Resuscitation
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Randomized Controlled Trial
The Effect of Intravenous Adrenaline on Electrocardiographic Changes During Resuscitation in Patients with Initial Pulseless Electrical Activity in Out of Hospital Cardiac Arrest.
Presence of electrocardiographic rhythm in the absence of palpable pulses defines pulseless electrical activity (PEA) and the electrocardiogram (ECG) may provide a source of information during resuscitation. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-hospital cardiac arrest (OHCA) with initial PEA, and to explore the potential effects of adrenaline on these characteristics. ⋯ ECG changes during ALS in cardiac arrest were associated with prognosis, and the administration of adrenaline impacted on these changes.
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Multicenter Study
Neuron-Specific-Enolase as a Predictor of the Neurologic Outcome after Cardiopulmonary Resuscitation in Patients on ECMO.
Neuron-specific-enolase (NSE) is frequently used to predict the neurologic outcome in persistently unconscious patients after cardiopulmonary resuscitation (CPR). However, its predictive value is unclear in the setting of veno-arterial extracorporeal membrane oxygenation therapy (ECMO). Aim of this project is to evaluate the predictive value of NSE in ECMO patients. ⋯ In post-CPR patients on ECMO, NSE can be used to assess the neurologic outcome. Importantly, specificity was highest if using serial NSE measurements. Further research using prospective datasets is needed to verify these findings.
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Multicenter Study Observational Study
Survival and neurological outcome with extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest caused by massive pulmonary embolism: A two center observational study.
Cardiac arrest (CA) due to pulmonary embolism (PE) is associated with low survival rates and poor neurological outcomes. We examined whether Extracorporeal Cardiopulmonary Resuscitation (ECPR) improves the outcomes of patients who suffer from CA due to massive PE. ⋯ ECPR seems a promising treatment for cardiac arrest patients due to (suspected) massive pulmonary embolism compared to conventional CPR, though outcomes remain poor.
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Review Retracted Publication
Epinephrine for out of hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials.
To evaluate the effectiveness of epinephrine, compared with control treatments, on survival at admission, ROSC, survival at discharge, and a favorable neurologic outcome in adult patients during OHCA. ⋯ In OHCA, standard or high doses of epinephrine should be used because they improved survival to hospital discharge and resulted in a meaningful clinical outcome. There was also a clear advantage of using epinephrine over a placebo or no drugs in the considered outcomes.
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The impact of prehospital physician care for out-of-hospital cardiac arrest (OHCA) on long-term neurological outcome is unclear. We aimed to determine the association between emergency medical services (EMS) physician-led cardiopulmonary resuscitation (CPR) versus paramedic-led CPR and neurologically intact survival after OHCA. ⋯ Within the limitations of this retrospective observational research, EMS physician-led CPR for OHCA was associated with improved 1-month neurologically intact survival compared with paramedic-led CPR. However, neurologically intact survival was similar for patients aged <18 years and those receiving bystander defibrillation.