Determinants and Prediction of Transport Ventilators' Oxygen Consumption.

This study investigates the determinants of oxygen consumption in transport ventilators, a critical factor for patient safety, especially during long-distance transfers and in resource-limited settings. A bench study was conducted on 4 ventilators to measure oxygen consumption under various ventilation settings. The main factor influencing oxygen consumption was the bias flow, a specific flow not contributing to patient ventilation.

Optimizing extracorporeal cardiopulmonary resuscitation delivery for out-of-hospital cardiac arrest: a Monte Carlo simulation study.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) can improve outcomes in refractory out-of-hospital cardiac arrest (OHCA), but access is limited by geographic and system constraints. We aimed to compare the potential impact of different ECPR delivery strategies in an urban setting using simulation modeling.

Methods: We performed a Monte Carlo simulation using historical OHCA data (2015-2019) from Montreal's sole EMS.

Association of epinephrine and outcome in cardiac arrest with refractory shockable rhythm: a population-based, propensity-score matched analysis.

Background: Epinephrine use in cardiac arrest is increasingly controversial, with contrasting results according to initial rhythm. We assessed the association between epinephrine use and favorable neurological outcome among patients with out of hospital cardiac arrest with refractory shockable arrest.

Methods: In this multicentric population-based prospective registry, we included all patients with out-of-hospital cardiac arrest, with persistent ventricular fibrillation after at least 3 defibrillations from 15/05/2011 to 31/12/2021 in Paris and its suburbs.

Impact of prehospital extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest on survival with good neurological function: a systematic review and meta-analysis.

Aim: Prehospital extracorporeal cardiopulmonary resuscitation (ECPR) has been proposed to reduce delays in ECPR delivery in refractory out-of-hospital cardiac arrests (OHCA) and improve outcomes. Our aim was to synthesize the literature on outcomes of prehospital ECPR in OHCA, focusing on low-flow times (emergency call to extracorporeal blood flow) and survival with good neurological function, comparing them to in-hospital ECPR when possible.

Methods: We conducted a systematic review and -analysis of studies reporting outcomes in adult OHCA patients treated with prehospital ECPR.

Design of the OverCool study: Lung-conservative liquid ventilation for the induction of Ultra-Rapid Cooling after Cardiac Arrest (OverCool).

Background: The therapeutic window within which induced hypothermia might be effective after cardiac arrest is still unknown. In animal cardiac arrest models, early induction and faster cooling are independently associated favorable outcome. However, induction of Ultra-Rapid Therapeutic Hypothermia (achieving core body temperature of 33.

Is preloading with amikacin a measure able to mitigate sequestration? A preliminary in vitro study.

Introduction: Amikacin is sequestered in polyacrylonitrile filters. Methods mitigating sequestration are unknown. Amikacin elimination in a polyacrylonitrile-derived filter preloaded with amikacin was studied in a preliminary study.

Long-term heart function in refractory out-of-hospital cardiac arrest treated with prehospital extracorporeal cardiopulmonary resuscitation.

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on heart function in surviving patients remains unclear.

Methods: We conducted a 9 year monocentric retrospective observational study in Paris, France (January 1, 2015, to December 31, 2023).

Novel gas mixture combined with an auto-transfusion tourniquet enhances cerebral O transport and hemodynamic indices in CPR swine. Part B - A pilot experimental study.

Objectives: The cognitive outcome of CPR is poor. This study aims to evaluate if enhancing blood flow to the brain and oxygen dissociation from the hemoglobin improve cerebral O transport during CPR in cardiac arrest swine.

Methods: Standard swine-CPR model of induced VF and recovery was treated with an auto-transfusion tourniquet (A-TT®; HemaShock® (HS) Oneg HaKarmel Ltd.

Sudden cardiac arrest in patients with cancer in the general population: insights from the Paris-SDEC registry.

Background: Data on the management of patients with cancer presenting with sudden cardiac arrest (SCA) are scarce. We aimed to assess the characteristics and outcomes of SCA according to cancer history.

Methods: Prospective, population-based registry including every out-of-hospital SCA in adults in Paris and its suburbs, between 2011 and 2019, with a specific focus on patients with cancer.

Controlled donation after circulatory death in post-cardiac arrest patients: Estimates from a large registry.

Background: Controlled donation after circulatory death (cDCD) in post-anoxic brain injury is a valuable source of organs that is still underused in some countries. We assessed the number of potential cDCD donors after out-of-hospital cardiac arrest (OHCA) in Paris and its suburbs and extrapolated the results to the French population.

