Resuscitation
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Multicenter Study Comparative Study
Comparison of the Between the Flags calling criteria to the MEWS, NEWS and the electronic Cardiac Arrest Risk Triage (eCART) score for the identification of deteriorating ward patients.
Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration. ⋯ An electronically generated eCART score was more accurate than commonly used paper based observation tools for predicting the composite outcome of in-hospital cardiac arrest, ICU transfer and death within 24h of observation. The outcomes of this analysis lend weight for a move towards an algorithm based electronic risk identification tool for deteriorating patients to ensure earlier detection and prevent adverse events in the hospital.
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Multicenter Study Observational Study
Early coronary angiography and percutaneous coronary intervention are associated with improved outcomes after out of hospital cardiac arrest.
Early coronary angiography (CAG) and percutaneous coronary intervention (PCI) are associated with better outcomes in subjects resuscitated from out-of-hospital cardiac arrest (OHCA). We sought to determine the relative contributions of early CAG and PCI to outcomes and adverse events after OHCA. ⋯ Early CAG and PCI are associated with improved survival and functional outcomes after OHCA, but only early PCI was associated with a significant benefit after statistical adjustment. Our analysis supports the performance of immediate CAG to determine the need for PCI in selected patients following resuscitation from OHCA.
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Multicenter Study
An automatic system for the comprehensive retrospective analysis of cardiac rhythms in resuscitation episodes.
An automatic resuscitation rhythm annotator (ARA) would facilitate and enhance retrospective analysis of resuscitation data, contributing to a better understanding of the interplay between therapy and patient response. The objective of this study was to define, implement, and demonstrate an ARA architecture for complete resuscitation episodes, including chest compression pauses (CC-pauses) and chest compression intervals (CC-intervals). ⋯ A general ARA architecture was defined and demonstrated on a comprehensive OHCA dataset. Results showed that semi-automatic resuscitation rhythm annotation, which may involve further revision/correction by clinicians for quality assurance, is feasible. The performance (UMS) dropped significantly during CC-intervals and sensitivity was lowest for PEA.
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Multicenter Study Observational Study
Telephone Cardiopulmonary Resuscitation is Independently Associated with Improved Survival and Improved Functional Outcome after Out-of-Hospital Cardiac Arrest.
This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. ⋯ TCPR is independently associated with improved survival and improved functional outcome after OHCA.
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Randomized Controlled Trial Multicenter Study
Neuron-specific enolase and S-100b in prolonged targeted temperature management after cardiac arrest: A randomised study.
We aimed to investigate the impact of prolonged targeted temperature management (TTM) in cardiac arrest patients on release of serum levels of NSE and S-100b and their prognostic performances. ⋯ No clinically relevant differences were found in the levels of NSE or S-100b between standard and prolonged TTM. Prognostic reliability of NSE and S-100b was unaltered by prolonged TTM.