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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mortality after cardiac arrest &#40;CA&#41; remains very high despite advances in advanced life support &#40;ALS&#41; and post-resuscitation care&#46; CA is usually divided into two categories&#58; out-of-hospital &#40;OHCA&#41; and in-hospital &#40;IHCA&#41; cardiac arrest&#46; Survival rates at hospital discharge vary considerably between studies and regions&#44; but major studies report rates of 15&#37; for IHCA<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> and 9&#37; for OHCA in Europe&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Mortality generally results from post-resuscitation circulatory failure&#44; mainly due to systemic ischemia-reperfusion&#44; or post-anoxic brain injury&#44; the two situations sharing similar risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Survival rates after OHCA are highly dependent on the organization of emergency medical services &#40;EMS&#41;&#44; rates of bystander basic life support &#40;BLS&#41;&#44; time to first defibrillation&#44; quality of ALS and post-resuscitation care&#44; i&#46;e&#46; the quality of the local chain of survival&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> On the other hand&#44; most patients who suffer IHCA will show signs of clinical deterioration in the hours preceding the event&#46; While the quality of the chain of survival is also important&#44; recognizing those at risk of CA and timely initiation of appropriate therapeutic interventions is of the utmost importance for preventing IHCA&#46; Regarding functional outcomes&#44; especially the crucial neurologic outcome of CA survivors&#44; these are in part determined by the patient&#39;s underlying health status and arrest-specific factors&#44; but many aspects of medical care may influence outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> There are significant site-specific differences in functional outcomes after adjusting for patient-specific factors&#46; The overall prevalence of good outcome can range from 11&#37; to 63&#37; between centers&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> These differences are partially explained by in-hospital treatment decisions&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> particularly regarding post-resuscitation care&#44; for which many measures are associated with outcome&#44; such as targeted temperature management&#44; use of coronary angiography and percutaneous coronary intervention&#44; mechanical circulatory support&#44; glucose control&#44; oxygenation and ventilation techniques&#44; blood pressure management&#44; sedation regimes&#44; and prognostication&#46; According to May et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> high-performing centers had faster time to target temperature&#44; were more likely to have a target temperature of 33<span class="elsevierStyleHsp" style=""></span>&#176;C and to perform unconscious cardiac catheterization and percutaneous coronary intervention&#44; and had differing prognostication methods &#40;which include modalities such as continuous electroencephalography and monitoring of somatosensory evoked potential&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Specialists in cardiology and intensive care medicine are in fact frequently involved in the early management of these patients&#44; and close collaboration between departments is absolutely essential&#46; The local incidence and outcomes of patients following CA are relevant issues in both cardiology and intensive care medicine&#44; especially so in Portugal&#44; given the scarcity of published data on this important subject&#46; Unfortunately&#44; at this time&#44; there is no risk-adjustment standard for benchmarking hospital performance&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context&#44; Menezes Fernandes et al&#46; performed a retrospective study of 187 patients &#40;median age 67 years&#41; admitted within 24 hours of CA of different etiologies to the intensive care medicine department of Faro Hospital between 1 January 2014 and 31 December 2018&#46; The authors describe the characteristics&#44; clinical outcomes and variables associated with survival and functional status at discharge&#46; They compare the characteristics of CA and management in the intensive care unit &#40;ICU&#41; between survivors and non-survivors&#44; and also between patients with good neurologic outcome &#40;defined by cerebral performance category &#91;CPC&#93; of 1 or 2 at hospital discharge&#41; and poor neurologic outcome &#40;CPC 3 or 4&#41;&#46; Finding factors associated with better survival and better neurologic outcome could help improve the management and consequently the prognosis of these patients&#44; which is of the utmost importance&#46; Unfortunately&#44; patients who suffered CA