Automatic Mechanical Ventilation vs Manual Bag Ventilation During CPR: A Pilot Randomized Controlled Trial.

Background: There is insufficient evidence supporting the theory that mechanical ventilation can replace the manual ventilation method during CPR.

Research Question: Is using automatic mechanical ventilation (MV) feasible and comparable to the manual ventilation method during CPR?

Study Design And Methods: This pilot randomized controlled trial compared MV and manual bag ventilation (BV) during CPR after out-of-hospital cardiac arrest (OHCA). Patients with medical OHCA arriving at the ED were randomly assigned to two groups: an MV group using a mechanical ventilator and a BV group using a bag valve mask.

A case of refractory ventricular fibrillation after caffeine poisoning successfully treated by supportive care.

Caffeine (1,3,7-trimethylxantine), a structural analog of adenosine, is widely used as a central nervous system stimulant in beverages and drugs. Caffeine overdose induces hypokalemia, fatal ventricular fibrillation, and cardiac arrest, resulting in death. We describe a case of caffeine overdose that presented with refractory ventricular fibrillation that was treated with supportive care because invasive care for severely ill patients was limited due to the COVID-19 pandemic.

Target temperature management versus normothermia without temperature feedback systems for out-of-hospital cardiac arrest survivors.

Objective: The clinical benefit of automatic temperature control devices remains unclear. We investigated the outcomes of out-of-hospital cardiac arrest (OHCA) survivors who had undergone either target temperature management (TTM) with a temperature feedback system (TFS) or maintenance of normothermia without a TFS during post-resuscitation care.

Methods: This study was a retrospective analysis of a multicenter prospective cohort of OHCA survivors who had received postcardiac arrest care from August 2014 to December 2018.

Association of Health Insurance Status with Outcomes of Sepsis in Adult Patients: A Retrospective Cohort Study.

(1) Background: Sepsis is a life-threatening disease, and various demographic and socioeconomic factors affect outcomes in sepsis. However, little is known regarding the potential association between health insurance status and outcomes of sepsis in Korea. We evaluated the association of health insurance and clinical outcomes in patients with sepsis.

Combination therapy of vitamin C and thiamine for septic shock in a multicentre, double-blind, randomized, controlled study (ATESS): study protocol for a randomized controlled trial.

Background: Septic shock is a life-threatening condition with underlying circulatory and cellular/metabolic abnormalities. Vitamin C and thiamine are potential candidates for adjunctive therapy; they are expected to improve outcomes based on recent experimental and clinical research. The aim of the Ascorbic Acid and Thiamine Effect in Septic Shock (ATESS) trial is to evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock.

The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients: A multicenter prospective registry-based observational study.

The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.

High-Prevalence Vitamin D Deficiency among Korean Emergency Department Homeless, with a Comparison to a Healthy Korean Population.

Although nutritional problems are a major concern for the homeless, their vitamin D status has not yet been widely evaluated. This study was a retrospective chart review conducted at a single academic, urban public hospital's emergency department (ED). Patients whose serum 25-hydroxyvitamin D [25(OH)D] levels had been checked in the ED from July 2014 to June 2015 were reviewed and enrolled.

A feasibility study for the continuous measurement of pupillary response using the pupillography during CPR in out-of-hospital cardiac arrest patients.

Purpose: We investigated the change in pupil size and pupil light reflex (PLR) using a pupillography capable of continuous measurement both during CPR and immediately following the return-of-spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) comatose patients in an emergency department.

Methods: Pupil size and PLR were continuously measured both during CPR and immediately following ROSC until intensive care unit (ICU) admission. The changes in pupil sizes during CPR were categorized into three groups (no change - N, decreased - D, and increased - I groups).

Clinical Effects of Activated Charcoal Unavailability on Treatment Outcomes for Oral Drug Poisoned Patients.

Background: Activated charcoal is the most frequently and widely used oral decontaminating agent in emergency departments (EDs). However, there is some debate about its clinical benefits and risks. In Korea, activated charcoal with sorbitol was unavailable as of the mid-2015, and our hospital had been unable to use it from September 2015.

