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Mil Med 2019 Mar;184(Supplement_1):361-366

Rochester Fire Department, Rochester, MN.

Background: Current military recommendations include the use of tourniquets (TQ) in appropriate pediatric trauma patients. Although the utility of TQs has been well documented in adult patients, the efficacy of TQ application in pediatric patients is less clear. The current study attempted to identify physical constraints for TQ use in two simulated pediatric limb models. Read More

Eur J Pediatr 2019 Mar 21. Epub 2019 Mar 21.

Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands.

Situation awareness (SA) is an important human factor and necessary for effective teamwork and patient safety. Human patient simulation (HPS) with video feedback allows for a safe environment where health care professionals can develop both technical and teamwork skills. It is, however, very difficult to observe and measure SA directly. Read More

Intensive Care Med 2019 Mar 21. Epub 2019 Mar 21.

Medico-Surgical Intensive Care Department, Centre Hospitalier de Versailles, Site André Mignot, 177 Rue de Versailles, 78150, Le Chesnay Cedex, France.

Anaesthesist 2019 Mar 21. Epub 2019 Mar 21.

Fachverband Leitstellen e. V., Glücksburg, Deutschland.

Background: The emergency call-taking process is crucial for the adequate disposition of emergency vehicles and the provision of first aid instructions. Moreover, it has a direct impact on the quality of out-of-hospital emergency care. Organizations such as the European Resuscitation Council, the German Federal Association of Emergency Medical Directors and the German Association of Emergency Dispatch Centers call for the nationwide implementation of a formal call-taking process in emergency dispatching. Read More

Trauma Surg Acute Care Open 2019 8;4(1):e000271. Epub 2019 Feb 8.

Department of Orthopedic, Trauma, and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany.

Background: Endotracheal intubation (ETI) is the gold standard for the out-of-hospital emergency airway management in severely injured patients. Due to time-critical circumstances, poor patient presentation and hostile environments, it may be prone for mechanical complications and failure.

Methods: In a retrospective study (January 2011 to December 2013), all patients who underwent out-of-hospital ETI before admittance to a level 1 trauma center were analyzed consecutively. Read More

J Exerc Rehabil 2019 Feb 25;15(1):170-174. Epub 2019 Feb 25.

Department of Kinesiology, College of Natural Science, Jeju National University, Jeju, Korea.

The study was undertaken to investigate the change of cardiac compression force relative to levels of information provision using components of ground reaction force. Male participants of 20s-30s (n=10) who was not trained on cardiopulmonary resuscitation (CPR) and used an automated external defibrillator carried out CPR using manikin on ground reaction force plate. All executed 30 times the CPR according to the levels (1-time viewing, repeated viewing, and basic life support education) of information provision and then total sample of 300 times of ground reaction force data was utilized for the analysis. Read More

J Hosp Med 2019 Mar 20;14:E1-E4. Epub 2019 Mar 20.

Division of Medical Ethics, Department of Medicine, Weill Cornell Medicine, New York, New York.

Little is known about the daily ethical conflicts encountered by hospitalists that do not prompt a formal clinical ethics consultation. We describe the frequencies of ethical issues identified during daily rounds on hospitalist teaching services at a metropolitan, tertiary-care, teaching hospital. Data were collected from September 2017 through May 2018 by two attending hospitalists from the ethics committee who were embedded on rounds. Read More

J Clin Ethics Spring 2019;30(1):67-73

Lerner College of Medicine, Case Western Reserve University in Cleveland, Ohio USA.

Questions related to end-of-life decision making are common in clinical ethics and may be exceedingly difficult. Chief among these are the provision of cardiopulmonary resuscitation (CPR) and do-not-resuscitate orders (DNRs). To better address such questions, clarity is needed on the values of medical ethics that underlie CPR and the relevant moral framework for making treatment decisions. Read More

Acta Med Port 2019 Feb 28;32(2):111-118. Epub 2019 Feb 28.

Biomedical Simulation Center. Faculty of Medicine. University of Porto. Porto. Center for Health Technology and Services Research (CINTESIS). Faculty of Medicine. University of Porto. Porto. Faculty of Engineering. University of Porto. Porto. Portugal.

