News Update on Cardiac Arrest Research: May – 2019

Epidemiology of out-of-hospital cardiac arrest: A French national incidence and mid-term survival rate study

Out-of-hospital asystole (OHCA) is taken into account a very important public health issue however its incidence has not been examined in France. The aim of this study is to outline the incidence of OHCA in France and to match this to different close countries. knowledge were extracted from the French OHCA written record. solely thorough centres throughout the amount from Gregorian calendar month one, 2013, to Sept thirty, 2014 were enclosed. All patients were enclosed, irrespective of their age and explanation for OHCA. The collaborating centres coated regarding tenth of the French population. The study concerned 6918 OHCA. The median age was sixty eight years, with sixty three of males. pediatric population (< fifteen years) delineated  one.8%. the world incidence of OHCA was sixty one.5 per 100,000 inhabitants annually within the total population such as around forty six,000 OHCA annually. within the adult population, we have a tendency to found associate degree incidence of seventy five.3 cases per a hundred,000 inhabitants annually. In adults, the incidences were a hundred.3 and 52.7 in males and females, severally. Most (75%) OHCA occurred reception and were thanks to medical causes (88%). half medical OHCA had vas causes. Survival rates at thirty days was four.9% [4.4; 5.4] and increased  to ten.4% [9.1; 11.7] once revitalization was straightaway performed by viewer at patient’s collapse. The incidence and survival at thirty days of OHCA in France appeared almost like that reportable in different European countries. Compared to different causes of deaths in France, OHCA is one in all the foremost frequent causes, irrespective of the initial pathology. [1]

Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest

Importance  Prognostication of neurological outcome once cardiopulmonary arrest is a vital however difficult side of patient medical care management in important care units.

Objective to see whether or not blood serum neurofilament lightweight chain (NFL) levels may be used for prognostication of neurological outcome once cardiopulmonary arrest.

Design, Setting and Participants  Prospective clinical biobank study of knowledge from the irregular Target Temperature Management once cardiopulmonary arrest trial, a world, multicenter study with twenty nine taking part sites. Patients were enclosed between legal holiday, 2010, and Jan ten, 2013. blood serum NFL levels were analyzed between Lammas Day and August twenty three, 2017, once trial completion. a complete of 782 unconscious patients with out-of-hospital cardiopulmonary arrest of likely internal organ origin were eligible.

Exposures blood serum NFL concentrations analyzed at twenty four, 48, associate degreed seventy two hours once cardiopulmonary arrest with an ultrasensitive immunochemical assay.

Main Outcomes and Measures  Poor neurological outcome at 6-month follow-up, outlined in keeping with the Cerebral Performance class Scale as cerebral performance category three (severe cerebral disability), 4 (coma), or five (brain death).

Results  Of 782 eligible patients, sixty five patients (8.3%) were excluded due to problems with aliquoting, missing sampling, missing outcome, or transport issues of samples. Of the 717 patients enclosed (91.7%), 580 were men (80.9%) and median (interquartile vary [IQR]) age was sixty five (56-73) years. a complete of 360 patients (50.2%) had poor neurological outcome at vi months. Median (IQR) blood serum NFL level was considerably accrued within the patients with poor outcome vs sensible outcome at twenty four hours (1426 [299-3577] vs thirty seven [20-70] pg/mL), forty eight hours (3240 [623-8271] vs forty six [26-101] pg/mL), and seventy two hours (3344 [845-7838] vs fifty four [30-122] pg/mL) (P [2]

Trends in Management and Mortality in Adults Hospitalized With Cardiac Arrest in the United States

Background:

We wanted to look at temporal trends in management (ie, use of extracorporeal membrane action [ECMO], therapeutic physiological condition [TH], coronary X-ray picture, and body covering coronary intervention [PCI]) and in-hospital mortality in adults hospitalized with asystole.

Methods:

Utilizing the Nationwide patient Sample, case history, clinical management, and in-hospital mortality were assessed in 942 495 hospitalizations in adults with asystole (identified through International Classification of Diseases-9 codes) from 2006 to 2012.

Results:

From 2006 to 2012, there was associate overall rise within the use of coronary X-ray picture (12.8%, 13.0%, 14.7%, 15.0%, 14.3%, 14.7%, and 15.8%), PCI (7.5%, 7.1%, 8.4%, 8.1%, 8.1%, 8.4%, and 8.9%), TH (0.2%, 0.3%, 0.6%, 1.2%, 1.9%, 2.8%, and 3.0%), and ECMO (0.1%, 0.1%, 0.1%, 0.2%, 0.2%, 0.3%, and 0.4%; P < .001 for all). In-hospital mortality considerably bated over the 7-year study amount (65.5%, 63.4%, 59.3%, 57.9%, 57.0%, 56.0%, and 56.3% from 2006 to 2012). In multivariable analysis, a thirty one decrease in mortality was in the course of a concomitant twenty fourth and twenty seven increase in coronary X-ray picture and PCI, severally, throughout the study amount. Therapeutic physiological condition associated ECMO were related to an approximate 11-fold and 7-fold increase, severally, from 2006 to 2012. The strongest predictors of use of ECMO, TH, coronary X-ray picture, and PCI were younger age and therefore the presence of arteria coronaria malady

