Browsing by Subject "Resuscitation"

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  • Böttiger, B. W.; Lockey, A.; Aickin, R.; Castren, M.; de Caen, A.; Escalante, R.; Kern, K. B.; Lim, S. H.; Nadkarni, V.; Neumar, R. W.; Nolan, J. P.; Stanton, D.; Wang, T. -L.; Perkins, G. D. (2018)
    "All citizens of the world can save a life". With these words, the International Liaison Committee on Resuscitation (ILCOR) is launching the first global initiative - World Restart a Heart (WRAH) - to increase public awareness and therefore the rates of bystander cardiopulmonary resuscitation (CPR) for victims of cardiac arrest. In most of the cases, it takes too long for the emergency services to arrive on scene after the victim's collapse. Thus, the most effective way to increase survival and favourable outcome in cardiac arrest by two-to fourfold is early CPR by lay bystanders and by "first responders". Lay bystander resuscitation rates, however, differ significantly across the world, ranging from 5 to 80%. If all countries could have high lay bystander resuscitation rates, this would help to save hundreds of thousands of lives every year. In order to achieve this goal, all seven ILCOR councils have agreed to participate in WRAH 2018. Besides schoolchildren education in CPR ("KIDS SAVE LIVES"), many other initiatives have already been developed in different parts of the world. ILCOR is keen for the WRAH initiative to be as inclusive as possible, and that it should happen every year on 16 October or as close to that day as possible. Besides recommending CPR training for children and adults, it is hoped that a unified global message will enable our policy makers to take action to address the inequalities in patient survival around the world.
  • Penketh, J. A.; Nolan, J. P.; Skrifvars, M. B.; Rylander, C.; Frenell,; Tirkkonen, J.; Reynolds, E. C.; Parr, M. J. A.; Aneman, A. (2020)
    Aim: To determine the type of airway devices used during in-hospital cardiac arrest (IHCA) resuscitation attempts. Methods: International multicentre retrospective observational study of in-patients aged over 18 years who received chest compressions for cardiac arrest from April 2016 to September 2018. Patients were identified from resuscitation registries and rapid response system databases. Data were collected through review of resuscitation records and hospital notes. Airway devices used during cardiac arrest were recorded as basic (adjuncts or bag-mask), or advanced, including supraglottic airway devices, tracheal tubes or tracheostomies. Descriptive statistics and multivariable regression modelling were used for data analysis. Results: The final analysis included 598 patients. No airway management occurred in 36 (6%), basic airway device use occurred at any time in 562 (94%), basic airway device use without an advanced airway device in 182 (30%), tracheal intubation in 301 (50%), supraglottic airway in 102 (17%), and tracheostomy in 1 (0.2%). There was significant variation in airway device use between centres. The intubation rate ranged between 21% and 90% while supraglottic airway use varied between 1% and 45%. The choice of tracheal intubation vs. supraglottic airway as the second advanced airway device was not associated with immediate survival from the resuscitation attempt (odds ratio 0.81; 95% confidence interval 0.35-1.8). Conclusion: There is wide variation in airway device use during resuscitation after IHCA. Only half of patients are intubated before return of spontaneous circulation and many are managed without an advanced airway. Further investigation is needed to determine optimal airway device management strategies during resuscitation following IHCA.
  • Luostarinen, Teemu (2020)
    Elinluovuttajan hoidossa pyritään huolehtimaan irrotettavien elinten elinkelpoisuudesta turvaamalla niiden riittävä verenkierto ja hapentarjonta. Elinluovuttajan hoidosta on olemassa kansalliset hoito-ohjeet. Tässä artikkelissa käydään läpi muutamia elinluovuttajaan hoitoon liittyviä keskeisiä asioita.
  • Castrén, Maaret; Nurmi, Jouni; Heinäaho, Emil; Hoppu, Sanna; Ikola, Kaisu; Myllyrinne, Kristiina; Peltoniemi, Outi; Skrifvars, Markus; Vaahersalo, Jukka; Kukkonen-Harjula, Katriina (2016)
  • Lyyra, Markus (2017)
    Ensihoito hälytettiin elvytykseen vanhainkotiin. Hälytysviestissä kerrottiin, että potilaalla on voimassa oleva ei elvytetä -päätös (DNR).
