Resuscitation
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Performing advanced cardiac life support (ACLS) in the cardiac catheterization laboratory (CCL) is challenging. Mechanical chest compression (MCC) devices deliver compressions in a small space, allowing for simultaneous percutaneous coronary intervention and reduced radiation exposure to rescuers. In refractory cases, MCC devices allow rescuers to initiate percutaneous mechanical circulatory support (MCS) and extracorporeal life support (ECLS) during resuscitation. This study sought to assess the efficacy and safety of MCC when compared to manual compressions in the CCL. ⋯ Use of MCC during resuscitation of cardiac arrest in the CCL increases the rate of ROSC. Simultaneous implantation of MCS, including percutaneous ECLS, is feasible and safe during MCC-assisted resuscitation in the CCL.
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Review Meta Analysis
Does transport time of out-of-hospital cardiac arrest patients matter? A systematic review and meta-analysis.
Despite increasing evidence for specialized cardiac arrest centers, the impact of transport time on out-of-hospital cardiac arrest (OHCA) patients' outcome remains unclear. We systematically reviewed the prognostic impact of transport time in OHCA patients. ⋯ Paramedic transport time was not associated with survival to hospital discharge or with neurological outcome at hospital discharge in adult OHCA patients. Future studies are needed to prospectively evaluate the prognostic impact of transport time particularly in rural settings and pediatric population.
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Randomized Controlled Trial Multicenter Study
Compression-to-Ventilation Ratio and Incidence of Rearrest - A Secondary Analysis of the ROC CCC Trial.
Previous work has demonstrated that when out-of-hospital cardiac arrest (OHCA) patients achieve return of spontaneous circulation (ROSC), but subsequently have another cardiac arrest prior to hospital arrival (rearrest), the probability of survival to hospital discharge is significantly decreased. Additionally, few modifiable factors for rearrest are known. We sought to examine the association between rearrest and compression-to-ventilation ratio during cardiopulmonary resuscitation (CPR) and to confirm the association between rearrest and outcomes. ⋯ Rearrest occurrence was not significantly different between patients receiving CCC and 30:2, and was inversely associated with survival to hospital discharge and MRS.