Latest & greatest articles for cardiac arrest

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Top results for cardiac arrest

1. Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial. (PubMed)

Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial. Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest).To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves (...) survival with good neurologic outcome compared with cooling initiated after hospital arrival.The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled.Patients were randomly assigned

2019 JAMA

2. In-Hospital Cardiac Arrest: A Review. (PubMed)

In-Hospital Cardiac Arrest: A Review. In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke, myocardial infarction, and out-of-hospital cardiac arrest.In-hospital cardiac arrest occurs in over 290 000 adults each year in the United States. Cohort data from the United States indicate that the mean age of patients with in-hospital (...) cardiac arrest is 66 years, 58% are men, and the presenting rhythm is most often (81%) nonshockable (ie, asystole or pulseless electrical activity). The cause of the cardiac arrest is most often cardiac (50%-60%), followed by respiratory insufficiency (15%-40%). Efforts to prevent in-hospital cardiac arrest require both a system for identifying deteriorating patients and an appropriate interventional response (eg, rapid response teams). The key elements of treatment during cardiac arrest include chest

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2019 JAMA

3. Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. (PubMed)

Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest.Cohort study between January 2014 and December 2016.Nationwide, population based registry in Japan (All-Japan Utstein Registry).Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first (...) ). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35).In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.Published by the BMJ Publishing Group Limited. For permission

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2019 BMJ

4. Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients

Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients Several scores are available to predict mortality and neurological outcome in cardiac arrest patients admitted to the intensive care unit (ICU). The aim of the study was to externally validate the prognostic value of four previously published risk scores.For this observational, single-center study, we prospectively included 349 consecutive adult cardiac arrest patients upon ICU admission (...) . We calculated two cardiac arrest specific risk scores (OHCA and CAHP) and two general severity of illness scores (APACHE II and SAPS II). The primary endpoint was in-hospital mortality. Secondary endpoints were neurological outcome at hospital discharge and 30-day mortality.170 patients (49%) died until hospital discharge. All scores were independently associated with outcomes in logistic regression analysis and showed acceptable discrimination for in-hospital mortality with highest AUCs

2019 EvidenceUpdates

5. Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis

Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis Double sequential external defibrillation (DSED) is a novel intervention which has shown potential in the management of refractory ventricular fibrillation (VF). This review aims to identify the literature surrounding the use of DSED in out-of-hospital refractory VF and assess whether this intervention improves survival outcomes.The databases (...) differed across studies. Over half of cases were witnessed cardiac arrests (58.7%, n = 293) and bystander CPR was initiated in 53.3% (n = 266) of cases. In the meta-analysis, DSED had no effect on survival to hospital discharge (OR 0.69, 95% CI: 0.30, 1.60), event survival (OR 0.98, CI: 0.59, 1.62) or ROSC (OR 0.86, 95% CI: 0.49-1.48).The effectiveness of DSED remains unclear. Further well-designed prospective studies are needed to determine whether DSED has a role in the treatment of refractory

2019 EvidenceUpdates

6. Revised Cardiac Risk Index as a Predictor for Myocardial Infarction and Cardiac Arrest Following Posterior Lumbar Decompression

Revised Cardiac Risk Index as a Predictor for Myocardial Infarction and Cardiac Arrest Following Posterior Lumbar Decompression A retrospective analysis of prospectively collected data.The aim of this study was to determine the ability of Revised Cardiac Risk Index (RCRI) to predict adverse cardiac events following posterior lumbar decompression (PLD).PLD is an increasingly common procedure used to treat a variety of degenerative spinal conditions. The RCRI is used to predict risk for cardiac (...) complications.Membership in the RCRI=1 cohort was a predictor for myocardial infarction (MI) [odds ratio (OR) = 3.3, P = 0.002] and cardiac arrest requiring cardiopulmonary resuscitation (CPR) (OR = 3.4, P = 0.013). Membership in the RCRI = 2 cohort was a predictor for MI (OR = 5.9, P = 0.001) and cardiac arrest requiring CPR (OR = 12.5), Membership in the RCRI = 3 cohort was a predictor for MI (OR = 24.9) and cardiac arrest requiring CPR (OR = 26.9, P = 0.006). RCRI had a good discriminative ability to predict both