Prediction of neurological outcomes following the return of spontaneous circulation in patients with out-of-hospital cardiac arrest: Retrospective fast-and-frugal tree analysis.

Aim: Although various quantitative methods have been developed for predicting neurological prognosis in patients with out-of-hospital cardiac arrest (OHCA), they are too complex for use in clinical practice. We aimed to develop a simple decision rule for predicting neurological outcomes following the return of spontaneous circulation (ROSC) in patients with OHCA using fast-and-frugal tree (FFT) analysis.

Methods: We performed a retrospective analysis of prospectively collected data archived in a multi-centre registry.

Niacin and Selenium Attenuate Brain Injury After Cardiac Arrest in Rats by Up-Regulating DJ-1-Akt Signaling.

Objectives: To determine neuroprotective effects and mechanism of the combination therapy of niacin and selenium in cardiac arrest rats.

Design: Prospective laboratory study.

Setting: University laboratory.

End-tidal CO-guided automated robot CPR system in the pig. Preliminary communication.

Background: Our aim was to compare the efficacy of the end-tidal CO-guided automated robot CPR (robot CPR) system with manual CPR and mechanical device CPR.

Methods: We developed the algorithm of the robot CPR system which automatically finds the optimal compression position under the guidance of end-tidal CO feedback in swine models of cardiac arrest. Then, 18 pigs after 11 min of cardiac arrest were randomly assigned to one of three groups, robot CPR, LUCAS CPR, and manual CPR groups (n = 6 each group).

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study.

Background: When an out-of-hospital cardiac arrest (OHCA) patient receives cardiopulmonary resuscitation (CPR) in the emergency department (ED), blood laboratory test results can be obtained by using point-of-care testing during CPR. In the present study, the relationship between blood laboratory test results during CPR and outcomes of OHCA patients was investigated.

Methods: This study was a multicenter retrospective analysis of prospective registered data that included 2716 OHCA patients.

Epileptiform discharge detection with the 4-channel frontal electroencephalography during post-resuscitation care.

Introduction: We performed this study to investigate whether the SEDline system, a 4-channel-processed electroencephalography (EEG) monitoring device in the frontal area, can detect epileptiform discharges accurately during post-resuscitation care in comatose cardiac arrest survivors.

Methods: Adult comatose cardiac arrest survivors, who were admitted to the intensive care unit (ICU) for post-resuscitation care including TTM, were enrolled. Within 72h post-return of spontaneous circulation (ROSC), conventional EEG was conducted for 30min.

Long-term survival of out-of-hospital cardiac arrest patients with malignancy.

Background: The aim of this study was to investigate whether the 1-year survival rate of out-of-hospital cardiac arrest (OHCA) patients with malignancy was different from that of those without malignancy.

Methods: All adult OHCA patients were retrospectively analyzed in a single institution for 6years. The primary outcome was 1-year survival, and secondary outcomes were sustained return of spontaneous circulation (ROSC), survival to hospital admission, survival to discharge and discharge with a good neurological outcome (CPC 1 or 2).

Real-time tidal volume feedback guides optimal ventilation during simulated CPR.

Purpose: We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR).

Basic Procedures: We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes.

Niacin and Selenium Attenuate Sepsis-Induced Lung Injury by Up-Regulating Nuclear Factor Erythroid 2-Related Factor 2 Signaling.

Objectives: To determine whether the combination therapy of niacin and selenium attenuates lung injury and improves survival during sepsis in rats and whether its benefits are associated with the activation of the glutathione redox cycle and up-regulation of nuclear factor erythroid 2-related factor 2.

Design: Prospective laboratory study.

Setting: University laboratory.

Enhanced reduction of nitrate by supported nanoscale zero-valent iron prepared in ethanol-water solution.

Nanoscale zero-valent iron is famous for its high reactivity originating from its high surface area, and has emerged as an extension of granular zero-valent iron technology. Due to its extremely small size, nanosized iron cannot be used as a medium in a permeable reactive barrier system, which is the most popular application of granular iron. To overcome this shortcoming, supported nanoscale zero-valent iron was created.