A simple decision rule predicts futile resuscitation of out-of-hospital cardiac arrest

Glober, Nancy; Tainter, Christopher; Abramson, Tiffany M.; Staats, Katherine; Gilbert, Greg; Kim, David A.

doi:10.1016/j.resuscitation.2019.06.011

Cited by 24 publications

(12 citation statements)

References 24 publications

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“…As in preceding research, witnessed arrest, bystander CPR and initial shockable rhythm were found to be statistically significant independent predictors for long term survival, with initial shockable rhythm being the most discriminating factor. [2, [13], [14], [15], [16], [17], [18], [19], [20], [21], [22]] In contrast to some of these papers, this study did not find age to be an independent predictor for mortality. It is important to note that our analyses only used patients for whom ROSC was achieved.…”

Section: Discussioncontrasting

confidence: 83%

The prognostic value of early lactate clearance for survival after out-of-hospital cardiac arrest

Lonsain

Lausnay

Wauters

et al. 2021

The American Journal of Emergency Medicine

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Section: Discussioncontrasting

confidence: 83%

The prognostic value of early lactate clearance for survival after out-of-hospital cardiac arrest

Lonsain

Lausnay

Wauters

et al. 2021

The American Journal of Emergency Medicine

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“…Recently, a simple rule consisting in non-shockable rhythm, unwitnessed arrest, and age ≥ 80 years has been proposed to predict futile resuscitation for out-of-hospital cardiac arrest [77].…”

Section: Futilitymentioning

confidence: 99%

Can we have a rationalized selection of intra-aortic balloon pump, Impella, and extracorporeal membrane oxygenation in the catheterization laboratory?

et al. 2022

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Cardiac assistance represents an emerging issue in cardiovascular medicine. The evolution of invasive cardiology techniques is making the catheterization laboratory one of the main hospital sites where implantation of percutaneous ventricular assistance devices (PVADs) is discussed and performed. Among available PVADs, intra-aortic balloon pump (IABP), Impella, and extracorporeal membrane oxygenation (ECMO) are the most popular and offer completely different levels and ways to assist critical patients. The main settings calling for PVAD consideration in the catheterization laboratory are clinically indicated high-risk patients (CHIP) undergoing percutaneous coronary intervention (PCI) and patients with cardiogenic shock or refractory cardiac arrest. In CHIP, PVAD serves the purpose of preventing hemodynamic collapse during PCI. This may also allow more extensive revascularizations and higher quality revascularization plans (imaging use, debulking, stent result optimization). IABP or Impella are more commonly selected whereas ECMO is seldom considered as a third option for highly selected patients. The “elective” nature of CHIP-PCI should allow careful procedure planning (peripheral artery disease assessment, access site selection and management) in order to minimize vascular/bleeding complications. Cardiogenic shock is still associated with high mortality rates, and PVAD theoretically offers further recovery chances. The lack of benefit observed with systematic IABP use is currently prompting consideration of the roles of Impella and ECMO. Prolonged assistance is often needed. Thus, team decisions and shared protocols for PVAD selection have to be promoted, taking into consideration available resources and operators’ skills. In this paper, we critically review the available data in the field and highlight the possible decision-making hubs that catheterization-laboratory teams may consider in order to rationalize PVAD selection.

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“…Studies Reporting the Derivation and Internal Validation of a TOR Rule to Predict Poor Neurological Outcome. We identified very low-certainty evidence (downgraded for risk of bias, inconsistency, indirectness, and imprecision) from 6 nonrandomized studies 57,58,61,66,74,80 These studies derived and internally validated 12 distinct TOR rules to predict poor neurological outcome. Studies by Haukoos et al, 61 Lee et al, 66 Shibahashi et al, 74 and Yoon et al 80 derived multiple TOR rules.…”

Section: Studies Reporting Clinical Validation Of a Tor Rule To Predictmentioning

confidence: 99%

Education, Implementation, and Teams

Greif¹,

Bhanji²,

Bigham³

et al. 2020

Resuscitation

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A simple decision rule predicts futile resuscitation of out-of-hospital cardiac arrest

Cited by 24 publications

References 24 publications

The prognostic value of early lactate clearance for survival after out-of-hospital cardiac arrest

The prognostic value of early lactate clearance for survival after out-of-hospital cardiac arrest

Can we have a rationalized selection of intra-aortic balloon pump, Impella, and extracorporeal membrane oxygenation in the catheterization laboratory?

Education, Implementation, and Teams

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