Resuscitation
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Randomized Controlled Trial
Selective or routine face mask application for breathing support of preterm infants at birth: a randomised trial.
Most preterm infants breathe spontaneously at birth. Despite this, the majority have a face mask immediately applied for breathing support. Face mask application may inhibit spontaneous breathing in newborn infants. We wished to determine whether selectively applying a mask to give positive pressure ventilation (PPV) for apnoea or bradycardia only compared to routinely applying a mask for continuous positive airway pressure (CPAP) resulted in fewer preterm infants receiving PPV in the delivery room (DR). ⋯ Selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the DR.
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Randomized Controlled Trial
Optimum oxygen concentration for initiation of delivery room stabilization in preterm neonates: A Randomized Controlled Trial.
The ideal choice of initial fraction of inspired oxygen (FiO2) to stabilize preterm neonates in the delivery room (DR) is not well-established. ⋯ A significantly higher number of preterm neonates < 34 weeks' gestation requiring DR stabilization achieved a 5-minute SpO2 of ≥ 80 % with higher minute-specific SpO2 trends when stabilized with an initial FiO2 of 60 % compared to 30 %.
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Randomized Controlled Trial
Interleukin 6 blockage alters the plasma metabolome in out-of-hospital cardiac arrest.
Comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA) exhibit a systemic inflammatory response, as indicated by elevated interleukin-6 (IL-6) levels, which is associated with increased mortality. Tocilizumab, an IL-6 receptor antagonist that reduced C-reactive protein response and markers of myocardial injury in a phase II OHCA trial. ⋯ Blocking the IL-6 receptor with tocilizumab early after OHCA impacts circulating metabolites, particularly those within the glycine, serine, and threonine pathways, highlighting the connection between acute systemic inflammation and metabolism. Further, early levels of TCA metabolites are independently associated with early inflammatory response and early medium-chain acylcarnitine with later markers of neurological injury.
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Randomized Controlled Trial Pragmatic Clinical Trial
Vasopressor or advanced airway first in cardiac arrest?
While resuscitation guidelines emphasize early vasopressor administration and advanced airway management, their optimal sequence remains unclear. We sought to determine the associations between vasopressor-airway resuscitation sequence and out-of-hospital cardiac arrest (OHCA) outcomes in the Pragmatic Airway Resuscitation Trial (PART). ⋯ Vasopressor-airway resuscitation sequence was not associated with OHCA outcomes or CPR quality.
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Randomized Controlled Trial Multicenter Study
Low physical activity level in out-of-hospital cardiac arrest survivors with obesity, mobility problems and cognitive impairment: Results from the TTM2 trial.
To describe the level of physical activity 6 months after an out-of-hospital cardiac arrest (OHCA) and to explore potential risk factors of a low level of physical activity. ⋯ NCT02908308.