Time to Return of Spontaneous Circulation and Survival: When to Transport in out-of-Hospital Cardiac Arrest?
TL;DR: In OHCA patients with prehospital ROSC survival significantly decreases with increasing time-to-ROSC, and the optimal time for the decision to transport is between 8 and 15 min after EMS arrival.
About: This article is published in Prehospital Emergency Care.The article was published on 2021-03-04 and is currently open access. It has received 20 citations till now. The article focuses on the topics: Return of spontaneous circulation.
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TL;DR: In this paper , the authors explored correlations between recording EEG type and mortality (primary outcome), or cerebral performance categories (CPC, secondary outcome), assessed blindly at 6 months, using uni-and multivariable analyses (adjusting for other prognostic variables showing some imbalance across groups).
12 citations
TL;DR: In this paper , the authors explored correlations between recording EEG type and mortality (primary outcome), or cerebral performance categories (CPC, secondary outcome), assessed blindly at 6 months, using uni-and multivariable analyses (adjusting for other prognostic variables showing some imbalance across groups).
8 citations
04 Jul 2020
TL;DR: The interaction between sCPR and mCPR is described and the impact of the sC PR‐mCPR transition upon outcomes in adult out‐of‐hospital cardiac arrest (OHCA) is described.
Abstract: Objective The quality of cardiopulmonary resuscitation (CPR) affects outcomes from cardiac arrest, yet manual CPR is difficult to administer. Although mechanical CPR (mCPR) devices offer high quality CPR, only limited data describe their deployment, their interaction with standard manual CPR (sCPR), and the consequent effects on chest compression continuity and patient outcomes. We sought to describe the interaction between sCPR and mCPR and the impact of the sCPR-mCPR transition upon outcomes in adult out-of-hospital cardiac arrest (OHCA). Methods We analyzed all adult ventricular fibrillation OHCA treated by the Anchorage Fire Department (AFD) during calendar year 2016. AFD protocols include the immediate initiation of sCPR upon rescuer arrival and transition to mCPR, guided by patient status. We compared CPR timing, performance, and outcomes between those receiving sCPR only and those receiving sCPR transitioning to mCPR (sCPR + mCPR). Results All 19 sCPR-only patients achieved return of spontaneous circulation (ROSC) after a median of 3.3 (interquartile range 2.2-5.1) minutes. Among 30 patients remaining pulseless after sCPR (median 6.9 [5.3-11.0] minutes), transition to mCPR occurred with a median chest compression interruption of 7 (5-13) seconds. Twenty-one of 30 sCPR + mCPR patients achieved ROSC after a median of 11.2 (5.7-23.8) additional minutes of mCPR. Survival differed between groups: sCPR only 14/19 (74%) versus sCPR + mCPR 13/30 (43%), P = 0.045. Conclusion In this series, transition to mCPR occurred in patients unresponsive to initial sCPR with only brief interruptions in chest compressions. Assessment of mCPR must consider the interactions with sCPR.
5 citations
Cites background from "Time to Return of Spontaneous Circu..."
...Longest chest compression interruption during the resuscitation attempt (s) 12 [9-16] 10 [7-12] 14 [10-19] 0....
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TL;DR: In this paper , the effect of coronavirus disease 2019 (COVID-19) on out-of-hospital cardiac arrest (OHCA) outcomes in South Korea was evaluated by a systematic review and meta-analysis.
Abstract: Purpose To evaluate the effect of coronavirus disease 2019 (COVID-19) on out-of-hospital cardiac arrest (OHCA) outcomes in South Korea, we conducted systematic review and meta-analysis. Materials and Methods MEDLINE, Embase, KoreaMed, and Korean Information Service System databases were searched up to June 2022. We included observational studies and letters on OHCA during the COVID-19 pandemic and compared them to those before the pandemic. Epidemiologic characteristics, including at-home OHCA, bystander cardiopulmonary resuscitation, unwitnessed arrest, use of an automated external defibrillator (AED), shockable cardiac rhythm, and airway management, were evaluated. Survival and favorable neurological outcomes were extracted. We conducted a meta-analysis of each characteristic and outcome. Results Six studies including 4628 OHCA patients were included in this study. The incidence of at-home OHCA significantly increased and the AED use decreased during the COVID-19 pandemic compared to before the pandemic [odds ratio (OR), 1.29; 95% confidence interval (CI), 1.08–1.55; I2=0% and OR, 0.74; 95% CI, 0.57–0.97; I2=0%, respectively]. Return of spontaneous circulation after OHCA, survival, and favorable neurological outcomes during and before the pandemic did not differ significantly (OR, 0.90; 95% CI, 0.71–1.13; I2=37%; OR, 0.74; 95% CI, 0.43–1.26; I2=72%; OR, 0.77; 95% CI, 0.43–1.37; I2=70%, respectively). Conclusion During the COVID-19 pandemic in South Korea, the incidence of at-home OHCA increased and AED use decreased among OHCA patients. However, survival and favorable neurological outcomes did not significantly differ from before the pandemic. This insignificant effect of the pandemic on OHCA in South Korea could be attributed to the slow increase in patient count in the early days of the pandemic. OSF Registry (DOI: 10.17605/OSF.IO/UGE9D).
4 citations
TL;DR: In this article , the authors constructed a Geographic Information System (GIS) model to estimate the number of extracorporeal cardiopulmonary resuscitation (ECPR) candidates in the U.S. based on a 45-minute transportation time to an ECMO-ready center.
3 citations
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