Resuscitation
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Serum creatinine levels in the post-resuscitative state have been associated with poor prognosis for out-of-hospital cardiac arrest (OHCA). Several studies have focused on kidney dysfunction in the general population, and the results suggested that serum creatinine level elevation or reduction of the estimated glomerular filtration rate (eGFR) are associated with increased risk of death and cardiovascular events. However, it is uncertain whether the serum creatinine levels or eGFR of OHCA patients are related to the incidence of OHCA. The aim of this study was to determine the association between eGFR and the incidence of OHCA. ⋯ In this study, we observed an association between reduced eGFR and the risk of OHCA incidence in a large, community-based population. Future prospective studies are needed to better understand how reduced renal function is associated with OHCA occurrence as well as the impact of intensive risk management and intervention of renal function on OHCA incidence.
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The objective of this study was to determine whether survival and post-arrest procedural utilization following in-hospital cardiac arrest (IHCA) differ in patients with and without comorbid cancer. ⋯ Patients with a history of cancer who sustain IHCA are less likely to receive post-arrest procedures and survive to hospital discharge. Given the expected rise in the rates of cancer survivorship, these findings highlight the need for broader application of potentially life-saving interventions to lower risk cancer patients who have sustained a cardiac arrest.
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There is no simple clinical tool that reliably indicates the presence of acute coronary lesions in out-of-hospital cardiac arrest (OHCA) patients without typical ST-segment elevations. ST-segment elevation in electrocardiographic lead aVR suggests global subendocardial ischemia. This study aimed to evaluate the diagnostic value of lead aVR for identifying acute coronary lesions following resuscitation from OHCA. ⋯ ST-segment elevation in lead aVR at early follow-up was associated with the presence of acute lesions accompanied by severe coronary artery disease in post-cardiac arrest patients without other ST-segment elevations. The analysis of ST-segment elevation in lead aVR may aid in the identification of patients who will benefit from further invasive coronary diagnostic procedures.