1393: AMPLIFYING FUNCTIONAL SURVIVAL FOR PATIENTS PRESENTING WITH UNWITNESSED CARDIAC ARRESTS AND ASYSTOLE
Rattachement africain : us, fr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Introduction: Each day, ~400 U.S. citizens have an unwitnessed out-of-hospital arrest (OHCA) presenting with asystole. The respective likelihood of resuscitation and eventual survival with good neurological function (SURV-GNF) remains bleak. This study was conducted to evaluate for any enhanced ability to achieve SURV-GNF by rapidly applying non-invasive CPR adjuncts known to boost cerebral circulation through the lowering of ICP and augmenting venous return to the heart (impedance threshold device [ITD], active compression-decompression {ACD] and automated gradual head-thorax upward positioning [AHUP]). Methods: Using prospectively-collected data from a national registry of non-traumatic OHCA patients receiving AHUP-CPR, those with unwitnessed arrests and asystole presentations were assessed for SURV-GNF and then directly compared to the conventional CPR (C-CPR) counterparts from published NIH clinical trials that used high performance EMS systems, including those requiring documented recordings of quality C-CPR performance. Outcomes also were compared to concurrent national CARES registry data. All patients received standard EMS interventions, but AHUP-CPR patients also quickly received 2 min of circulation priming with ITD/ACD-CPR followed by head/thorax elevation (24 cm at occiput) over 2 mins. All well-known outcome-related variables were compared (age, sex, EMS-witnessed, bystander-witnessed, bystander-CPR, elapsed-time from 9-1-1 call receipt to EMS-initiated CPR [T-CPR]). Results: Baseline characteristics were all comparable across groups including median T-CPR (uniformly ~8 min); median AHUP time (T-AHUP) was 11 min. Evaluating all unwitnessed/asystole patients, including outliers with delayed-response, unadjusted SURV-GNF for AHUP-CPR was 1.5% (n=480) vs 0.3% for C-CPR (n=766) in the NIH trial groups (p=0.015) and 0.6% (n=101,421) for the CARES registry patients (p=0.0097). Conclusions: These findings provide evidence that the AHUP-CPR strategy is capable of increasing likelihoods of SURV-GNF for OHCA patients for whom resuscitation efforts have traditionally been considered relatively futile. Though the % surviving remains relatively low, the sheer magnitude of daily cases encountered indicates the potential for annually restoring many hundreds of functional lives in the U.S. alone.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- 1393: AMPLIFYING FUNCTIONAL SURVIVAL FOR PATIENTS PRESENTING WITH UNWITNESSED CARDIAC ARRESTS AND ASYSTOLE
- Date Crossref
- 14/12/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Texas Health Science Center at Houston pays non établi dans la noticeUniversité ou école supérieure
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New York City Fire Department pays non établi dans la noticeOrganisme public
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St. John's School pays non établi dans la noticeUniversité ou école supérieure
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University of Minnesota pays non établi dans la noticeUniversité ou école supérieure
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Hennepin County Medical Center pays non établi dans la noticeÉtablissement de santé
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Hofstra University pays non établi dans la noticeUniversité ou école supérieure
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Centre National de la Recherche Scientifique pays non établi dans la noticeOrganisme public
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Centre Hospitalier Universitaire de Grenoble pays non établi dans la noticeÉtablissement de santé
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Université Grenoble Alpes pays non établi dans la noticeUniversité ou école supérieure
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Illinois Central College pays non établi dans la noticeUniversité ou école supérieure
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Allina Health pays non établi dans la noticeÉtablissement de santé
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The University of Texas Health Science Center at Houston, New York City Fire Department et St. John's School, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.