  • Graesner, Jan-Thorsten; Lefering, Rolf; Koster, Rudolph W.; Masterson, Siobhan; Boettiger, Bernd W.; Herlitz, Johan; Wnent, Jan; Tjelmeland, Ingvild B. M.; Rosell Ortiz, Fernando; Maurer, Holger; Baubin, Michael; Mols, Pierre; Hadzibegovic, Irzal; Ioannides, Marios; Skulec, Roman; Wissenberg, Mads; Salo, Ari; Hubert, Herve; Nikolaou, Nikolaos I.; Loczi, Gerda; Svavarsdottir, Hildigunnur; Semeraro, Federico; Wright, Peter J.; Clarens, Carlo; Pijls, Ruud; Cebula, Grzegorz; Correia, Vitor Gouveia; Cimpoesu, Diana; Raffay, Violetta; Trenkler, Stefan; Markota, Andrej; Stroemsoee, Anneli; Burkart, Roman; Perkins, Gavin D.; Bossaert, Leo L.; EuReCa ONE Collaborators (2016)
    Introduction: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. Methods: This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries. Results: Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge. Conclusion: The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.
  • Kupari, Petteri; Skrifvars, Markus; Kuisma, Markku (2017)
    Background: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. Methods: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated. The endpoint was ROSC defined as palpable pulse over 30 s. Calibration was assessed by comparing predicted and observed ROSC rates in the whole sample, separately for shockable and non-shockable rhythm, and separately for resuscitations lead by a specialist, registrar or medical supervisor (i.e., senior paramedic). Data are presented as medians and interquartile ranges. Statistical testing included chi-square test, the Mann-Whitney U test, Hosmer-Lemeshow goodness of fit test and calculation of 95% confidence intervals (CI) for proportions. Results: A total of 680 patients were included of whom 340 attained ROSC. The RACA score was higher in patients with ROSC (0.62 [0.46-0.69] than in those without (0.46 [0.36-0.57]) (p <0.001). Observed against predicted ROSC indicated reasonable calibration overall (p = 0.30), with better calibration in patients with a shockable initial rhythm (p = 0.75) than in patients with a non-shockable rhythm (p = 0.04). There was no statistical difference between observed and predicted ROSC rates in resuscitations attended by a specialist (50% vs 53%, 95% CI 45-55) or registrar (55% vs 53%, 95% CI 48-62), but rates were lower than predicted in resuscitations lead by a medical supervisor (36% vs 49%, 95% CI 25-47). Discussion: Developing a practical severity-of-illness scoring system for out-of-hospital cardiac arrest patients would allow patient heterogeneity adjustment and measurement of quality of care in analogy to commoly used severity-of-illness-scores developed for the similar purposes for the general intensive care unit population. However, transferring RACA score to another country with different population and EMS system might affect the performance and generalizability of the score. Conclusions: This study found a good overall calibration and moderate discrimination of the RACA score in a physician staffed urban EMS system which suggests external validity of the score. Calibration was suboptimal in patients with a non-shockable rhythm which may due to a local do-not-attempt-resuscitation policy. The lower than expected overall ROSC rate in resuscitations attended by medical supervisors requires further study.
  • Pitkänen, Mikko; Kontio, Risto; Förster, Johannes (2018)
    Lähtökohdat Hammasvaurio on yleinen anestesiaan, intubaatioon ja elvytykseen liittyvä haittatapahtuma. Menetelmät Analyysi perustuu Potilasvakuutuskeskuksessa v. 2000–13 loppuun käsiteltyihin vahinkoilmoituksiin. Tulokset Hammasvaurioita anestesian ja intubaation yhteydessä koski 137 vahinkoilmoitusta. Potilaille oli tehty leikkaus (83 %), intubaatio hätätilanteessa (7 %) tai muu toimenpide (mm. kardioversio). Tapauksista 66 % liittyi laryngoskopiaan ja intubaatioon ja vajaa 20 % nielutuubin tai kurkunpäänaamarin käyttöön.Vaikea intubaatio oli riskitekijä. Terve hammas vaurioitui 7 %:ssa. Vaurio korvattiin neljälle potilaalle (2,9 %). Päätelmät Hammasvahingolle altistavat heikentynyt hampaisto ja intubaatio. Oikeusturvan takia on tärkeää kirjata hammasstatus etukäteen. Potilasvakuutuskeskus korvaa anestesian aikaisen hammasvaurion harvoin. Nopea hoito voi pelastaa vaurioituneen hampaan.
