) algorithm gives the option of either intravenous (IV) or intraosseous (IO) routes for adrenaline administration during cardiac arrest. However, the optimal route during prehospital resuscitation remains controversial. This study aims to investigate whether IV and IO routes lead to different outcomes in OHCA patients who received prehospital adrenaline. ⋯ Compared with the IO approach, the IV approach appears to be the optimal route for adrenaline administration in advanced life support for OHCA during prehospital resuscitation.
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Multicenter Study
In-hospital cardiac arrest in hospitals with mature rapid response systems - a multicentre, retrospective cohort study.
To investigate in-hospital cardiac arrests (IHCAs) according to the Ustein template in hospitals with mature systems utilizing rapid response teams (RRTs), with a special reference to preceding RRT factors and factors associated with a favourable neurological outcome (cerebral performance category (CPC) 1-2) at hospital discharge. ⋯ In hospitals with mature rapid response systems most IHCA patients live a fully independent life with low burden of comorbid diseases before their hospital admission, the IHCA incidence is low and outcome better than traditionally believed. Deterioration before IHCA is present in a significant number of patients and improved monitoring and earlier interventions may further improve outcomes.