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- Hellevuo, H., et al.
(författare)
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Good quality of life before cardiac arrest predicts good quality of life after resuscitation
- 2018
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Ingår i: Acta Anaesthesiologica Scandinavica. - : WILEY. - 0001-5172 .- 1399-6576. ; 62:4, s. 515-521
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Tidskriftsartikel (refereegranskat)abstract
- Background: The survival rate of cardiac arrest patients is increasing. Our aim was to compare the quality of life before and after cardiac arrest and analyse the factors associated with outcome.Methods. All adult cardiac arrest patients admitted to the Tampere University Hospital intensive care unit between 2009 and 2011 were included in a retrospective follow-up study if surviving to discharge and were asked to return a questionnaire after 6 months. Data on patient demographics and pre-arrest quality of life were retrieved from medical records. Data are given as means (SD) or medians [Q(1), Q(3)]. We used logistic regression to identify factors associated with better quality of life after cardiac arrest.Results. Six months after cardiac arrest, 36% (79/222) were alive and 70% (55/79) of those patients completed the follow-up EuroQoL (EQ-5D) quality of life questionnaire. Median values for the EQ-5D before and after cardiac arrest were 0.89 [0.63, 1] and 0.89 [0.62, 1], respectively (P = 0.75). Only the EQ-5D prior to cardiac arrest was associated with better quality of life afterwards (OR 1.2; 95% CI 1.0-1.3; P = 0.02).Conclusions. Quality of life remained good after cardiac arrest especially in those patients who had good quality of life before cardiac arrest.
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| 2. |
- Hellevuo, H, et al.
(författare)
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The quality of manual chest compressions during transport : effect of the mattress assessed by dual accelerometers
- 2014
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 58:3, s. 323-328
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThe quality of cardiopulmonary resuscitation (CPR) has an impact on survival. The quality may be impaired if the patient needs to be transported to the hospital with ongoing CPR. The aim of this study was to analyse whether the quality of CPR can be improved during transportation by using real-time audiovisual feedback. In addition, we sought to evaluate the real compression depths taking into account the mattress and stretcher effect.METHODSParamedics (n = 24) performed standard CPR on a Resusci Anne Mannequin in a moving ambulance. Participants were instructed to perform CPR according to European Resuscitation Council Resuscitation guidelines 2010. Each pair acted as their own controls performing CPR first without and then with the feedback device. Compression depth, rate and no-flow fraction and also the mattress effect were recorded by using dual accelerometers by two Philips, HeartStart MRx Q-CPR defibrillators.RESULTSIn the feedback phase, the mean compression depth increased from 51 (10) to 56 (5) mm (P < 0.001), and the percentage of compression fractions with adequate depth was 60% vs. 89% (P < 0.001). However, taking account of the mattress effect, the real depth was only 41 (8) vs. 44 (5) mm without and with feedback, respectively (P < 0.001). The values for compression rate did not differ.CONCLUSIONSCPR quality was good during transportation in general. However, the results suggest that the feedback system improves CPR quality. Dual accelerometer measurements show, on the other hand, that the mattress effect may be a clinically relevant impediment to high quality CPR.
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| 3. |
- Tirkkonen, J., et al.
(författare)
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Cardiac arrest teams and medical emergency teams in Finland : a nationwide cross- sectional postal survey
- 2014
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 58:4, s. 420-427
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe implementation, characteristics and utilisation of cardiac arrest teams (CATs) and medical emergency teams (METs) in Finland are unknown. We aimed to evaluate how guidelines on advanced in-hospital resuscitation have been translated to practice. MethodsA cross-sectional postal survey including all public hospitals providing anaesthetic services. ResultsOf the 55 hospitals, 51 (93%) participated in the study. All hospitals with intensive care units (university and central hospitals, n=24) took part. In total, 88% of these hospitals (21/24) and 30% (8/27) of the small hospitals had CATs. Most hospitals with CATs (24/29) recorded team activations. A structured debriefing after a resuscitation attempt was organised in only one hospital. The median incidence of in-hospital cardiac arrest in Finland was 1.48 (Q(1)=0.93, Q(3)=1.93) per 1000 hospital admissions. METs had been implemented in 31% (16/51) of the hospitals. A physician participated in MET activation automatically in half (8/16) of the teams. Operating theatres (13/16), emergency departments (10/16) and paediatric wards (7/16) were the most common sites excluded from the METs' operational areas. The activation thresholds for vital signs varied between hospitals. The lower upper activation threshold for respiratory rate was associated with a higher MET activation rate. The national median MET activation rate was 2.3 (1.5, 4.8) per 1000 hospital admissions and 1.5 (0.96, 4.0) per every cardiac arrest. ConclusionsCurrent guidelines emphasise the preventative actions on in-hospital cardiac arrest. Practices are changing accordingly but are still suboptimal especially in central and district hospitals. Unified guidelines on rapid response systems are required.
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