Resuscitation

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AIM: To describe the association between patient- and hospital-level factors and coronary angiography among patients who suffer out-of-hospital cardiac arrest (OHCA). METHODS: A population-based retrospective cohort study using data from 28 hospitals in Southern Ontario between March 1, 2010 and December 31, 2014. We included consecutive adult patients with atraumatic, OHCA, who achieved return of spontaneous circulation, and were alive at least six hours after hospital arrival...

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BACKGROUND: Out-of-hospital cardiac arrest (OHCA) affects nearly 400,000 people each year in the United States of which only 10% survive. Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), and machine learning (ML) techniques, we developed a model of neurological outcome prediction for OHCA in Chicago, Illinois. METHODS: Rescue workflow data of 2,639 patients with witnessed OHCA were retrieved from Chicago's CARES. An Embedded Fully Convolutional Network (EFCN) classification model was selected to predict the patient outcome (survival with good neurological outcomes or not) based on 27 input features with the objective of maximizing the average class sensitivity...

AIM: To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest. METHODS: 184 adult patients from a multi-centric prospective register who underwent an early EEG after cardiac arrest were included. Auditory and somatosensory stimulation was performed during EEG-recording. EEG reactivity (EEG-R) and EMG reactivity (EMG-R) were retrospectively assessed visually by board-certified electroencephalographers, and compared with clinical outcome (cerebral performance category, CPC) at three months...

BACKGROUND: Early prognostication is a major challenge after out-of-hospital cardiac arrest (OHCA). AIMS: We hypothesized that a genome-wide analysis of blood gene expression could offer new prognostic tools and lines of research. METHODS: Sixty-nine patients were enrolled from an ancillary study of the clinical trial NCT00999583 that tested the effect of erythropoietin (EPO) after OHCA. Blood samples were collected in comatose survivors of OHCA at hospital admission and 1 and 3 days after resuscitation...

INTRODUCTION: Laryngeal tubes (LT) are supraglottic airway devices routinely used in emergency airway management. During cardiac arrest in a swine model, the carotid artery blood flow is reduced after insertion of a LT. A compression of the internal carotid (ICA) artery by the inflated cuff was shown. Up to now there is no information if the LT has similar effects in humans with possible negative implications for use of the LT in case of cardiac arrest. OBJECTIVE: We hypothesized that the use of a LT in humans significantly reduces the blood flow in the ICA compared facemask ventilation...

Fifty years ago, the ad hoc committee of the Harvard medical school provided the influential first guidance on confirming death using neurological criteria (DNC). Now 70% of countries have a legal or professional framework enabling DNC. While there is virtually universal acceptance of a three staged approach to the clinical diagnosis of brain death, international variation in practice continues. The need to develop international consensus and standards is essential in the future if public and professional confidence in the diagnosis is to be maintained and increased...

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AIMS: We evaluated the diagnostic performance of optic nerve sheath diameter (ONSD) for prediction of neurologic outcome in post-cardiac arrest patients and relative prediction performance according to ONSD measurement modality. DATA SOURCES: PubMed and EMBASE databases were searched for diagnostic accuracy studies that used ocular ultrasound or brain computed tomography (CT) for prediction of neurologic outcome. Bivariate modelling and hierarchical-summary and receiver-operating-characteristic modelling were performed to evaluate diagnostic performance...

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AIMS: The introduction of dispatcher assistance (DA) services has led to increased bystander cardiopulmonary resuscitation (CPR) participation rates. However, the extent to which DA improves CPR quality remains unclear. This study aimed to evaluate the efficacy of DA in improving CPR quality among healthcare professionals and laypersons within a multi-ethnic Southeast Asian population. METHODS: A parallel, randomised controlled, open label trial was performed. Four hundred and twelve participants were recruited via convenience sampling in a public location...

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AIM: This study aimed to seek evidence for the usefulness of the procalcitonin as a prognostic blood biomarker for outcomes in post-cardiac arrest patients. METHODS: We systematically searched MEDLINE, EMBASE, and the Cochrane Library (search date: 8 Jan, 2019). Studies on patients who experienced return of spontaneous circulation, who had out of hospital cardiac arrest and had their level of procalcitonin measured and outcomes assessed at and after hospital discharge, were included...