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By Prentice R.L., Qi L.

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Moreover, many animal studies indicate that outcomes from sudden short-duration VF cardiac arrests are at least as good with chest compressions alone as with chest compressions plus rescue breathing. In addition, several retrospec- 22 tive studies of witnessed VF cardiac arrest in adults also suggest that outcomes are similar after bystander-initiated CPR with either chest compressions alone or chest compressions plus rescue breathing. A randomized, controlled study of dispatcher-assisted bystander CPR in adults found a trend toward improved survival in the patients who received chest compressions alone compared with those who received dispatcher-instructed ventilation and chest compressions [63,64].

Postresuscitation Interventions Temperature Management Mild induced hypothermia is the most celebrated goal-directed postresuscitation therapy for adults. Two seminal articles established that induced hypothermia (32°–34°C) could improve outcome for comatose adults after resuscitation from VF cardiac arrest [33,34]. In both randomized controlled trials, the inclusion criteria were patients older than 18 years who were persistently comatose after successful resuscitation from nontraumatic VF. The multicenter European study had a goal of 32°–34°C for the first 24 hr postarrest.

Despite these promising results, CPR and ECMO are not curative treatments; rather, they are simply cardiopulmonary supportive measures that may allow tissue perfusion and viability until recovery from the precipitating disease process can occur. Most remarkably, Morris et al. reported 66 children who over 7 years were placed on ECMO during CPR at Children’s Hospital of Philadelphia [101]. The median duration of CPR before establishment of ECMO was 50 min, and 35% (23/66) of these children survived to hospital discharge.

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Aspects of the design and analysis of high-dimensional SNP studies for disease risk estimation by Prentice R.L., Qi L.


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