2019 EvidenceUpdates

7. Use of public defibrillators linked to out-of-hospital cardiac arrest survival

Use of public defibrillators linked to out-of-hospital cardiac arrest survival Use of public defibrillators linked to out-of-hospital cardiac arrest survival Discover Portal Discover Portal Use of public defibrillators linked to out-of-hospital cardiac arrest survival Published on 5 September 2017 doi: Providing a shock using a defibrillator to people with out-of-hospital cardiac arrest before the arrival of emergency medical services increases their chance of survival. The UK survival rate (...) response time, although time to intervention was not reported by the researchers. Whether it was the speed of first response or cause of cardiac arrest that accounted for these differences, it is clear that members of the public have an important role to play. Although this review did not examine training, pilot studies are investigating the potential of medical dispatch alerts for public first aiders. Overall, the review findings support the current installation of publicly available defibrillators so

2019 NIHR Dissemination Centre

8. Routine use of a mechanical compression device is no better than manual chest compression in cardiac arrest

Routine use of a mechanical compression device is no better than manual chest compression in cardiac arrest Mechanical versus manual chest compression in cardiac arrest Discover Portal Discover Portal Routine use of a mechanical compression device is no better than manual chest compression in cardiac arrest Published on 27 November 2018 doi: Compared with manual compression, mechanical chest compression does not improve survival rates after cardiac arrest. However, in situations where manual (...) compression may be difficult, such as in a moving ambulance, mechanical compression may still be an option. Each minute that a person waits for treatment after a cardiac arrest can make a difference of up to 10% to their chance of survival. Cardiopulmonary resuscitation (CPR) is the crucial first step to keep oxygen circulating to vital organs such as the heart and brain. While in theory, the use of automated chest compression could ensure optimum CPR delivery, this is not supported convincingly

2019 NIHR Dissemination Centre

9. Adrenaline and vasopressin for cardiac arrest. (PubMed)

Adrenaline and vasopressin for cardiac arrest. Adrenaline and vasopressin are widely used to treat people with cardiac arrest, but there is uncertainty about the safety, effectiveness and the optimal dose.To determine whether adrenaline or vasopressin, or both, administered during cardiac arrest, afford any survival benefit.We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase and DARE from their inception to 8 May 2018, and the International Liaison Committee (...) on Resuscitation 2015 Advanced Life Support Consensus on Science and Treatment Recommendations. We also searched four trial registers on 5 September 2018 and checked the reference lists of the included studies and review papers to identify potential papers for review.Any randomised controlled trial comparing: standard-dose adrenaline versus placebo; standard-dose adrenaline versus high-dose adrenaline; and adrenaline versus vasopressin, in any setting, due to any cause of cardiac arrest, in adults and children

2019 Cochrane

10. Induced hypothermia is associated with reduced circulating subunits of mitochondrial DNA in cardiac arrest patients. (PubMed)

Induced hypothermia is associated with reduced circulating subunits of mitochondrial DNA in cardiac arrest patients. Induced hypothermia may protect from ischemia reperfusion injury. The mechanism of protection is not fully understood and may include an effect on mitochondria. Here we describe the effect of hypothermia on circulating mitochondrial (mt) DNA in a substudy of a multicenter randomized trial (the Target Temperature Management trial). Circulating levels of mtDNA were elevated (...) in patients with cardiac arrest at all-time points compared to healthy controls. After 24 h of temperature management, patients kept at 33 °C had significantly lower levels of COX3, NADH1 and NADH2 compared to baseline, in contrast to those kept at 36 °C. After regain of temperature, cytochrome - B was significantly reduced in patients kept at 33 °C with cardiac arrest. Cardiac arrest results in circulating mtDNA levels, which reduced during a temperature management protocol in patients with a target

2019 Mitochondrial DNA. Part A, DNA mapping, sequencing, and analysis

11. 2018 American Heart Association Focused Update on Advanced Cardiovascular Life Support Use of Antiarrhythmic Drugs During and Immediately After Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Em

2018 American Heart Association Focused Update on Advanced Cardiovascular Life Support Use of Antiarrhythmic Drugs During and Immediately After Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Em Antiarrhythmic medications are commonly administered during and immediately after a ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, it is unclear whether these medications improve patient outcomes. This 2018 (...) American Heart Association focused update on advanced cardiovascular life support guidelines summarizes the most recent published evidence for and recommendations on the use of antiarrhythmic drugs during and immediately after shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. This article includes the revised recommendation that providers may consider either amiodarone or lidocaine to treat shock-refractory ventricular fibrillation/pulseless ventricular

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2019 EvidenceUpdates

12. A systematic review to determine the rate of sudden cardiac arrest and death in athletes, and to determine the benefits and harms of the electrocardiogram screening of athletes

