Adult advanced life support (ALS) is an important part of the chain of survival, promoting systemic circulation and oxygen supply during high-quality basic life support in patients with cardiac arrest. It includes advanced airway management, manual defibrillation, pharmacological therapy with vasopressors and antiarrhythmic agents, use of an extracorporeal circulation device, and other techniques to achieve return of spontaneous circulation (ROSC). [1][2][3] Several milestone studies on ALS have been published since the publication of the 2015 Korean cardiopulmonary resuscitation (CPR) guidelines. These include a multicenter, randomized, double-blind, placebo-controlled study evaluating the effect of epinephrine in patients with out-ofhospital cardiac arrest (OHCA) as well as a comparative study on amiodarone, lidocaine, or placebo in patients with refractory shockable rhythm. 4,5 A study comparing the use of a supraglottic airway (SGA) device and endotracheal intubation for advanced airway management during OHCA S27

This study investigated the incidence of acquired cytomegalovirus (CMV) infection in very low birth weight infants (VLBWI) given CMV seropositive blood, and sought to determine whether filtering and irradiation of blood products could help prevent CMV infection and the time required to clear passively-derived anti-CMV IgG among 80 VLBWI transfused with filtered-irradiated blood, 20 VLBWI transfused with nonfiltered-nonirradiated blood and 26 nontransfused VLBWI. CMV IgG and IgM values were obtained from all blood products prior to transfusions, and from VLBWI at birth until the infants became seronegative. Urine was obtained for CMV culture at birth and every 3-4 weeks until 12 weeks after the final transfusion. The incidence of CMV IgG seropositivity among the 126 infants at birth and the blood products given were 96% and 95%, respectively. The incidence of acquired CMV infection was 4/100 (4%) in the transfused group: 2/80 (2.5%) and 2/20 (10%) in the filtered-irradiated and nonfiltered-nonirradiated transfusion groups, respectively. Approximately 9-10 months elapsed to clear passively acquired CMV IgG. The irradiation and filtering of the blood products did not seem to decrease the transfusion-related CMV infection rate in Korea among VLBWI, however, further validation is recommended in a larger cohort of infants.

BACKGROUNDOut-of-hospital cardiac arrest (OHCA) is one of the growing medical issues in developing and developed countries. The incidence of OHCA ranges from 24 to 186 per 100,000 population, and varies according to ethnic group, country, and region. 1 The annual incidence of OHCA in Korea increased from 21,905 (44.3 per 100,000 population) in 2008 to 30,539 (59.5 per 100,000 population) in 2018. 2 Considering the demographic structure of Korea, which is entering an aging society, the incidence of cardiac arrest is likely to increase. The survival rate of victims of cardiac arrest is affected by various factors such as the demographic and social characteristics of each country or community, the effectiveness of the emergency medical system (EMS), the rate of bystander cardiopulmonary resuscitation (CPR), and the public access defibrillation program. Although 60 years have passed since the introduction of modern CPR, the survival rate of victims of cardiac arrest remains low. The survival-to-discharge rate of OHCA in Korea increased from 3.0% in 2008 to 8.6% in 2018, and the rate of favorable neurological outcomes increased from 0.9% in 2008 to 5.1% in 2018. 2 The survival rate of OHCA in the United States, Europe, and Japan, where research on cardiac arrest started early, CPR education was provided to citizens and public access defibrillation programs were implemented, is over 10%. [3][4][5] Cardiac arrest occurs in locations outside the hospital such as home, street, public places, or sports facilities. Due to the nature of OHCA, witnesses who are not medical personnel play an important role in the process of rescuing a victim of cardiac arrest. The survival of victims of OHCA is affected by the effectiveness of out-of-hospital rescue activities, including the recognition of cardiac arrest by witnesses, bystander CPR, response time of the EMS, and on-site use of