Introduction: Basic life support is a key manoeuvre in a cardiac arrest situation that can often save a victim's life. This study investigates the general public's knowledge about the fundamentals of basic life support, and its association with previous training/education on basic life support and self-perception of knowledge. A secondary goal is to assess the opinion on training needs. Read More

Sci Rep 2019 Mar 20;9(1):4941. Epub 2019 Mar 20.

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Few data are available regarding treatment outcomes in lung cancer patients with metastasis who initiated mechanical ventilation in the emergency department (ED). We aimed to evaluate 28-day mortality in lung cancer patients with metastasis who initiated mechanical ventilation in the ED. Patients with solid malignancy who initiated mechanical ventilation in the ED of a tertiary hospital were retrospectively identified and stratified into four groups according to the presence of lung cancer and metastasis. Read More

Pediatr Emerg Care 2019 Mar 19. Epub 2019 Mar 19.

University of Colorado School of Medicine, Aurora, CO.

Background: Vascular access in critically ill pediatric patients can be challenging with delays potentially leading to worse outcomes. Intraosseous (IO) access has a low rate of complications and can be utilized to administer lifesaving medications. Combat medics are trained to treat adults but may also be required to treat children in the deployed setting. Read More

Neurocrit Care 2019 Mar 19. Epub 2019 Mar 19.

Division of Neurology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC, 20010, USA.

Background/objective: Children supported by extracorporeal membrane oxygenation (ECMO) are at risk of catastrophic neurologic injury and brain death. Timely determination of brain death is important for minimizing psychological distress for families, resource allocation, and organ donation. Reports of successful determination of brain death in pediatric patients supported by ECMO are limited. Read More

Circ J 2019 Mar 20. Epub 2019 Mar 20.

Department of Emergency Medicine, Teikyo University.

Background: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) and sustained ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) or conversion to pulseless electrical activity/asystole (PEA/asystole) benefit more from extracorporeal cardiopulmonary resuscitation (ECPR). Methods and Results: We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, which was a prospective, multicenter, observational study with 22 institutions in the ECPR group and 17 institutions in the conventional CPR (CCPR) group. Patients were divided into 4 groups by cardiac rhythm and CPR group. Read More

J Clin Med 2019 Mar 18;8(3). Epub 2019 Mar 18.

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, D-40225 Düsseldorf, Germany.

Background: We evaluated critically ill patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) due to cardiac arrest (CA) with respect to baseline characteristics and laboratory assessments, including lactate and lactate clearance for prognostic relevance.

Methods: The primary endpoint was 30-day mortality. The impact on 30-day mortality was assessed by uni- and multivariable Cox regression analyses. Read More

N Engl J Med 2019 Mar 19. Epub 2019 Mar 19.

