Resuscitation
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Review Meta Analysis
Chest-compression-only versus conventional cardiopulmonary resuscitation by bystanders for children with out-of-hospital cardiac arrest: a systematic review and meta-analysis.
For children with out-of-hospital cardiac arrest, previous observational studies regarding chest-compression-only CPR (CC-CPR) versus conventional CPR yielded inconsistent results. We aimed to summarize the current evidence and compare the outcomes after CC-CPR with those after conventional CPR by bystanders in children with out-of-hospital cardiac arrest. ⋯ Children who receive conventional CPR for out-of-hospital cardiac arrest may have better outcomes than those who receive CC-CPR. Due to the limited number of studies and lack of randomized trials included in this meta-analysis, more evidence is needed to confirm our findings.
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Randomized Controlled Trial Multicenter Study
Prolonged targeted temperature management reduces memory retrieval deficits six months post-cardiac arrest: A randomised controlled trial.
Cognitive sequelae, most frequently memory, attention, and executive dysfunctions, occur commonly in out-of-hospital cardiac arrest (OHCA) survivors. Targeted temperature management (TTM) following OHCA is associated with improved cognitive function. However, the relationship between the duration of TTM and cognitive outcome remains unclear. We hypothesised that OHCA survivors that were subjected to prolonged TTM of 48 h (TTM48) would exhibit better cognitive functions compared to those subjected to standard TTM of 24 h (TTM24) six months post-OHCA. ⋯ This study reports an association between the duration of TTM and cognitive outcome. In OHCA survivors with perceived good cognitive outcome (CPC ≤ 2), TTM48 was associated with reduced memory retrieval deficits and lower relative risk of cognitive impairment six months after OHCA compared to standard TTM24. ClinicalTrials.gov (identifier: NCT01689077).
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Randomized Controlled Trial
Smaller facemasks for positive pressure ventilation in preterm infants: A randomised trial.
Facial measurements of preterm infants indicate that standard diameter facemasks used during positive pressure ventilation are too large, which may lead to mask leak and compromise resuscitation. We aimed to determine whether the use of a facemask that better complies with the dimensions of preterm faces, compared with a standard facemask, reduces facemask leak. ⋯ This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12614000709640, www.anzctr.org.au.
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Randomized Controlled Trial
What is the best position to place and re-evaluate an unconscious but normally breathing victim? A randomised controlled human simulation trial on children.
Current resuscitation guidelines endorse placing the unconscious and normally breathing victims in the recovery position (RP), but this technique might hinder breathing evaluation. ⋯ The strategy involving head-tilt-chin-lift significantly increased the likelihood of detecting cardiac arrest. Re-evaluating every minute when the RP was used significantly increased the likelihood of detecting cardiac arrest.
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Since the introduction of targeted temperature management (TTM), the accuracy and timing of prognostic tests for post-cardiac arrest patients have changed. Although previous studies have demonstrated the effectiveness of a multimodal approach in assessing the prognosis of TTM patients, few studies have investigated an optimised strategy that sequentially combines different prognostic modalities. This study identified an optimal sequential combination of prognostic modalities to predict poor neurologic outcomes in patients undergoing TTM. ⋯ Our stepwise model showed excellent prognostic ability to predict poor outcomes at one month after cardiac arrest and may be used to minimise the risk of false pessimistic predictions in patients undergoing TTM.