due to ST-elevation myocardial infarction &#40;the most frequent cause of out-of-hospital CA everywhere&#41; or other cardiac cause of CA identified before hospital admission were admitted directly to the coronary ICU in the cardiology department and were excluded from the analysis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this series&#44; most CAs occurred at the hospital &#40;61&#37;&#41;&#44; mostly in the ward &#40;36&#37;&#41;&#46; The first monitored rhythm was non-shockable in 87&#37; of patients and the median time between CA and return of spontaneous circulation &#40;ROSC&#41; &#40;downtime&#41; was 10 min&#44; which indicates a good organization of the local EMS&#46; Presumed cardiac causes accounted for only 31&#37; of CAs and of these&#44; 33&#37; were acute coronary syndrome&#44; 32&#37; acute or chronic decompensated heart failure and 32&#37; pulmonary embolism&#46; As expected&#44; neurologic lesions were the main post-CA dysfunction &#40;43&#37;&#41;&#46; In-hospital mortality was 63&#37;&#44; 45&#37; of which was associated with withholding or withdrawal of life support&#46; Forty-seven of the 69 patients who survived and were discharged were classified as CPC 1&#44; resulting in a prevalence of good neurologic outcome of 25&#37;&#46; Mortality at 12 months was 72&#37;&#44; which is high but lower than in previous reports&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Comparisons of CA characteristics and ICU management between survivors and non-survivors enable important conclusions to be drawn&#46; First and foremost&#44; non-immediate initiation of BLS&#44; higher Simplified Acute Physiology Score II score and higher indexed duration of vasopressor support were found to be independent predictors of in-hospital mortality&#44; while shockable rhythms were associated with improved survival&#46; These conclusions highlight the importance of the pre-hospital approach&#44; including immediate initiation of BLS and prompt defibrillation&#44; supporting the need to train &#40;and periodically re-train&#41; populations both outside and inside the hospital&#46; They also reinforce the impact of optimal post-resuscitation care on clinical outcome&#46; Regarding neurologic outcomes&#44; patients discharged with a good neurologic outcome &#40;CPC 1 or 2&#41;&#44; as expected&#44; had significantly less frequent epileptic activity &#40;in which the authors included myoclonus&#41; and a shorter course of ventilatory support than those with CPC 3 or 4&#44; but&#44; unlike in other series&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> there were no significant differences in terms of witnessed arrest&#44; initiation of BLS&#44; first monitored rhythm&#44; downtime&#44; Glasgow Coma Scale after ROSC&#44; or implementation of the normothermia protocol&#46; As expected&#44; immediate BLS and downtime in patients who suffered OHCA were worse than in IHCA patients&#44; but there were no statistically significant differences between their clinical outcomes&#44; with mortality of 63&#37; for both&#46; One explanation for this phenomenon could be the well-organized local EMS&#44; as stated by the authors&#44; and as indicated by the good downtime in both groups&#46; Finally&#44; unlike some studies that report worse survival in women&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> there were no significant differences in mortality or neurologic outcomes between the sexes&#46; As observed above&#44; excluding patients admitted directly to the coronary ICU meant that the prevalence of cardiac causes and the percentage of shockable rhythms were lower than in other series&#44; which affected the overall results and clinical outcomes&#46; This is one of the study&#39;s main limitations&#44; but it is also of value&#44; since this effect is less explored and more representative of the actual work of a general ICU&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Overall survival from CA&#44; although increasing&#44; remains comparatively low&#44; and studies powered to show significant reductions in mortality typically need to recruit several thousand patients&#44; which would be difficult in this dramatic scenario&#46; Prospective controlled studies in resuscitation require collaboration across multiple sites&#44; thorough organization and careful ethical consideration&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> and we all look forward to seeing them soon&#46; Meanwhile&#44; it is essential to make a common effort&#44; including the general population as well as the medical profession&#44; to improve all links of the chain of survival&#44; so that outcomes can be improved now&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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Surviving a cardiac arrest: need for action now!
Sobreviver a uma paragem cardíaca: é necessário agir agora!