From the Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute (G.L., F.M., R.L., N.D.T., M.C., M.P., A.B., A.M.S., M.G.C., A.Z.), and Vita-Salute San Raffaele University (G.L., A.Z.), Milan, Istituto di Anestesia e Rianimazione, Azienda Ospedaliera di Padova, Padua (C.C.), Anesthesia and Intensive Care Department, University Campus Bio-Medico of Rome (F.E.A.), and Anestesia e Rianimazione, Dipartimento Cardiovascolare, Azienda Ospedaliera San Camillo Forlanini (L.S.), Rome, the Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, University Hospital Policlinico S. Orsola, Bologna (M.B.), Dipartimento di Scienze Mediche e Chirurgiche, Università Magna Graecia di Catanzaro, Catanzaro (P.N.), Anestesia e Terapia Intensiva Cardiochirurgica, Istituto Clinico Humanitas, Rozzano (G.C.), the Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, and the Department of Surgical Sciences, University of Turin, Turin (L.B.), and the Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, Udine (T.B.) - all in Italy; the Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk (V.V. Lomivorotov, V.A.S., D.N.P.), the Departments of Anesthesiology and Intensive Care (V.V.P.) and Cardiac Surgery (D.G.T.), Federal Center for Cardiovascular Surgery Astrakhan, Astrakhan, the Department of Anesthesia and Intensive Care, First Moscow State Medical University (V.V.P., V.V. Likhvantsev), and the Department of Intensive Care, Moscow Regional Clinical and Research Institute (V.V. Likhvantsev), Moscow, the Department of Anesthesia and Intensive Care, Ural Institute of Cardiology, Ekaterinburg (A.L.), the Laboratory for Anesthesiology and Intensive Care, Almazov National Medical Research Center, Saint Petersburg (A.E.B.), and the Intensive Care Unit, Scientific Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (E.V.G.) - all in Russia; the Anesthesia Section, Department of Surgery, Dante Pazzanese Institute of Cardiology (C.N.N.), the Department of Cardiopneumology, Instituto do Coração, Universidade de São Paulo, and the Intensive Care Unit, Hospital SirioLibanes (L.A.H.), and the Cardiac Surgery Section, Department of Surgery, Dante Pazzanese Institute of Cardiology (R.A.), São Paulo, Brazil; the Department of Cardiovascular Anesthesiology and Intensive Care Medicine, and the Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Dubrava, Zagreb (N.B.), and the Department of Biomedical Sciences, University North, Varaždin (N.B.) - both in Croatia; the Department of Anesthesia and Intensive Care, Cardiovascular Institute Dedinje (G.G., M.J.), and the School of Medicine, University of Belgrade (M.J.), Belgrade, Serbia; the Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi (C.L.), and the Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing (J.M.) - both in China; the Cardiothoracic Intensive Care Unit and Anesthesia Department, Mohammed Bin Khalifa Cardiac Center, Riffa, Bahrain (N.A.R.B.); the Department of Anesthesiology, Hospital de Santa Maria, Lisbon, Portugal (F.S.S.); the Department of Anesthesia, King Abdullah Medical City-Holy Capital, Makkah (A.M.G.A.F.), and the Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam (M.R.E.-T.) - both in Saudi Arabia; Anesthesia and Intensive Care, Acibadem City Clinic-Cardiac Surgery Center, Burgas, Bulgaria (N.S.U.); the Department of Anesthesiology, Resuscitation and Intensive Medicine, Charles University in Prague, First Faculty of Medicine and General Teaching Hospital (J.K.), and the Cardiothoracic Anesthesiology and Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine (H.R.), Prague, Czech Republic; the Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (C.Y.W.); the Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Zagazig University Hospitals, Zagazig (A.M.E.), and the Department of Anesthesia and Surgical Intensive Care, Mansoura University, Mansoura (M.A.H.) - both in Egypt; and the School of Medicine, University of Melbourne, Melbourne, VIC, Australia (R.B.).

Background: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG).

Methods: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. Read More

Eur Respir J 2019 Mar 18;53(3). Epub 2019 Mar 18.

Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada

J R Army Med Corps 2019 Mar 17. Epub 2019 Mar 17.

St George's University of London, London, UK.

A 25-year-old infantry soldier, who was previously fit and well, had a cardiac arrest while undertaking an advanced fitness test. Despite early cardiopulmonary resuscitation by colleagues and the emergency services, he was later pronounced dead. A postmortem performed by an expert pathologist and a toxicology screen were normal and the death was attributed to sudden arrhythmic death syndrome (SADS). Read More

Resuscitation 2019 Mar 15. Epub 2019 Mar 15.

Center of Dissemination and Implementation Science, University of Illinois at Chicago, Chicago, Illinois, United States.

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. Read More

Resuscitation 2019 Mar 15. Epub 2019 Mar 15.

Service de Réanimation Médicale, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France.

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. Read More

Biochem Biophys Res Commun 2019 Mar 15. Epub 2019 Mar 15.

Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Clinical Research Center for Emergency and Critical Care Medicine of Shandong Province, Institute of Emergency and Critical Care Medicine of Shandong University, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China; Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, China.

Moderate alcohol consumption has been shown to reduce atherosclerosis-associated diseases. As shown in our earlier works, ethanol has a dose-dependent protective effects against endothelial cellular senescence by activating aldehyde dehydrogenase 2 (ALDH2) in vitro. However, whether ethanol administration possesses anti-atherosclerosis properties and whether ALDH2 is involved in the underlying mechanisms are unknown. Read More

Catheter Cardiovasc Interv 2019 Mar 18. Epub 2019 Mar 18.

Department of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.

