ReSS 2019 Science News

Resuscitation Science Symposium 2019

Nov. 16–17, 2019

The Philadelphia 201 Hotel | 201 N. 17th St., Philadelphia, Pennsylvania

Selected science from Saturday, Nov. 16

Per Nordberg | Center for Resuscitation Science, Stockholm, Sweden

The Importance of Time to Cooling in Out-Of-Hospital Cardiac Arrest Patients to Influence Neurologically Intact Survival: A Sub-Analysis of the Princess Trial
Per Nordberg | Center for Resuscitation Science, Stockholm, Sweden

  • RESULTS: In a PRINCESS trial sub-analysis, for OHCA patients intra-arrest cooling started during pre-hospital resuscitation, compared to those who received hypothermia in the ICU with the return of spontaneous circulation, showed better survival with good neurological outcomes and complete neurological recovery, especially in those with initial shockable rhythms.
  • Nordberg's Abstract
  • Nordberg's presentation slides (PDF)
Jason Lesnick | UT Health - University of Texas Health Science Center at Houston, Houston, TX

Effect of Airway Insertion First-Pass Success Upon Patient Outcomes in the Pragmatic Airway Resuscitation Trial
Jason Lesnick | UT Health - University of Texas Health Science Center at Houston, Houston, TX

  • RESULTS: Results from the multicenter Pragmatic Airway Resuscitation Trial (PART) show that successful first-pass airway insertion (FPS) in adult OHCA was associated with better return of spontaneous circulation and72-hour survival. Differences between laryngeal tube insertion and endotracheal intubation (ETI) airway management were explained by FPS differences.
  • Lesnick's Abstract
  • Lesnick's presentation slides (PDF)
Tulasi Jinka | Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care (MCIRCC), University of Michigan Medical School, Ann Arbor, MI

High-Dose Intranasal Insulin During CPR Improves Neurological Outcomes in a Rat Model of Cardiac Arrest
Tulasi Jinka | Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care (MCIRCC), University of Michigan Medical School, Ann Arbor, MI

Kelley R Branch | University of Washington, Seattle, WA

Diagnostic Accuracy of Coronary CT in Survivors of Out-Of-Hospital Circulatory Arrest: Can CT Serve as a Gatekeeper for Invasive Coronary Angiography?
Kelley R Branch | University of Washington, Seattle, WA

  • RESULTS: For OHCA survivors, the early use of coronary CT angiography (CCTA) demonstrated a high diagnostic accuracy for obstructive CAD, suggesting its value as a gatekeeper to invasive coronary angiography (ICA). Both ICA and CCTA showed excellent diagnostic accuracy.
  • Branch's Abstract
  • Branch's presentation slides (PDF)
Mathias Johan Holmberg | Aarhus University Hospital, Aarhus N, Denmark

Epinephrine In Children Receiving Cardiopulmonary Resuscitation For Bradycardia With Poor Perfusion
Mathias Johan Holmberg | Aarhus University Hospital, Aarhus N, Denmark

  • RESULTS: Time-dependent propensity score matching using data from the GWTG Registry compared receiving epinephrine vs. at risk of receiving epinephrine for children getting in-hospital CPR for bradycardia and poor perfusion (non-pulseless event). In this comparison the use of epinephrine within the first 10 minutes of resuscitation during in-hospital CPR was associated with poorer outcomes. The potential for confounding was not eliminated in this study.
  • Holmberg's Abstract
  • Holmberg's presentation slides (PDF)

Selected science from Sunday, Nov. 17

Rajat Kalra | University of Minnesota, Minneapolis, MN

Echocardiographic Evaluation of Left Ventricular Recovery After Refractory Out-Of-Hospital Cardiac Arrest
Rajat Kalra | University of Minnesota, Minneapolis, MN

  • RESULTS: In a small patient sample, patients with refractory ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA cardiac arrest and treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) had significant recovery of ventricular function noted on echocardiography.
  • Kalra's Abstract
  • Kalra's presentation slides (PDF)
Brian E Grunau | St Paul's Hospital, Vancouver, BC, Canada

Public Access Defibrillators: Sex-Based Inequities in Access and Application
Brian E Grunau | St Paul's Hospital, Vancouver, BC, Canada

  • RESULTS: Data from the North American Resuscitation Outcomes Consortium (ROC) Epistry dataset showed that women had less OHCA’s in public locations that needed PAD and were less likely to have PAD used by bystanders in public locations.
  • Grunau's Abstract
  • Grunau's presentation slides (PDF)

The Usefulness of Neuron-Specific Enolase in Cerebrospinal Fluid to Predict Neurological Prognosis in Cardiac Arrest Survivors Who Underwent Target Temperature Management: A Prospective Observational Study
Jung Soo Park | Chungnam National University, Daejeon, South Korea

  • RESULTS: A comparison of serum neuron-specific enolase (NSE) and cerebrospinal fluid NSE for 6-month neurologic outcome in OHCA survivors who underwent target temperature management (TTM) found the CSF-NSE to be predictive and sensitive markers of poor 6-month neurological outcome.
  • Park's Abstract
  • Park's presentation slides (PDF)

Association Between Serum Lactate During Cardiopulmonary Resuscitation and Survival in Adult Out-Of-Hospital Cardiac Arrest: A Multicenter Cohort Study (The Critical Study in Osaka, Japan)
Norihiro Nishioka | Daisuke Kobayashi, Kyoto University, Kyoto, Japan

  • RESULTS: The Critical Study examines the role of serum lactate as a prognostic survival marker after OHCA. Higher serum lactate levels with a non-shockable rhythm before return of spontaneous circulation (ROSC) was associated with worse 1-month survival, suggesting a possible role for serum lactate as prognosis marker in OHCA in non-shockable rhythm.
  • Nishioka's Abstract
  • Nishioka's presentation slides (PDF)

Chest Compression Fraction Increased When Police Used AED That Analyses Heart Rhythm During CPR
Corina de Graaf | Amsterdam University Medical Centers, Amsterdam, Netherlands