Resuscitation
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Cardiac arrest in peripartum patients is a rare but devastating event; reported rates in the literature range from 0.019% to 0.0085%. In the general population, a well-described complication of cardiopulmonary resuscitation (CPR), liver laceration and injury, is reported at a rate of between 0.5-2.9% after CPR. Liver laceration rate among peripartum patients receiving CPR has not been well-studied. We sought to find the rate of liver lacerations in the peripartum population associated with CPR, with the hypothesis that the rate would be higher than in the general population. ⋯ Based on a small retrospective study, liver lacerations requiring intervention occurred in 43% of gravidas patients that survived CPR, and is significantly higher than published rates (0.6-2.1%) for the general patient population. Further studies are indicated to determine the incidence of liver injury after peripartum CPR.
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To investigate if the serum biomarkers of cerebral injury, neuron-specific enolase and S100b protein, may classify unfavourable neurological outcome after paediatric cardiac arrest. ⋯ Neuron-specific enolase and S100b classify unfavourable neurological outcome in this large paediatric cardiac arrest cohort. Further multi-institutional prospective studies to comprehensively evaluate the diagnostic accuracy of these biomarkers under various clinical conditions and to determine reliable cut-off values in children are warranted.
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24/7 in house attending staff coverage improves neonatal short-term outcomes: A retrospective study.
to compare short-term outcomes of newborns over 36 weeks with Apgar scores≤3 at 1min, following the adoption of a 24/7 in house coverage schedule STUDY DESIGN: A retrospective chart review comparing two 12-month epochs. Epoch 1: coverage provided by residents with availability on call at home of attending staff. Epoch 2: On site coverage by attending staff. ⋯ Continuous coverage by attending staff decreased the number of admissions to intensive care as well as the duration of hospitalization stay for newborns with low Apgar scores.
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Asystole (ASY) and pulseless electrical activity (PEA) are increasing and ventricular fibrillation (VF) or ventricular tachycardia (VT) declining as presenting rhythms of sudden cardiac arrest (SCA). Since there is limited information on possible differences in the etiology of underlying structural heart disease, we analyzed the clinical and/or autopsy findings of victims with ASY, PEA or VT/VF. ⋯ Asystole and PEA are a more common presenting rhythm than VT/VF at the time of SCA in non-ischemic cardiac disease. The decreasing trend of ischemic heart disease as a cause of SCA may partly explain the increasing trend of ASY/PEA.