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- Kiguchi, Tekeyuki, et al.
(författare)
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Out-of-hospital cardiac arrest across the World : First report from the International Liaison Committee on Resuscitation (ILCOR).
- 2020
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 152, s. 39-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Since development of the Utstein style recommendations for the uniform reporting of cardiac arrest, increasing numbers of national and regional out-of-hospital cardiac arrest (OHCA) registries have been established worldwide. The International Liaison Committee on Resuscitation (ILCOR) created the Research and Registries Working Group and aimed to systematically report data collected from these registries.METHODS: We conducted two surveys of voluntarily participating national and regional registries. The first survey aimed to identify which core elements of the current Utstein style for OHCA were collected by each registry. The second survey collected descriptive summary data from each registry. We chose the data collected for the second survey based on the availability of core elements identified by the first survey.RESULTS: Seven national and four regional registries were included in the first survey and nine national and seven regional registries in the second survey. The estimated annual incidence of emergency medical services (EMS)-treated OHCA was 30.0-97.1 individuals per 100,000 population. The combined data showed the median age varied from 64 to 79 years and more than half were male in all 16 registries. The provision of bystander cardiopulmonary resuscitation (CPR) and bystander automated external defibrillator (AED) use was 19.1-79.0% in all registries and 2.0-37.4% among 11 registries, respectively. Survival to hospital discharge or 30-day survival after EMS-treated OHCA was 3.1-20.4% across all registries. Favorable neurological outcome at hospital discharge or 30 days after EMS-treated OHCA was 2.8-18.2%. Survival to hospital discharge or 30-day survival after bystander-witnessed shockable OHCA ranged from 11.7% to 47.4% and favorable neurological outcome from 9.9% to 33.3%.CONCLUSION: This report from ILCOR describes data on systems of care and outcomes following OHCA from nine national and seven regional registries across the world. We found variation in reported survival outcomes and other core elements of the current Utstein style recommendations for OHCA across nations and regions.
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- Nolan, Jerry P, et al.
(författare)
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Intensive care medicine research agenda on cardiac arrest
- 2017
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 43:9, s. 1282-1293
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Tidskriftsartikel (refereegranskat)abstract
- Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)—requiring mechanical ventilation and sedation—and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care. This review addresses the major recent advances in the treatment of cardiac arrest, recent trials that have challenged current practice and the remaining areas of uncertainty.
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- Nolan, J. P., et al.
(författare)
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Post Resuscitation Care
- 2015
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Ingår i: Notfall & Rettungsmedizin. - : Springer Science and Business Media LLC. - 1436-0578 .- 1434-6222. ; 18:8, s. 904-931
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Tidskriftsartikel (refereegranskat)
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- Sandroni, Claudio, et al.
(författare)
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Prediction of good neurological outcome in comatose survivors of cardiac arrest : a systematic review
- 2022
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 48:4, s. 389-413
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To assess the ability of clinical examination, blood biomarkers, electrophysiology or neuroimaging assessed within 7 days from return of spontaneous circulation (ROSC) to predict good neurological outcome, defined as no, mild, or moderate disability (CPC 1–2 or mRS 0–3) at discharge from intensive care unit or later, in comatose adult survivors from cardiac arrest (CA). Methods: PubMed, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews were searched. Sensitivity and specificity for good outcome were calculated for each predictor. The risk of bias was assessed using the QUIPS tool. Results: A total of 37 studies were included. Due to heterogeneities in recording times, predictor thresholds, and definition of some predictors, meta-analysis was not performed. A withdrawal or localisation motor response to pain immediately or at 72–96 h after ROSC, normal blood values of neuron-specific enolase (NSE) at 24 h-72 h after ROSC, a short-latency somatosensory evoked potentials (SSEPs) N20 wave amplitude > 4 µV or a continuous background without discharges on electroencephalogram (EEG) within 72 h from ROSC, and absent diffusion restriction in the cortex or deep grey matter on MRI on days 2–7 after ROSC predicted good neurological outcome with more than 80% specificity and a sensitivity above 40% in most studies. Most studies had moderate or high risk of bias. Conclusions: In comatose cardiac arrest survivors, clinical, biomarker, electrophysiology, and imaging studies identified patients destined to a good neurological outcome with high specificity within the first week after cardiac arrest (CA).