Cardiopulmonary resuscitation (CPR) is essential for the survival of cardiac arrest patients. High-quality chest compressions are critical for survival, but energetic resuscitation efforts can lead to chest injuries. Internal mammary artery (IMA) injury is a rare complication of CPR, but can lead to life-threatening intrathoracic hemorrhage. Read More

Acta Anaesthesiol Scand 2019 Mar 18. Epub 2019 Mar 18.

Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Objective: Concerns for iatrogenic injuries associated with cardiopulmonary resuscitation led us to investigate the extent and the pattern of chest compression-related injuries in patients subjected to either mechanical and/or manual cardiac compression.

Method: In a retrospective study, we performed a manual review of all prehospital discharge reports, in-hospital records, and autopsy reports for evidence of injuries related to chest compression. We included all patients receiving physician-administrated treatment for out-of-hospital cardiac arrest in the Region of Southern Denmark from 2015 to 2017. Read More

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

From the University of Washington/Seattle Children's Hospital, Seattle, Washington.

We describe the use of extracorporeal life support (ECLS) for Legionellosis in the pediatric and adult populations and report complications, morbidity, and mortality by conducting a retrospective review of patients from the Extracorporeal Life Support Organization registry, including two cases at our pediatric institution. A total of 194 patients with ECLS for Legionella pneumophila infection who received ECLS were included in the analysis. Overall survival was 71%. Read More

Crit Care Med 2019 Apr;47(4):e383

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, and Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, and Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA.

Crit Care Med 2019 Apr;47(4):613-615

Division of Pediatric Critical Care, Department of Pediatrics, C.S. Mott Children's Hospital; and Child Health Evaluation and Research (CHEAR) Center, Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI Cardiothoracic Intensive Care Unit, National University Health System, Singapore; and Paediatric Intensive Care Unit, Department of Paediatrics, The Royal Children's Hospital, University of Melbourne, Melbourne, VIC, Australia.

West J Emerg Med 2019 Mar 6;20(2):323-330. Epub 2019 Feb 6.

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

Emergency physicians (EP) frequently resuscitate and manage critically ill patients. Resuscitation of the crashing obese patient presents a unique challenge for even the most skilled physician. Changes in anatomy, metabolic demand, cardiopulmonary reserve, ventilation, circulation, and pharmacokinetics require special consideration. Read More

Am J Cardiol 2019 Feb 21. Epub 2019 Feb 21.

Department of Internal Medicine, Riverside Community Hospital/UCR SOM, Riverside, California.

Out-of-hospital cardiac arrest is a major public health concern. Research has shown that initiation of cardiopulmonary resuscitation (CPR) by lay bystanders increases survival rates. Evidence also shows that CPR training, delivered in various ways, is successful in a wide age range of children. Read More

Resuscitation 2019 Mar 12. Epub 2019 Mar 12.

Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore.

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. Read More

Prehosp Emerg Care 2019 Mar 15:1-11. Epub 2019 Mar 15.

f University of Pittsburgh Department of Emergency Medicine , 3600 Forbes Ave., Suite 400A , Pittsburgh , 15260 United States.

Introduction: Hypotension in the prehospital environment is common and linked to dose-dependent mortality. Bolus dose epinephrine (BDE) may reverse hypotension. We tested if BDE use to treat profound hypotension is associated with 24-hour survival. Read More

Acta Anaesthesiol Scand 2019 Mar 15. Epub 2019 Mar 15.

Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.

Background: Anaesthesiologists are expected to master an increasing number of technical procedures. Simulation-based procedural training can supplement and, in some areas, replace the classical apprenticeship approach during patient care. However, simulation-based training is very resource-intensive and must be prioritised and optimised. Read More

Cardiovasc Res 2019 Mar 14. Epub 2019 Mar 14.

Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg.

Aims: Heart disease of different etiology remains the leading cause of cardiac arrest (CA). Despite efforts to improve the quality of cardiopulmonary resuscitation (CPR), subsequent myocardial and systemic damage after CA still present a major long-term burden. Low-dose carbon monoxide (CO) is known to exert protective effects in cardiovascular pathophysiology but clinical applications are challenged by unfavorable delivery modes. Read More

Resuscitation 2019 Mar 11. Epub 2019 Mar 11.

