Article

Part 2: International Collaboration in Resuscitation Science 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Circulation (Impact Factor: 14.43). 10/2010; 122(16 Suppl 2):S276-82. DOI: 10.1161/CIRCULATIONAHA.110.970921
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Available from: Michael Shuster, Aug 20, 2015
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    • "Therefore, to assess the factors influencing the outcome of CPR will help to evaluate the efficiency of resuscitation. Utstein-style definitions and reporting templates have been used while increasing effectively the clinical outcomes after resuscitation and making great progress toward international guidelines or consensus on resuscitation science.[5,6] In recent years, Utstein-style registering templates have been used clinically in a few domestic regions.[7–11] "
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    ABSTRACT: BACKGROUND: The outcome of cardiopulmonary resuscitation (CPR) may depend on a variety of factors related to patient status or resuscitation management. To evaluate the factors influencing the outcome of CPR after cardiac arrest (CA) will be conducive to improve the effectiveness of resuscitation. Therefore, a study was designed to assess these factors in the emergency department (ED) of a city hospital. METHODS: A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011. The outcomes of CPR were compared in various factors groups. The primary outcomes were rated to return of spontaneous circulation (ROSC), 24-hour survival, survival to discharge and discharge with favorable neurological outcomes. Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival. RESULTS: A total of 725 patients were analyzed in the study. Of these patients, 187 (25.8%) had ROSC, 100 (13.8%) survived for 24 hours, 48 (6.6%) survived to discharge, and 23 (3.2%) survived to discharge with favorable neurologic outcomes. A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology, first monitored rhythms, CPR duration, and total adrenaline dose. The independent predictors of 24-hour survival included traumatic etiology, cardiac etiology, first monitored rhythm and CPR duration. Previous status, cardiac etiology, first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge. CONCLUSIONS: Shockable rhythms, CPR duration ≤15 minutes and total adrenaline dose ≤5 mg were favorable predictors of ROSC, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms and CPR duration ≤15 minutes were favorable predictors of 24-hour survival, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms, CPR duration ≤15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge, but previous terminal illness or multiple organ failure (MOF) was unfavorable.
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    ABSTRACT: Health care associated with cardiac arrest exhibits a significant economic burden, rather than effectiveness. Hypothesis: The time of the out-of-hospital cardiac arrest (OHCA) onset during a diurnal period alters the survival chance. Professionally resuscitated patients for witnessed OHCA (n = 495) from the study were prospectively followed for 12 months. The distribution of the onset of cardiac arrest during the 24-hour period was tested in the survivors (the total group, the other groups). In the ultrashort-term survivors (n = 136, follow-up = admission to hospital) the highest incidence was seen between 18:01-22:00 h. The same trend was seen in both the short-term (n = 48, follow-up = discharge from hospital) and the long-term survivors (n = 39, follow-up = 1 year). Furthermore, when the ultrashort-, short-, and long-term survivors were analysed according to indicators of prehospital care (early electrical defibrillation < or =5 min, bystander cardiopulmonary resuscitation, ambulance response time < or =10 min; locations of arrest; initial cardiac rhythms) an OHCA peak was observed for early defibrillation and ambulance response time (ultrashort-term survivors, 18:01-22:00 h) and/or in the case of OHCA that occurred in a public place (short-term survivors, 18:01-22:00 h). The lowest incidence of cardiac arrest was between 22:01-06:00 h in all groups. The evening incidence of OHCA reflects a higher chance of survival in our study area (East Bohemian region).
    Full-text · Article · Apr 2008 · International Heart Journal
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