Doroteia Silvaa,b
a Intensive Care Department, Santa Maria University Hospital, Lisbon North Hospital Centre, CCUL, Lisbon, Portugal
b Academic Medical Center, Faculty of Medicine of Lisbon, Lisbon, Portugal
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    "titulo" => "Surviving a cardiac arrest&#58; need for action now&#33;"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mortality after cardiac arrest &#40;CA&#41; remains very high despite advances in advanced life support &#40;ALS&#41; and post-resuscitation care&#46; CA is usually divided into two categories&#58; out-of-hospital &#40;OHCA&#41; and in-hospital &#40;IHCA&#41; cardiac arrest&#46; Survival rates at hospital discharge vary considerably between studies and regions&#44; but major studies report rates of 15&#37; for IHCA<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> and 9&#37; for OHCA in Europe&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Mortality generally results from post-resuscitation circulatory failure&#44; mainly due to systemic ischemia-reperfusion&#44; or post-anoxic brain injury&#44; the two situations sharing similar risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Survival rates after OHCA are highly dependent on the organization of emergency medical services &#40;EMS&#41;&#44; rates of bystander basic life support &#40;BLS&#41;&#44; time to first defibrillation&#44; quality of ALS and post-resuscitation care&#44; i&#46;e&#46; the quality of the local chain of survival&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> On the other hand&#44; most patients who suffer IHCA will show signs of clinical deterioration in the hours preceding the event&#46; While the quality of the chain of survival is also important&#44; recognizing those at risk of CA and timely initiation of appropriate therapeutic interventions is of the utmost importance for preventing IHCA&#46; Regarding functional outcomes&#44; especially the crucial neurologic outcome of CA survivors&#44; these are in part determined by the patient&#39;s underlying health status and arrest-specific factors&#44; but many aspects of medical care may influence outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> There are significant site-specific differences in functional outcomes after adjusting for patient-specific factors&#46; The overall prevalence of good outcome can range from 11&#37; to 63&#37; between centers&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> These differences are partially explained by in-hospital treatment decisions&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> particularly regarding post-resuscitation care&#44; for which many measures are associated with outcome&#44; such as targeted temperature management&#44; use of coronary angiography and percutaneous coronary intervention&#44; mechanical circulatory support&#44; glucose control&#44; oxygenation and ventilation techniques&#44; blood pressure management&#44; sedation regimes&#44; and prognostication&#46; According to May et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> high-performing centers had faster time to target temperature&#44; were more likely to have a target temperature of 33<span class="elsevierStyleHsp" style=""></span>&#176;C and to perform unconscious cardiac catheterization and percutaneous coronary intervention&#44; and had differing prognostication methods &#40;which include modalities such as continuous electroencephalography and monitoring of somatosensory evoked potential&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Specialists in cardiology and intensive care medicine are in fact frequently involved in the early management of these patients&#44; and close collaboration between departments is absolutely essential&#46; The local incidence and outcomes of patients following CA are relevant issues in both cardiology and intensive care medicine&#44; especially so in Portugal&#44; given the scarcity of published data on this important subject&#46; Unfortunately&#44; at this time&#44; there is no risk-adjustment standard for benchmarking hospital performance&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context&#44; Menezes Fernandes et al&#46; performed a retrospective study of 187 patients &#40;median age 67 years&#41; admitted within 24 hours of CA of different etiologies to the intensive care medicine department of Faro Hospital between 1 January 2014 and 31 December 2018&#46; The authors describe the characteristics&#44; clinical outcomes and variables associated with survival and functional status at discharge&#46; They compare the characteristics of CA and management in the intensive care unit &#40;ICU&#41; between survivors and non-survivors&#44; and also between patients with good neurologic outcome &#40;defined by cerebral performance category &#91;CPC&#93; of 1 or 2 at hospital discharge&#41; and poor neurologic outcome &#40;CPC 3 or 4&#41;&#46; Finding factors associated with better survival and better neurologic outcome could help improve the management and consequently the prognosis of these patients&#44; which is of the utmost importance&#46; Unfortunately&#44; patients who suffered CA due to ST-elevation myocardial infarction &#40;the most frequent cause of out-of-hospital CA everywhere&#41; or other cardiac cause of CA identified before