Cloudphysician Healthcare, 7 Bellary road, Ganganagar, Bengaluru, India.

J Clin Med 2019 Mar 13;8(3). Epub 2019 Mar 13.

Physiotherapy Department at the University of Balearic Islands, Ctra. de Valldemossa, km 7.5, 07122 Palma de Mallorca, Balearic Islands, Spain.

The latest guidelines identify capnography as an instrument used to assess bag-valve-mask ventilation during cardiopulmonary resuscitation (CPR). In this review, we analyzed the feasibility and reliability of capnography use with face mask ventilation during CPR maneuvers in adults and children. This systematic review was completed in December 2018; data for the study were obtained from the following databases: EBSCOhost, SCOPUS, PubMed, Índice Bibliográfico Español en Ciencias de la Salud (IBECS), TESEO, and Cochrane Library Plus. Read More

J Clin Med 2019 Mar 13;8(3). Epub 2019 Mar 13.

Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, Luodong, Yilan 26546, Taiwan.

Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) is an excellent prognostic⁻predictive tool in heart failure (HF) patients, but its plasma level changes following therapy. The comparison of prognosis⁻predictivity of a single measurement of plasma NT-pro BNP in different follow-up periods in acute HF patients has been less studied. This study aimed to evaluate whether the association between initial plasma NT-proBNP levels and all-cause mortality would decrease along with an increased follow-up period in patients with acute HF. Read More

Klin Padiatr 2019 Mar 14;231(2):80-86. Epub 2019 Mar 14.

Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Recurrent myocarditis is rare with only few reports having been published for paediatric cases. Repeated use of extracorporeal membrane oxygenation is also uncommon. In this paper we will present a very rare case of a 7-year old girl with recurrent fulminant myocarditis with heart failure requiring cardiopulmonary resuscitation and mechanical circulatory support with extracorporeal membrane oxygenation. Read More

Intern Emerg Med 2019 Mar 13. Epub 2019 Mar 13.

German Society of Aerospace Medicine (DGLRM), Munich, Germany.

Am J Hosp Palliat Care 2019 Mar 13:1049909119836939. Epub 2019 Mar 13.

1 Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Background:: Racial and ethnic disparities in the provision of end-of-life care are well described in the adult oncology literature. However, the impact of racial and ethnic disparities at end of life in the context of pediatric oncology remains poorly understood.

Objective:: To investigate associations between end-of-life experiences and race/ethnicity for pediatric patients with cancer. Read More

Circulation 2019 Mar;139(10):1272-1274

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (P.D., S.L.).

J Thorac Dis 2019 Jan;11(1):68-83

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju-si, Chungbuk, Republic of Korea.

Background: Prediction of survival and weaning probability in VA ECMO (veno-arterial extracorporeal membrane oxygenation) patients could be of great benefit for real-time decision making on VA ECMO initiation in critical ill patients. We investigated whether the SAPS II score would be a real-time determinant for VA ECMO initiation and could be a predictor of survival and weaning probability in patients on VA ECMO.

Methods: Between January 1, 2010 and December 31, 2014, VA ECMO was carried out on 135 adult patients suffering from primary cardiogenic shock. Read More

Resuscitation 2019 Mar 9. Epub 2019 Mar 9.

Department of Emergency Medicine, University of Michigan Medical School, Michigan Medicine, Ann Arbor, Michigan, USA; The Michigan Center for Integrative Research in Critical Care (MCIRCC), University of Michigan Medical School, Michigan Medicine, Ann Arbor, Michigan, USA. Electronic address:

Background: Extracorporeal cardiopulmonaryresuscitation (ECPR) is emerging as a viable rescue strategy for refractory out-of-hospital cardiac arrest. In the U.S. Read More

Resuscitation 2019 Mar 9. Epub 2019 Mar 9.

Emory University School of Medicine, United States. Electronic address:

Background: Interruptions in compressions reducethe efficacy of cardiopulmonary resuscitation (CPR) and are inevitable during hands-off periods for shocks. Clinical exam gloves were found to facilitate safe contact with patients during shock delivery but the safety of this practice has been questioned. Polyethylene is of interest because of its safety record in the medical arena and its electrical insulation properties. Read More

Br J Hosp Med (Lond) 2019 Mar;80(3):176

Coventry.

