Resuscitation

Is Early ECPR Better than ACLS for OHCA?

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Early extracorporeal cardiopulmonary resuscitation was not superior to standard advanced cardiac life support for 180-day survival with good neurological outcome, but there may be a silver lining.

Source
Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2022 Feb 22;327(8):737-747. doi: 10.1001/jama.2022.1025.

Finger (or is that…probe) on the Pulse | Doppler vs Manual Palpation During Arrest

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Use of pulsed-wave Doppler ultrasound by a trained emergency medicine physician to detect any femoral pulse was more accurate than manual palpation but did not necessarily confer an adequate blood pressure (i.e. SBP ≥ 60 mmHg).  Calculation of peak systolic velocity of ≥20 cm/s had a stronger correlation with a SBP ≥ 60 mmHg.

Source
Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest. Resuscitation. 2022 Feb 4;S0300-9572(22)00032-6. doi: 10.1016/j.resuscitation.2022.01.030. Online ahead of print.

Battle of the Catecholamines – Epi vs Norepi for Post-Resuscitation Shock

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Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine.

Source
Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022 Mar;48(3):300-310. doi: 10.1007/s00134-021-06608-7. Epub 2022 Feb 7.

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