Histological examinations of the brain in control and OM groups.

(a) Hematoxylin and eosin staining in brains 72 h after cardiac arrest. (b) Quantification of damaged neurons in each group. (*: P = 0.004).</p

Study design and protocol for inducing cardiac arrest, resuscitation, drug administration, and monitoring.

Study design and protocol for inducing cardiac arrest, resuscitation, drug administration, and monitoring.</p

Neurological functioning scores in the study.

Total possible score, 0 to 12. (PDF)</p

Hemodynamic parameters of control and OM groups following cardiac arrest and resuscitation.

(a) Left ventricular ejection time. (b) Cardiac output. (c) Heart rate. (d) Left ventricular systolic function represented by dp/dt40. (n = 20 in each group, *: P<0.05 between two groups by mixed linear model analysis).</p

Neurological outcome of control and OM groups at 6, 24, 48 and 72 h after cardiac arrest and resuscitation.

(*: P = 0.026).</p

Kaplan-Meier survival curve of control and OM groups 72 h after cardiac arrest and resuscitation.

(P = 0.386 by log-rank test).</p

Features and interventions of cardiac arrest events by neurological status at hospital discharge.

Features and interventions of cardiac arrest events by neurological status at hospital discharge.</p

Multivariate survival analysis for termination of cardiopulmonary resuscitation efforts using a Cox’s proportional hazards model.

Multivariate survival analysis for termination of cardiopulmonary resuscitation efforts using a Cox’s proportional hazards model.</p

Outcomes of Adult In-Hospital Cardiac Arrest Treated with Targeted Temperature Management: A Retrospective Cohort Study

<div><p>Aim</p><p>Targeted temperature management (TTM) for in-hospital cardiac arrest (IHCA) is given different recommendation levels within international resuscitation guidelines. We aimed to identify whether TTM would be associated with favourable outcomes following IHCA and to determine which factors would influence the decision to implement TTM.</p><p>Methods</p><p>We conducted a retrospective observational study in a single medical centre. We included adult patients suffering IHCA between 2006 and 2014. We used multivariable logistic regression analysis to evaluate associations between independent variables and outcomes.</p><p>Results</p><p>We included a total of 678 patients in our analysis; only 22 (3.2%) patients received TTM. Most (81.1%) patients met at least one exclusion criteria for TTM. In all, 144 (21.2%) patients survived to hospital discharge; among them, 60 (8.8%) patients displayed favourable neurological status at discharge. TTM use was significantly associated with favourable neurological outcome (OR: 3.74, 95% confidence interval [CI]: 1.19–11.00; <i>p</i>-value = 0.02), but it was not associated with survival (OR: 1.41, 95% CI: 0.54–3.66; <i>p</i>-value = 0.48). Arrest in the emergency department was positively associated with TTM use (OR: 22.48, 95% CI: 8.40–67.64; <i>p</i> value < 0.001) and having vasopressors in place at the time of arrest was inversely associated with TTM use (OR: 0.08, 95% CI: 0.004–0.42; <i>p</i>-value = 0.02).</p><p>Conclusion</p><p>TTM might be associated with favourable neurological outcome of IHCA patients, irrespective of arrest rhythms. The prevalence of proposed exclusion criteria for TTM was high among IHCA patients, but these factors did not influence the use of TTM in clinical practice or neurological outcomes after IHCA.</p></div

Validation of the Cardiac Arrest Survival Postresuscitation In-hospital (CASPRI) score in an East Asian population

BackgroundThe Cardiac Arrest Survival Postresuscitation In-hospital (CASPRI) score is a useful tool for predicting neurological outcome following in-hospital cardiac arrest (IHCA), and was derived from a cohort selected from the Get With The Guidelines-Resuscitation registry between 2000 and 2009 in the United States. In an East Asian population, we aimed to identify the factors associated with outcomes of resuscitated IHCA patients and assess the validity of the CASPRI score.MethodsA retrospective study was conducted in a single centre in Taiwan. Patients with IHCA between 2006 and 2014 were screened.ResultsAmong the 796 included patients, 94 (11.8%) patients achieved neurologically intact survival. Multivariable logistic regression analyses identified factors significantly associated with neurological outcome. Six of these factors were also components of the CASPRI score, including duration of resuscitation, neurological status before IHCA, malignant disease, initial arrest rhythms, renal insufficiency and age. In univariate logistic regression analysis, the CASPRI score was significantly associated with neurological outcome (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.80–0.87); the area under the receiver operating characteristics curve was 0.79 (95% CI: 0.74–0.84).ConclusionIn this retrospective study conducted in a single centre at Taiwan, we identified the common prognosticators of IHCA shared by both East Asian and Western societies. As a composite prognosticator, CASPRI score predicts outcomes with excellent accuracy among successfully resuscitated IHCA patients in an East Asian population. This tool allows accurate IHCA prognostication in an East Asian population.</div