Resuscitation

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OBJECTIVE: Positive pressure ventilation (PPV) using a ventilation device and a face mask is recommended for compromised newborn infants in the delivery room (DR). Airway obstruction and face mask leak during PPV may contribute to failure of resuscitation. Using an oropharyngeal airway (OPA) may improve efficacy of mask PPV. To determine whether the use of an OPA with mask PPV in the DR during stabilization of infants <34 weeks' gestational age, reduces the rate of airway obstruction...

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INTRODUCTION: Acute respiratory compromise (ARC), respiratory distress requiring emergent assisted ventilation, has a mortality of 20-40%. The relationship between recent discharge from an intensive care unit (ICU) and outcomes of patients suffering ARC on hospital wards is not well known. We hypothesized that a significant percentage of ARC events would occur in patients recently discharged from an ICU, that these patients would have worse outcomes than those without prior ICU stays, and that weekend ICU discharge would be associated with higher than expected post-ICU ARC frequency...

AIM: Patients with accidental hypothermia without vital signs increasingly receive venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, there is limited knowledge regarding the efficacy of this advanced rewarming method. We aimed to determine whether VA-ECMO improved outcomes in patients with accidental hypothermia without vital signs, using a large nationwide inpatient database in Japan. METHODS: Using the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2017, we identified patients diagnosed with accidental hypothermia who received closed-chest cardiac massage in-hospital on the day of admission...

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BACKGROUND: Little is known about the long-term trends in the incidence and outcomes of drug overdose out-of-hospital cardiac arrests (OHCA). METHOD: Between 2000 and 2017, we retrospectively reviewed drug overdose OHCAs from the Victorian Ambulance Cardiac Arrest Registry. Incidence was assessed using linear regression, and the baseline characteristics and survival outcomes were assessed using nonparametric test for trend. Arrest factors associated with survival to hospital discharge were assessed using logistic regression...

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INTRODUCTION: Survival of in-hospital cardiac arrest (IHCA) depends on fast and effective action of the first responding team. Not only technical skills, but professional teamwork is required. Observational studies and theoretical models suggest that shared mental models of members improve teamwork. This study investigated if a training on shared mental models, improves team performance in simulated in-hospital cardiac arrest. METHODS: On the background of an introduction of mandatory Basic Life Support (BLS) training for clinical staff a randomized controlled trial was performed to compare two training methods...

AIM OF THE STUDY: Patients presenting with acute type A aortic dissection (ATAAD) and cardiac arrest before surgery are considered to have very poor prognosis, but limited data is available. We used a large database to evaluate the outcome of ATAAD patients with a cardiac arrest before surgery. METHODS: We evaluated 1154 surgically treated ATAAD patients from the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database between 2005 and 2014. Patients with (n = 44, 3...

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AIM: Cardiac arrest (CA) was considered irreversible until 1960, when basic cardiopulmonary resuscitation (CPR) was defined. CPR guidelines include early recognition of CA, rapid and effective CPR, effective defibrillation strategies and organized post-resuscitation to ensure a strengthening of the survival chain. Bystanders are the key to extremely early management, which is associated with the early medical care provided by EMS. This study aims to assess the prognosis of a bystander's cardiac CPR when it is initiated by the Dispatch Centre (DC)...

AIM: This study aimed to investigate the effects of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) in Japan using a nationwide population-based registry. METHODS: Adult Japanese patients with out-of-hospital cardiac arrest (OHCA; n = 582,483, age ≥18 years) were selected from a nationwide Utstein-style database (2010-2016) and divided into 3 groups: no bystander CPR (NCPR) before emergency medical service arrival (n = 448,606), bystander-initiated CPR (BCPR) performed without assistance (n = 46,964), and TCPR (n = 86,913)...

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BACKGROUND: This study aimed to estimate the cost-effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest treatment. METHODS: A decision tree and Markov model were constructed based on current literature. The model was conditional on age, Charlson Comorbidity Index (CCI) and sex. Three treatment strategies were considered: ECPR for patients with an Age-Combined Charlson Comorbidity Index (ACCI) below different thresholds (2 - 4), ECPR for everyone (EALL), and ECPR for no one (NE)...

Formula one pit crews are renowned for their teamwork and efficiency. Pit crew models have been successfully applied to pre-hospital resuscitation but their use in-hospital remains untested. In this issue of Resuscitation Spitzer and colleagues share their findings from the implementation of a pit crew model for cardiac arrest teams at their institution. Their study used several interventions including mock codes and debriefing to implement the model. It is unclear if improved team communication is due to the pit crew model alone or other interventions...

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INTRODUCTION: Evidence about the immediate survival from in-hospital cardiac arrest (IHCA) is well established, however, beyond discharge there is very little describing the long-term outcomes of these patients. Of the few existing studies, all have been conducted in metropolitan centres. Therefore, this study describes survival from IHCA in both the short and long-term in a large regional hospital cohort. METHOD: A retrospective cohort study was conducted including all adult patients who suffered an IHCA between 1 February 2000 and 31 December 2017 in a large regional (non-metropolitan) hospital in Victoria, Australia...

AIM: There are limited data on long-term outcome in out-of-hospital cardiac arrest patients following the treatment shift of target temperature management (TTM) from 33 °C to 36 °C outside the controlled settings of randomised trials. The aim of this study was to evaluate the adherence to TTM guidelines after the publication of the TTM trial and if the change in temperature level influence six-month survival. METHODS: OHCA patients admitted to intensive care units (ICU) and recorded in the Swedish Intensive care Registry (January 2010 to March 2016) were included...