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- Sandroni, Claudio, et al.
(författare)
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Prediction of poor neurological outcome in comatose survivors of cardiac arrest : a systematic review
- 2020
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 46:10, s. 1803-1851
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To assess the ability of clinical examination, blood biomarkers, electrophysiology, or neuroimaging assessed within 7 days from return of spontaneous circulation (ROSC) to predict poor neurological outcome, defined as death, vegetative state, or severe disability (CPC 3–5) at hospital discharge/1 month or later, in comatose adult survivors from cardiac arrest (CA). Methods: PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews (January 2013–April 2020) were searched. Sensitivity and false-positive rate (FPR) for each predictor were calculated. Due to heterogeneities in recording times, predictor thresholds, and definition of some predictors, meta-analysis was not performed. Results: Ninety-four studies (30,200 patients) were included. Bilaterally absent pupillary or corneal reflexes after day 4 from ROSC, high blood values of neuron-specific enolase from 24 h after ROSC, absent N20 waves of short-latency somatosensory-evoked potentials (SSEPs) or unequivocal seizures on electroencephalogram (EEG) from the day of ROSC, EEG background suppression or burst-suppression from 24 h after ROSC, diffuse cerebral oedema on brain CT from 2 h after ROSC, or reduced diffusion on brain MRI at 2–5 days after ROSC had 0% FPR for poor outcome in most studies. Risk of bias assessed using the QUIPS tool was high for all predictors. Conclusion: In comatose resuscitated patients, clinical, biochemical, neurophysiological, and radiological tests have a potential to predict poor neurological outcome with no false-positive predictions within the first week after CA. Guidelines should consider the methodological concerns and limited sensitivity for individual modalities. (PROSPERO CRD42019141169).
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- Ocko, Samuel A., et al.
(författare)
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Solar-powered ventilation of African termite mounds
- 2017
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Ingår i: Journal of Experimental Biology. - : The Company of Biologists. - 0022-0949 .- 1477-9145. ; 220:18, s. 3260-3269
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Tidskriftsartikel (refereegranskat)abstract
- How termite mounds function to facilitate climate control is still only partially understood. Recent experimental evidence in the mounds of a single species, the south Asian termite Odontotermes obesus, suggests that the daily oscillations of radiant heating associated with diurnal insolation patterns drive convective flow within them. How general this mechanism is remains unknown. To probe this, we consider the mounds of the African termite Macrotermes michaelseni, which thrives in a very different environment. By directly measuring air velocities and temperatures within the mound, we see that the overall mechanisms and patterns involved are similar to that in the south Asian species. However, there are also some notable differences between the physiology of these mounds associated with the temporal variations in radiant heating patterns and CO2 dynamics. Because of the difference between direct radiant heating driven by the position of the sun in African conditions, and the more shaded south Asian environments, we see changes in the convective flows in the two types of mounds. Furthermore, we also see that the south Asian mounds showa significant overturning of stratified gases, once a day, while the African mounds have a relatively uniform concentration of CO2. Overall, our observations show that despite these differences, termite architectures can harness periodic solar heating to drive ventilation inside them in very different environments, functioning as an external lung, with clear implications for human engineering.
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| 18. |
- Soar, J, et al.
(författare)
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[Adult advanced life support]
- 2021
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Ingår i: Notfall & rettungsmedizin. - : Springer Science and Business Media LLC. - 1434-6222 .- 1436-0578. ; 24:4, s. 406-446
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Tidskriftsartikel (refereegranskat)
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