Int J Health Care Qual Assur 2019 Feb;32(1):11-20

Department of Emergency and Disaster Medicine, Graduate School of Medicine, Junteno University , Tokyo-To, Japan.

Purpose: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program is known to improve team and clinical performance, but the relationship to psychological stress has not been clarified. The purpose of this paper is to evaluate team performance, clinical performance and psychological stress simultaneously in a simulation-based training combined with or without the TeamSTEPPS program.

Design/methodology/approach: This randomized, controlled, prospective pilot study was performed to reveal TeamSTEPPS impact on psychological stress. Read More

Nat Rev Cardiol 2019 Mar 11. Epub 2019 Mar 11.

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death worldwide, with substantial geographical, ethnic and socioeconomic disparities in outcome. Successful resuscitation efforts depend on the 'chain of survival', which includes immediate recognition of cardiac arrest and activation of the emergency response system, early bystander cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions, rapid defibrillation, basic and advanced emergency medical services and integrated post-cardiac arrest care. Well-orchestrated telecommunicator CPR programmes can improve rates of bystander CPR - a critical link in the chain of survival. Read More

J Paediatr Child Health 2019 Mar 10. Epub 2019 Mar 10.

Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

Aim: Chest compression depth (CCD) decreases significantly when performing one-handed chest compression (OHCC). We modified OHCC posture to increase CCD as follows: first, the axis of the compression hand was adjusted to the compression area; second, the opposite hand was wrapped around the elbow of the compression arm. This study compared modified OHCC with conventional OHCC for child cardiopulmonary resuscitation. Read More

Ann Cardiothorac Surg 2019 Jan;8(1):109-115

Pediatric Cardiovascular Surgery, Pediatric Heart Center, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland.

Extracorporeal membrane oxygenation (ECMO) is a general term that describes the short- or long-term support of the heart and/or lungs in neonates, children and adults. Due to favorable results and a steady decline in absolute contraindications, its use is increasing worldwide. Indications in children differ from those in adults. Read More

Resuscitation 2019 Mar 8;138:42-43. Epub 2019 Mar 8.

PICU, Birmingham Women's and Children's Hospital, Birmingham B4 6NH, United Kingdom.

There is interest in the association between partial pressure of carbon dioxide (PCO) and neurological outcome following cardiac arrest. Extracorporeal life support is increasingly used in the setting of refractory cardiac arrest (ECPR) but there is a lack of standardisation of PCO management during ECPR. We prospectively evaluated CO values and investigated the importance of blood sampling site in a series of 23 children undergoing ECPR, comparing the patient's arterial PCO (PaCO) with samples taken pre- (Ppre-oxyCO), and post- (Ppost-oxyCO) the circuit oxygenator. Read More

Resuscitation 2019 Mar 8. Epub 2019 Mar 8.

Department of Emergency Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest.

Methods: We undertook a systematic review and meta-analysis to evaluate the impact of DA-CPR programs on key clinical outcomes following out-of-hospital cardiac arrest. We searched the PubMED, EMBASE, CINAHL, ERIC and Cochrane Central Register of Controlled Trials databases from inception until July 2018. Read More

Appl Nurs Res 2019 Apr 21;46:8-15. Epub 2019 Jan 21.

Centre of Excellence for Nursing Scholarship, OPI Rome, Italy.

Background: The current debate regarding decision-making at the End-of-Life (EoL) is increasing remarkably and has spread all over the world. However, literature has paid little attention to describe choice's differences in EoL care between healthcare professionals and general public.

Objectives: The aim of this study was to explore the difference between choices in EoL care made by healthcare professionals and those of the general public within the Italian context. Read More

BMJ Case Rep 2019 Mar 8;12(3). Epub 2019 Mar 8.

Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA.

Current advanced cardiac life support (ACLS) guidelines for the management of ventricular fibrillation (VF) and pulseless ventricular tachycardia is defibrillation. However, refractory VF, which is defined as VF that persists despite three defibrillation attempts, is challenging for all ACLS providers; the best resuscitation strategy for patients that persist in refractory VF remains unclear. We report on a 51-year-old man who presented to the emergency department with chest pain and subsequently went into witnessed VF cardiac arrest. Read More