A systematic review to determine the rate of sudden cardiac arrest and death in athletes, and to determine the benefits and harms of the electrocardiogram screening of athletes Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability (...) of induction of cardiac ischemia, duration of ischemia and duration of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may be recalculated from mg/dL); Renal

2019 PROSPERO

13. Oxygen's effect on mortality and pulmonary hypertension with out-of-hospital cardiac arrest patients: a systematic review and meta-analysis

Oxygen's effect on mortality and pulmonary hypertension with out-of-hospital cardiac arrest patients: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration (...) software. In case data are not reported or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia

2019 PROSPERO

14. Diagnostic performance of diffusion weighted imaging for predicting neurologic outcome in post-cardiac arrest patients: A systematic review and meta-analysis

Diagnostic performance of diffusion weighted imaging for predicting neurologic outcome in post-cardiac arrest patients: A systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content (...) ruler software. In case data are not reported or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac

2019 PROSPERO

15. Bystander versus no bystander cardiopulmonary resuscitation for pediatric out of hospital cardiac arrest

Bystander versus no bystander cardiopulmonary resuscitation for pediatric out of hospital cardiac arrest Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files (...) or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration

2019 PROSPERO

16. Coronary angiography after cardiac arrest without ST-segment elevation: a meta-analysis of randomized trials

Coronary angiography after cardiac arrest without ST-segment elevation: a meta-analysis of randomized trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files (...) or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration

2019 PROSPERO

17. Efficacy of the cooling method for targeted temperature management in post-cardiac arrest patients: a systematic review and meta-analysis

Efficacy of the cooling method for targeted temperature management in post-cardiac arrest patients: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration (...) software. In case data are not reported or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia

2019 PROSPERO

18. Therapeutic hypothermia after paediatric cardiac arrest: Pooled randomized controlled trials

Therapeutic hypothermia after paediatric cardiac arrest: Pooled randomized controlled trials Separate trials to evaluate therapeutic hypothermia after paediatric cardiac arrest for out-of-hospital and in-hospital settings reported no statistically significant differences in survival with favourable neurobehavioral outcome or safety compared to therapeutic normothermia. However, larger sample sizes might detect smaller clinical effects. Our aim was to pool data from identically conducted trials (...) of blood-product use, infection, and serious cardiac arrhythmia adverse events, and 28-day mortality, did not differ between groups.Analysis of combined data from two paediatric cardiac arrest targeted temperature management trials including both in-hospital and out-of-hospital cases revealed that hypothermia, as compared with normothermia, did not confer a significant benefit in survival with favourable functional outcome at one year.Copyright © 2018 Elsevier B.V. All rights reserved.

2018 EvidenceUpdates

19. Incidence, outcomes and guideline compliance of out-of-hospital maternal cardiac arrest resuscitations: A population-based cohort study

Incidence, outcomes and guideline compliance of out-of-hospital maternal cardiac arrest resuscitations: A population-based cohort study Incidence and survival rates after cardiac arrest among pregnant women are reported for in-hospital cardiac arrests; the incidence and outcomes of maternal out-of-hospital cardiac arrest (OHCA) are unknown. Current cardiopulmonary resuscitation guidelines contain recommendations specific to this population; compliance with these has not been investigated.To

2018 EvidenceUpdates

20. Which Compression-to-Ventilation Ratio Yields Better Cardiac Arrest Outcomes? (SRS therapy)

Which Compression-to-Ventilation Ratio Yields Better Cardiac Arrest Outcomes? (SRS therapy) TAKE-HOME MESSAGE Continuous compressions with asynchronous ventilations and a compression-to- ventilation ratio of 30:2 resulted in improved outcomes in adults in cardiopulmonary arrest, whereas either 30:2 or 15:2 improved outcomes in children. Which Compression-to-Ventilation Ratio Yields Better Cardiac Arrest Outcomes? EBEM Commentators Dhimitri A. Nikolla, DO Jestin N. Carlson, MD, MS Department (...) evidence has suggested harm from long pauses in chest compressions, 1,2 greater emphasis has been placed on bystander compression-only CPR and continuous-compression CPR by out-of-hospital providers. 3 In addition, hyperventilation may negatively affect outcomes. 4,5 As such, there is equipoise in regard to the ideal compression-to- ventilation ratio in cardiac arrest, and limited high-quality data exist. The study by Nichol et al 6 comparing continuous- compression CPR to 30:2 CPR represents

2018 Annals of Emergency Medicine Systematic Review Snapshots