Resuscitation
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Abdominal fatty tissue deposition in obese individuals could alter the proper hand position for chest compression during cardiopulmonary resuscitation, similar to that in pregnant women. This study aimed to identify the difference in body mass index between obese and normal weight individuals by measuring the optimal point of maximal left ventricular diameter (OPLV), using computed tomography (CT). ⋯ OPLV on the sternum in obese individuals was more cranial than that in normal weight individuals. The optimal point for chest compression in obese individuals could be slightly more cranial than that in the others.
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To identify proteins of which depletion are associated with the poor 6-month neurological outcome of out-of-hospital cardiac arrest survivors. ⋯ The depletion of serum kallistatin at admission to the ICU was associated with the poor neurological outcome of out-of-hospital cardiac arrest survivors.
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Observational Study
Description of hot debriefings after in-hospital cardiac arrests in an international pediatric quality improvement collaborative.
The American Heart Association recommends debriefing after attempted resuscitation from in-hospital cardiac arrest (IHCA) to improve resuscitation quality and outcomes. This is the first published study detailing the utilization, process and content of hot debriefings after pediatric IHCA. ⋯ Approximately half of pediatric IHCAs were followed by hot debriefings. Hot debriefings were multi-disciplinary, timely, and often addressed issues of team cooperation/coordination, communication, clinical standards, and equipment. Additional studies are warranted to identify barriers to hot debriefings and to evaluate the impact of these debriefings on patient outcomes.
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Observational Study
Trends in the incidence and outcome of paediatric out-of-hospital cardiac arrest: A 17-year observational study.
System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. ⋯ Survival following paediatric OHCA increased in our region over a 17 year period. This was driven, in part, by improving outcomes for initial shockable arrests.
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Prognostication following out-of-hospital cardiac arrest (OHCA) remains challenging. A multimodal approach is favoured, including consideration of the biomarker neuron-specific enolase (NSE) (Sandroni et al., 2014). Our objective was to investigate the utility of serial NSE measurements and to determine an appropriate cut-off value for prediction of death before hospital discharge using data from our tertiary care center. ⋯ Serial measurement of NSE levels (at 0 and 48 h after admission) provides a useful tool to aid prognostication following out-of-hospital cardiac arrest.