Methods: Using the large regional registry of the Great Paris area, we prospectively included all consecutive adults with OHCA with a stable return of spontaneous circulation (ROSC) who ultimately died in the intensive care unit (ICU) after withdrawal of life-sustaining treatments (WLST) due to post anoxic brain injury.

Evolution of REperfusion Strategies and impact on mortality in Old and Very OLD STEMI patients. The RESOVOLD-e-MUST study.

Background: The use of myocardial reperfusion-mainly via angioplasty-has increased in our region to over 95%. We wondered whether old and very old patients have benefited from this development.

Methods: Setting: Greater Paris Area (Ile-de-France).

Cumulative dose of epinephrine and mode of death after non-shockable out-of-hospital cardiac arrest: a registry-based study.

Background: Epinephrine increases the chances of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA), especially when the initial rhythm is non-shockable. However, this drug could also worsen the post-resuscitation syndrome (PRS). We assessed the association between epinephrine use during cardiopulmonary resuscitation (CPR) and subsequent intensive care unit (ICU) mortality in patients with ROSC after non-shockable OHCA.

Extracorporeal cardiopulmonary resuscitation for hypothermic refractory cardiac arrests in urban areas with temperate climates.

Background: Accidental hypothermia designates an unintentional drop in body temperature below 35 °C. There is a major risk of ventricular fibrillation below 28 °C and cardiac arrest is almost inevitable below 24 °C. In such cases, conventional cardiopulmonary resuscitation is often inefficient.

Caspofungin sequestration in a polyacrylonitrile-derived filter: Increasing the dose does not mitigate sequestration.

Objectives: Critically ill patients frequently require continuous renal replacement therapy. Echinocandins are recommended as first-line treatment of candidemia. Preliminary results suggested echinocandin sequestration in a polyacrylonitrile filter.

Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study.

Background: A multidisciplinary group of stakeholders were used to identify: (1) the core competencies of a training program required to perform in-hospital ECPR initiation (2) additional competencies required to perform pre-hospital ECPR initiation and; (3) the optimal training method and maintenance protocol for delivering an ECPR program.

Methods: A modified Delphi process was undertaken utilising two web based survey rounds and one virtual meeting. Experts rated the importance of different aspects of ECPR training, competency and governance on a 9-point Likert scale.

Trends in survival from out-of-hospital cardiac arrest with a shockable rhythm and its association with bystander resuscitation: a retrospective study.

Objective: Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Despite decades of investment and research, survival remains disappointingly low. We report the trends in survival after a ventricular fibrillation/pulseless ventricular tachycardia OHCA, over a 13-year period, in a French urban region, and describe the simultaneous evolution of the rescue system.

Kidneys recovered from brain dead cardiac arrest patients resuscitated with ECPR show similar one-year graft survival compared to other donors.

Introduction: Among patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) as a second line of treatment for refractory out-of-hospital cardiac arrest (OHCA), some may develop brain death and become eligible for organ donation. The objective of this study was to evaluate long-term outcomes of kidney grafts recovered from these patients.

Material And Methods: We conducted a retrospective monocentric observational study between January 1, 2011, and December 31, 2017.

Factors associated with circulatory death after out-of-hospital cardiac arrest: a population-based cluster analysis.

Background: Out-of-hospital cardiac arrest (OHCA) is a common cause of death. Early circulatory failure is the most common reason for death within the first 48 h. This study in intensive care unit (ICU) patients with OHCA was designed to identify and characterize clusters based on clinical features and to determine the frequency of death from refractory postresuscitation shock (RPRS) in each cluster.

Vancomycin Sequestration in ST Filters: An In Vitro Study.

Background: Sequestration of vancomycin in ST filters used in continuous renal therapy is a pending question. Direct vancomycin-ST interaction was assessed using the in vitro NeckEpur technology.

Method: ST150 filter and Prismaflex dialyzer, Baxter-Gambro, were used.

Differential Effect of Targeted Temperature Management Between 32 °C and 36 °C Following Cardiac Arrest According to Initial Severity of Illness: Insights From Two International Data Sets.

Background: Recent guidelines have emphasized actively avoiding fever to improve outcomes in patients who are comatose following resuscitation from cardiac arrest (ie, out-of-hospital cardiac arrest). However, whether targeted temperature management between 32 °C and 36 °C (TTM32-36) can improve neurologic outcome in some patients remains debated.

Research Question: Is there an association between the use of TTM32-36 and outcome according to severity assessed at ICU admission using a previously derived risk score?

Study Design And Methods: Data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (France) between May 2011 and December 2017 and in the Resuscitation Outcomes Consortium Continuous Chest Compressions (ROC-CCC) trial (United States and Canada) between June 2011 and May 2015 were used for this study.