Resuscitation
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Multicenter Study Observational Study
Deep-learning-based out-of-hospital cardiac arrest prognostic system to predict clinical outcomes.
Out-of-hospital cardiac arrest (OHCA) is a major healthcare burden, and prognosis is critical in decision-making for treatment and the withdrawal of life-sustaining therapy. This study aimed to develop and validate a deep-learning-based out-of-hospital cardiac arrest prognostic system (DCAPS) for predicting neurologic recovery and survival to discharge. ⋯ The DCAPS predicted neurologic recovery and survival to discharge of OHCA patients accurately and outperformed the conventional method and other machine-learning methods.
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Observational Study
Hemodynamic effects of chest compression interruptions during pediatric in-hospital cardiopulmonary resuscitation.
Animal studies have established deleterious hemodynamic effects of interrupting chest compressions. The objective of this study was to evaluate the effect of interruptions on invasively measured blood pressures (BPs) during pediatric in-hospital cardiac arrest (IHCA). ⋯ BPs following chest compression interruptions did not differ from pre-interruption BPs. These findings suggest that in the setting of high-quality in-hospital CPR, brief chest compression interruptions do not have persistent detrimental hemodynamic impact.
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Observational Study
Vital Sign Patterns Before Shock-Related Cardiopulmonary Arrest.
Traditional vital sign thresholds reflect an increased risk of mortality, which may occur hours, days, or weeks following illness/injury, limiting immediate clinical significance to guide rescue therapy to avoid arrest. Our objective is to explore vital sign patterns prior to arrest due to shock. ⋯ Vital sign patterns were defined for SBP, MAP, HR, shock index, and EtCO2 with clear inflection points identified 2-5 min prior to arrest. These patterns may help guide therapy to reverse deterioration and prevent arrest.
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Observational Study
Effect of vertical location on survival outcomes for out-of-hospital cardiac arrest in Singapore.
A large proportion of out-of-hospital cardiac arrest (OHCA) cases occur in high-rise residential buildings. This study aims to investigate the effect of vertical location on survival outcomes and response times. ⋯ Vertical location is associated with OHCA survival probability with a U-shaped response, and this significance remained after adjustment for other significant OHCA variables. This relationship is likely multifactorial and more research is needed to elucidate the various factors.
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Cerebral oximetry (rSO2) may be useful in assessing the probability of return of spontaneous circulation (ROSC). However, the potential of assessing the trend in the rSO2 value has not been discussed when determining the probability of ROSC. ⋯ The combination of rSO2 (baseline) with the amount of maximum rise in rSO2 value over time might be a new index for the prediction of ROSC that could be useful in guiding cardiopulmonary resuscitation. Further studies are needed to validate these findings.