A Dutch randomised trial tests extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest. This appraisal examines survival with favourable neurological outcomes, patient selection and delays to treatment, asking how much the result reflects the system delivering ECPR.
ECPR for refractory cardiac arrest Read More
What do we actually mean by ‘downtime’ after cardiac arrest? This discussion examines how a single number can obscure periods of CPR, low flow and restored circulation, and explores clearer ways to communicate the patient’s course during handover.
What’s the down time? St Emlyn’s Read More
A 2022 appraisal of a randomised trial comparing double sequential, vector-change and standard defibrillation for refractory ventricular fibrillation. It examines survival outcomes, the limitations of a trial stopped early and the practical challenges of introducing alternative defibrillation strategies.
Alternate defibrillation strategies in refractory ventricular fibrillation Read More
Does cooling to 33°C improve outcomes after out-of-hospital cardiac arrest? This 2021 review of TTM2 compares hypothermia with actively managed normothermia, examining survival, neurological outcomes, adverse events and why fever control should not be confused with leaving temperature unmanaged.
JC: The TTM2 trial. Normothermia or hypothermia post cardiac arrest. Read More
Could carotid ultrasound make pulse checks more reliable? Natalie May examines a proof-of-concept study using recordings from patients undergoing cardiac surgery, and explains why interpreting those images is a different challenge from obtaining and using them during a real cardiac arrest.
JC: Finger on the Pulse? Read More
What does cardiac movement on ultrasound mean when no pulse can be felt? This 2019 review explores pseudo-PEA, its distinction from cardiac standstill and reported outcomes, while highlighting the limited evidence for proposed treatment changes and the need for further research.
JC: Pseudo PEA in the ED. St Emlyn's Read More
What can an animal study tell us about chest compressions in traumatic cardiac arrest? This 2019 appraisal examines a haemorrhage model in pigs, the role of blood resuscitation and the substantial limits of applying those findings to patients with different causes of arrest.
Should we use chest compressions in traumatic cardiac arrest? Read More
Could serum neurofilament light chain help predict neurological outcomes after out-of-hospital cardiac arrest? Dan Horner’s 2019 appraisal examines an analysis of TTM trial samples, considering promising test performance alongside validation gaps, false predictions and the risks of relying on a biomarker in isolation.