  • Lönnqvist, Tuula; Lauronen, Leena; Palomäki, Maarit; Suominen, Pertti (2016)
    •Hukkumistapaturman aikana kehittyy hypoksis-iskeeminen aivovaurio, eikä syntyneeseen vaurioon voi ­juurikaan vaikuttaa myöhemmin. •Elvytyksessä tärkeää on lisävaurion ehkäiseminen, happivajeen korjaaminen ja riittävän aivoperfuusion ­ylläpitäminen. •Ennusteen kannalta merkittävin asia on aivojen hapenpuutteen kesto eli hukuksissaoloaika. •Ennusteen arvioinnissa käytetään neurologisen tutkimuksen lisäksi aivojen magneettikuvausta, EEG-tutkimusta sekä somatosensorisia herätevasteita. •Neurologinen status sairaalasta kotiutettaessa ei kuvaa riittävästi myöhempää ennustetta, vaan tarvitaan neurologista ja neurokognitiivista pitkäaikaisseurantaa.
  • Pasquier, Mathieu; Hugli, Olivier; Paal, Peter; Darocha, Tomasz; Blancher, Marc; Husby, Paul; Silfvast, Tom; Carron, Pierre-Nicolas; Rousson, Valentin (2018)
    Aims: Currently, the decision to initiate extracorporeal life support for patients who suffer cardiac arrest due to accidental hypothermia is essentially based on serum potassium level. Our goal was to build a prediction score in order to determine the probability of survival following rewarming of hypothermic arrested patients based on several covariates available at admission. Methods: We included consecutive hypothermic arrested patients who underwent rewarming with extracorporeal life support. The sample comprised 237 patients identified through the literature from 18 studies, and 49 additional patients obtained from hospital data collection. We considered nine potential predictors of survival: age; sex; core temperature; serum potassium level; mechanism of hypothermia; cardiac rhythm at admission; witnessed cardiac arrest, rewarming method and cardiopulmonary resuscitation duration prior to the initiation of extracorporeal life support. The primary outcome parameter was survival to hospital discharge. Results: Overall, 106 of the 286 included patients survived (37%; 95% CI: 32-43%), most (84%) with a good neurological outcome. The final score included the following variables: age, sex, core temperature at admission, serum potassium level, mechanism of cooling, and cardiopulmonary resuscitation duration. The corresponding area under the receiver operating characteristic curve was 0.895 (95% CI: 0.859-0.931) compared to 0.774 (95% CI: 0.720-0.828) when based on serum potassium level alone. Conclusions: In this large retrospective study we found that our score was superior to dichotomous triage based on serum potassium level in assessing which hypothermic patients in cardiac arrest would benefit from extracorporeal life support. External validation of our findings is required.
  • Ilmakunnas, Minna; Ahonen, Jouni (2020)
    Vuotavan potilaan hoidossa pyritään antamaan veren eri komponentteja – punasoluja, plasmaa, trombosyyttejä – fysiologisessa suhteessa. Miksei kolmen eri verivalmisteen sijaan käytettäisi suoraan kokoverta.
  • Suominen, Pertti K. (2017)
    •Lasten elvytykset ja muut hätätilanteet ovat onneksi melko harvinaisia. •Vakavasti sairaan lapsen peruselintoiminnot kannattaa aina arvioida systemaattisesti ja toistuvasti ¬ABCDE-mallin mukaisesti. •Muista tehdä ennakkoilmoitus vastaanottavaan sairaalaan ennen potilaan siirtokuljetusta.