Conclusion:

During 2006 to 2012, a decline in mortality was in the course of a gradual rise within the use of ECMO, TH, coronary X-ray picture, and PCI in adults hospitalized with asystole. Patients of younger age and with arteria coronaria malady were a lot of doubtless to receive these advanced therapies. [3]

Key components of a community response to out-of-hospital cardiac arrest

Out-of-hospital asystole (OHCA) remains a number one reason behind death worldwide, with substantial geographical, ethnic and socioeconomic disparities in outcome. productive revitalization efforts rely on the ‘chain of survival’, which incorporates immediate recognition of asystole and activation of the emergency response system, early viewer resuscitation (CPR) with a stress on chest compressions, speedy medical care, basic and advanced emergency medical services and integrated post-cardiac arrest care. Well-orchestrated telecommunicator kiss of life programmes will improve rates of viewer CPR — a important link within the chain of survival. superior kiss of life by emergency medical service suppliers includes minimizing interruptions in chest compressions and guaranteeing adequate depth of compressions. Developing native, regional and broad systems with dedicated high-performing cardiopulmonary resuscitation centres for post-resuscitation care will considerably improve survival once OHCA. Innovative digital tools for recognizing asystole wherever and once it happens, notifying potential national rescuers and providing automatic external defibrillators at the scene hold the promise of rising survival once OHCA. Improved implementation of the chain of survival will save thousands of lives every year. [4]

Awareness and Attitudes of University of Ibadan Freshmen towards Learning and Performing Cardiopulmonary Resuscitation

Objectives: To assess the amount of awareness of cardiac resuscitation (CPR), and also the angle of the University of Ibadan (UI) freshmen towards learning kiss of life, and activity kiss of life on pathology victims.

Methods: This analysis was a cross-sectional study. Between Oct and Nov 2014, questionnaires were administered to 370 freshman collegian students of UI to get data concerning their bio-data, awareness of kiss of life, and attitudes toward learning kiss of life, and activity kiss of life on pathology victims. Their participation was voluntary and anonymous. a complete of 333 questionnaires were came back stuffed, out of that four were discarded as a result of they weren’t properly stuffed. thus solely the info of 329 respondents were used. Analysis was done victimisation the SPSS version sixteen computer code.

Results: a complete of 305 (92.7%) respondents had not received any coaching on a way to perform kiss of life, 59 (17.9%) had witnessed things wherever a personal folded and died, 282 (85.0%) showed positive angle towards learning kiss of life, and 311 (94.5%) respondents were willing to rescue a pathology victims if they need the power of what to try and do.

Conclusion: the bulk of the UI freshmen had ne’er received any kiss of life coaching before, but the bulk of them showed positive angle towards learning kiss of life, and activity kiss of life. there’s a necessity to introduce kiss of life coaching into the UI info for the freshmen, as counseled by the Liaison Committee on revitalisation. [5]

Reference

[1] Luc, G., Baert, V., Escutnaire, J., Genin, M., Vilhelm, C., Di Pompéo, C., El Khoury, C., Segal, N., Wiel, E., Adnet, F. and Tazarourte, K., 2019. Epidemiology of out-of-hospital cardiac arrest: A French national incidence and mid-term survival rate study. Anaesthesia Critical Care & Pain Medicine38(2), pp.131-135. (Web Link)

[2] Moseby-Knappe, M., Mattsson, N., Nielsen, N., Zetterberg, H., Blennow, K., Dankiewicz, J., Dragancea, I., Friberg, H., Lilja, G., Insel, P.S. and Rylander, C., 2019. Serum neurofilament light chain for prognosis of outcome after cardiac arrest. JAMA neurology76(1), pp.64-71. (Web Link)

[3] Patel, J.K., Meng, H. and Parikh, P.B., 2019. Trends in management and mortality in adults hospitalized with cardiac arrest in the United States. Journal of intensive care medicine34(3), pp.252-258. (Web Link)

[4] Key components of a community response to out-of-hospital cardiac arrest

David D. BergBentley J. Bobrow & Robert A. Berg 

Nature Reviews Cardiology (2019) (Web Link)

[5] Ismahil Badru, A., & Kazeem Kanmodi, K. (2017). Awareness and Attitudes of University of Ibadan Freshmen towards Learning and Performing Cardiopulmonary Resuscitation. Cardiology and Angiology: An International Journal6(3), 1-7. https://doi.org/10.9734/CA/2017/29506 (Web Link)

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