hospital admission were admitted directly to the coronary ICU in the cardiology department and were excluded from the analysis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this series&#44; most CAs occurred at the hospital &#40;61&#37;&#41;&#44; mostly in the ward &#40;36&#37;&#41;&#46; The first monitored rhythm was non-shockable in 87&#37; of patients and the median time between CA and return of spontaneous circulation &#40;ROSC&#41; &#40;downtime&#41; was 10 min&#44; which indicates a good organization of the local EMS&#46; Presumed cardiac causes accounted for only 31&#37; of CAs and of these&#44; 33&#37; were acute coronary syndrome&#44; 32&#37; acute or chronic decompensated heart failure and 32&#37; pulmonary embolism&#46; As expected&#44; neurologic lesions were the main post-CA dysfunction &#40;43&#37;&#41;&#46; In-hospital mortality was 63&#37;&#44; 45&#37; of which was associated with withholding or withdrawal of life support&#46; Forty-seven of the 69 patients who survived and were discharged were classified as CPC 1&#44; resulting in a prevalence of good neurologic outcome of 25&#37;&#46; Mortality at 12 months was 72&#37;&#44; which is high but lower than in previous reports&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Comparisons of CA characteristics and ICU management between survivors and non-survivors enable important conclusions to be drawn&#46; First and foremost&#44; non-immediate initiation of BLS&#44; higher Simplified Acute Physiology Score II score and higher indexed duration of vasopressor support were found to be independent predictors of in-hospital mortality&#44; while shockable rhythms were associated with improved survival&#46; These conclusions highlight the importance of the pre-hospital approach&#44; including immediate initiation of BLS and prompt defibrillation&#44; supporting the need to train &#40;and periodically re-train&#41; populations both outside and inside the hospital&#46; They also reinforce the impact of optimal post-resuscitation care on clinical outcome&#46; Regarding neurologic outcomes&#44; patients discharged with a good neurologic outcome &#40;CPC 1 or 2&#41;&#44; as expected&#44; had significantly less frequent epileptic activity &#40;in which the authors included myoclonus&#41; and a shorter course of ventilatory support than those with CPC 3 or 4&#44; but&#44; unlike in other series&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> there were no significant differences in terms of witnessed arrest&#44; initiation of BLS&#44; first monitored rhythm&#44; downtime&#44; Glasgow Coma Scale after ROSC&#44; or implementation of the normothermia protocol&#46; As expected&#44; immediate BLS and downtime in patients who suffered OHCA were worse than in IHCA patients&#44; but there were no statistically significant differences between their clinical outcomes&#44; with mortality of 63&#37; for both&#46; One explanation for this phenomenon could be the well-organized local EMS&#44; as stated by the authors&#44; and as indicated by the good downtime in both groups&#46; Finally&#44; unlike some studies that report worse survival in women&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> there were no significant differences in mortality or neurologic outcomes between the sexes&#46; As observed above&#44; excluding patients admitted directly to the coronary ICU meant that the prevalence of cardiac causes and the percentage of shockable rhythms were lower than in other series&#44; which affected the overall results and clinical outcomes&#46; This is one of the study&#39;s main limitations&#44; but it is also of value&#44; since this effect is less explored and more representative of the actual work of a general ICU&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Overall survival from CA&#44; although increasing&#44; remains comparatively low&#44; and studies powered to show significant reductions in mortality typically need to recruit several thousand patients&#44; which would be difficult in this dramatic scenario&#46; Prospective controlled studies in resuscitation require collaboration across multiple sites&#44; thorough organization and careful ethical consideration&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> and we all look forward to seeing them soon&#46; Meanwhile&#44; it is essential to make a common effort&#44; including the general population as well as the medical profession&#44; to improve all links of the chain of survival&#44; so that outcomes can be improved now&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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                        "volumen" => "39"
                        "paginaInicial" => "1972"
                        "paginaFinal" => "1980"
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                        "volumen" => "43"
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                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "237"
                        "paginaFinal" => "245"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17019558"
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ISSN: 21742049
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Revista Portuguesa de Cardiologia (English edition)
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