  • Nurmi, Elisa; Peltoniemi, Outi; Suominen, Pertti (2016)
  • Kiguchi, Tekeyuki; Okubo, Masashi; Nishiyama, Chika; Maconochie, Ian; Ong, Marcus Eng Hock; Kern, Karl B.; Wyckoff, Myra H.; McNally, Bryan; Christensen, Erika; Tjelmeland, Ingvild; Herlitz, Johan; Perkins, Gavin D.; Booth, Scott; Finn, Judith; Shahidah, Nur; Shin, Sang Do; Bobrow, Bentley J.; Morrison, Laurie J.; Salo, Ari; Baldi, Enrico; Burkart, Roman; Lin, Chih-Hao; Jouven, Xavier; Soar, Jasmeet; Nolan, Jerry P.; Iwami, Taku (2020)
    Background Since development of the Utstein style recommendations for the uniform reporting of cardiac arrest, increasing numbers of national and regional out-of-hospital cardiac arrest (OHCA) registries have been established worldwide. The International Liaison Committee on Resuscitation (ILCOR) created the Research and Registries Working Group and aimed to systematically report data collected from these registries. Methods We conducted two surveys of voluntarily participating national and regional registries. The first survey aimed to identify which core elements of the current Utstein style for OHCA were collected by each registry. The second survey collected descriptive summary data from each registry. We chose the data collected for the second survey based on the availability of core elements identified by the first survey. Results Seven national and four regional registries were included in the first survey and nine national and seven regional registries in the second survey. The estimated annual incidence of emergency medical services (EMS)-treated OHCA was 30.0 to 97.1 individuals per 100,000 population. The combined data showed the median age varied from 64 to 79 years and more than half were male in all 16 registries. The provision of bystander cardiopulmonary resuscitation (CPR) and bystander automated external defibrillator (AED) use was 19.1% to 79.0% in all registries and 2.0% to 37.4% among 11 registries, respectively. Survival to hospital discharge or 30-day survival after EMS-treated OHCA was 3.1% to 20.4% across all registries. Favourable neurological outcome at hospital discharge or 30 days after EMS-treated OHCA was 2.8% to 18.2%. Survival to hospital discharge or 30-day survival after bystander witnessed shockable OHCA ranged from 11.7% to 47.4% and favourable neurological outcome from 9.9% to 33.3%. Conclusion This report from ILCOR describes data on systems of care and outcomes following OHCA from nine national and seven regional registries across the world. We found variation in reported survival outcomes and other core elements of the current Utstein style recommendations for OHCA across nations and regions.
  • Jousi, Mille; Skrifvars, Markus B.; Nelskylä, Annika; Ristagno, Giuseppe; Schramko, Alexey; Nurmi, Jouni (2019)
    Introduction: Screening and correcting reversible causes of cardiac arrest (CA) are an essential part of cardiopulmonary resuscitation (CPR). Point-ofcare (POC) laboratory analyses are used for screening pre-arrest pathologies, such as electrolyte disorders and acid-base balance disturbances. The aims of this study were to compare the intraosseous (10), arterial and central venous POC values during CA and CPR and to see how the CPR values reflect the pre-arrest state. Methods: We performed an experimental study on 23 anaesthetised pigs. After induction of ventricular fibrillation (VF), we obtained POC samples from the 10 space, artery and central vein simultaneously at three consecutive time points. We observed the development of the values during CA and CPR and compared the CPR values to the pre-arrest values. Results: The 10, arterial and venous values changed differently from one another during the course of CA and CPR. Base excess and pH decreased in the venous and 10 samples during untreated VF, but in the arterial samples, this only occurred after the onset of CPR. The 10, arterial and venous potassium values were higher during CPR compared to the pre-arrest arterial values (mean elevations 4.4 mmol/l (SD 0.72), 3.3 mmol/l (0.78) and 2.8 mmol/l (0.94), respectively). Conclusions: A dynamic change occurs in the common laboratory values during CA and CPR. POC analyses of lactate, pH, sodium and calcium within 10 samples are not different from analyses of arterial or venous blood. Potassium values in 10, arterial and venous samples during CPR are higher than the pre-arrest arterial values.
