Resuscitation
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Editorial Comment
Does psychological trauma affect resuscitation providers?
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To evaluate the Inadequate oxygen delivery (IDO2) index dose as a predictor of cardiac arrest (CA) in neonates following congenital heart surgery. ⋯ In neonates post-CPB surgery, higher IDO2 index dose over a 120-min monitoring period is associated with increased risk of cardiac arrest, even when censoring data 10, 20 or 30 min prior to the CA event.
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Observational Study
Association of antiepileptic drugs with resolution of epileptiform activity after cardiac arrest.
We tested the impact of antiepileptic drug (AED) administration on post-cardiac arrest epileptiform electroencephalographic (EEG) activity. ⋯ After cardiac arrest, the impact of AEDs may depend on the presence of continuous cortical background activity. These data serve to inform experimental work to better define the opportunities to improve neurologic care post-cardiac arrest.
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Conversion to shockable rhythm from an initial non-shockable rhythm is associated with good neurologic prognoses in patients with out-of-hospital cardiac arrest (OHCA). We aimed to investigate whether conversion to shockable rhythm has an association with good neurologic outcomes, according to the etiology of cardiac arrest. ⋯ Conversion to shockable rhythm had an association with good neurologic outcome in patients with OHCA with initial non-shockable rhythms, especially due to cardiac cause. However, rhythm conversion was not associated with better outcome in patients with non-medical causes.
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Resuscitation of cardiac arrest involves invasive and traumatic interventions and places a large burden on limited EMS resources. Our aim was to identify prehospital cardiac arrests for which resuscitation is extremely unlikely to result in survival to hospital discharge. ⋯ A simple decision rule (non-shockable rhythm, unwitnessed arrest, age ≥ 80) identifies arrests for which resuscitation is futile. If validated, this rule could be applied by EMS policymakers to identify cardiac arrests for which the trauma and expense of resuscitation are extremely unlikely to result in survival.