  • Hjortrup, Peter B.; Haase, Nicolai; Bundgaard, Helle; Thomsen, Simon L.; Winding, Robert; Pettilä, Ville; Aaen, Anne; Lodahl, David; Berthelsen, Rasmus E.; Christensen, Henrik; Madsen, Martin B.; Winkel, Per; Wetterslev, Jorn; Perner, Anders; CLASSIC Trial Grp; Scandinavian Critical Care Trials (2016)
    Purpose: We assessed the effects of a protocol restricting resuscitation fluid vs. a standard care protocol after initial resuscitation in intensive care unit (ICU) patients with septic shock. Methods: We randomised 151 adult patients with septic shock who had received initial fluid resuscitation in nine Scandinavian ICUs. In the fluid restriction group fluid boluses were permitted only if signs of severe hypoperfusion occurred, while in the standard care group fluid boluses were permitted as long as circulation continued to improve. Results: The co-primary outcome measures, resuscitation fluid volumes at day 5 and during ICU stay, were lower in the fluid restriction group than in the standard care group [ mean differences -1.2 L (95 % confidence interval -2.0 to -0.4); p <0.001 and -1.4 L (-2.4 to -0.4) respectively; p <0.001]. Neither total fluid inputs and balances nor serious adverse reactions differed statistically significantly between the groups. Major protocol violations occurred in 27/75 patients in the fluid restriction group. Ischaemic events occurred in 3/75 in the fluid restriction group vs. 9/76 in the standard care group (odds ratio 0.32; 0.08-1.27; p = 0.11), worsening of acute kidney injury in 27/73 vs. 39/72 (0.46; 0.23-0.92; p = 0.03), and death by 90 days in 25/75 vs. 31/76 (0.71; 0.36-1.40; p = 0.32). Conclusions: A protocol restricting resuscitation fluid successfully reduced volumes of resuscitation fluid compared with a standard care protocol in adult ICU patients with septic shock. The patient-centred outcomes all pointed towards benefit with fluid restriction, but our trial was not powered to show differences in these exploratory outcomes.
  • Jakkula, Pekka; Reinikainen, Matti; Hästbacka, Johanna; Pettilä, Ville; Loisa, Pekka; Karlsson, Sari; Laru-Sompa, Raili; Bendel, Stepani; Oksanen, Tuomas; Birkelund, Thomas; Tiainen, Marjaana; Toppila, Jussi; Hakkarainen, Antti; Skrifvars, Markus B.; COMACARE Study Grp (2017)
    Background: Arterial carbon dioxide tension (PaCO2), oxygen tension (PaO2), and mean arterial pressure (MAP) are modifiable factors that affect cerebral blood flow (CBF), cerebral oxygen delivery, and potentially the course of brain injury after cardiac arrest. No evidence regarding optimal treatment targets exists. Methods: The Carbon dioxide, Oxygen, and Mean arterial pressure After Cardiac Arrest and REsuscitation (COMACARE) trial is a pilot multi-center randomized controlled trial (RCT) assessing the feasibility of targeting low-or high-normal PaCO2, PaO2, and MAP in comatose, mechanically ventilated patients after out-of-hospital cardiac arrest (OHCA), as well as its effect on brain injury markers. Using a 23 factorial design, participants are randomized upon admission to an intensive care unit into one of eight groups with various combinations of PaCO2, PaO2, and MAP target levels for 36 h after admission. The primary outcome is neuron-specific enolase (NSE) serum concentration at 48 h after cardiac arrest. The main feasibility outcome is the between-group differences in PaCO2, PaO2, and MAP during the 36 h after ICU admission. Secondary outcomes include serum concentrations of NSE, S100 protein, and cardiac troponin at 24, 48, and 72 h after cardiac arrest; cerebral oxygenation, measured with near-infrared spectroscopy (NIRS); potential differences in epileptic activity, monitored via continuous electroencephalogram (EEG); and neurological outcomes at six months after cardiac arrest. Discussion: The trial began in March 2016 and participant recruitment has begun in all seven study sites as of March 2017. Currently, 115 of the total of 120 patients have been included. When completed, the results of this trial will provide preliminary clinical evidence regarding the feasibility of targeting low-or high-normal PaCO2, PaO2, and MAP values and its effect on developing brain injury, brain oxygenation, and epileptic seizures after cardiac arrest. The results of this trial will be used to evaluate whether a larger RCT on this subject is justified.
  • FINNRESUSCI Study Grp; Wihersaari, Lauri; Tiainen, Marjaana; Skrifvars, Markus B.; Bendel, Stepani; Kaukonen, Kirsi-Maija; Vaahersalo, Jukka; Romppanen, Jarkko; Pettilä, Ville; Reinikainen, Matti (2019)
    Aim of the study: We evaluated the impact of patient age and time from collapse to return of spontaneous circulation (ROSC) on the prognostic accuracy of neuron specific enolase (NSE) after out-of-hospital cardiac arrest (OHCA). Methods: Using electrochemiluminescence immunoassay, we measured serum concentrations of NSE in 249 patients who were admitted to intensive care units after resuscitation from OHCA. In each quartile according to age and time to ROSC, we evaluated the ability of NSE at 48 h after OHCA to predict poor outcome (Cerebral Performance Category 3-5) at 12 months. Results: The outcome at 12 months was poor in 121 (49%) patients. The prognostic performance of NSE was excellent (area under the receiver operating characteristic curve, AUROC, 0.91 [95% confidence interval, 0.81-1.00]) in the youngest quartile (18-56 years), but worsened with increasing age, and was poor (AUROC 0.53 [0.37-0.70]) in the oldest quartile (72 years or more). The prognostic performance of NSE was worthless (AUROC 0.45 [0.30-0.61]) in the quartile with the shortest time to ROSC (1-13 min), but improved with increasing time to ROSC, and was good (AUROC 0.84 [0.74-0.95]) in the quartile with the longest time to ROSC (29 min or over). Conclusion: NSE at 48 h after OHCA is a useful predictor of 12-month-prognosis in young patients and in patients with a long time from collapse to ROSC, but not in old patients or patients with a short time to ROSC.
  • Hallikainen, Juhana (2016)
  • Silfvast, Catharina (Helsingin yliopisto, 2020)
    Akut hjärtstopp är den vanligaste dödsorsaken i västländerna. Av prehospitala patienter med hjärtstopp överlever endast 7-8%. Speciellt initialrytmen pulslös elektsik aktivitet (PEA) har en väldigt dålig prognos. På senare tid har man märkt att incidensen av PEA ökat samtidigt som prognosen blivit något bättre. Trots det är överlevnaden fortfarande låg. Avsikten med denna studie är att kartlägga hurdana patienter som återfår spontan cirkulation (ROSC) efter prehospitalt PEA inom Nyland samt att beskriva faktorer som påverkar överlevnaden. Detta är en retrospektiv observationsstudie där data samlades för hand från läkarhelikoptern Medi-Helis (nuförtiden FinnHEMS 10) Vanda basens pappersjournaler mellan åren 2010 - 2013. Ur journalerna identifierades alla över 18 år gamla patienter som prehospitalt fått hjärtstopp med initialrytmen PEA, uppnått spontan cirkulation och överlevt till sjukhuset. Sammanlagt inkluderades 90 patienter i studien, var av 64 var män och 26 kvinnor. Patienterna hade en medelålder på 67,5 år och ROSC uppnåddes i medeltal på 19 minuter. Etiologin bakom initialrytmen PEA är bred och patienterna i regel mångsjuka. En 90 dygns överlevnad tyder på en god fortsatt prognos. Varken kön eller ålder påverkade signifikant överlevnaden i denna studie. Självständiga patienter med god cerebral prestationsförmåga vid tidpunkten för hjärtstoppet har en större sannolikhet att överleva. Även en kort ROSC tid korrelerar positivt med prognosen. (208 ord)