3 CPR by first responders improves acid-base balance and prognosis in out-of-hospital non-traumatic cardiac arrest
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
<h3>Background</h3> Early basic-CPR has been shown to be effective. However, its effect on homeostasis in non-traumatic out-of-hospital cardiac arrest (OHCA) is unknown. We analyze pathophysiological and prognostic consequences of basic-CPR performed by first responders (FR) previous to EMS arrival. <h3>Method</h3> Prospective observational cohort study including all patients treated for OHCA by an EMS from 2015 to 2017. Basic-CPR by FR and venous blood gas by Epocal (Ottawa, Canada) at the beginning of advanced-CPR were covariates. Dependent variables included analytical values and final outcomes (ROSC and final neurological condition CPC grades I–II). Statistical analysis: Kolmogorov-Smirnov/Lilliefors test of normality, bivariate (T-test and Chi-square-test) and multivariate (logistic regression and recursive partitioning) analysis and association measures (odds ratio-OR). <h3>Results</h3> Our EMS attended 749 OHCA. Eighty-seven cases were excluded due to lack of data on gasometry (52)/FR (35). We analyzed 662 cases (137 women, 65.1±16.1 years-old), 46.1% were shockable rhythms and 63% received basic-CPR. pH was 7.13±0.15 in CPR-by-FR-cases and 7.06±0.18 in non-CPR-by-FR-cases (p<0.001). PvCO2 69±23 vs 77±25 mmHg (p<0.001), base excess −6.6±5.4 vs −8.6±6.6 mmol/L (p<0.001) and lactate 6.4±2.9 vs 7.1±3.3 mmol/L (p=0.008). CPR-by-FR (OR 1.83, CI95% 1.30–2.56, p<0.001) and shockable-rhythm (OR 3.32, CI95% 2.37–4.65, p<0.001) were independently associated with higher pH. ROSC occurred in 62.8% of CPR-by-FR-cases and 54.7% of non-CPR-by-FR-cases; OR 1.40, CI95% 1.02–1.93, p=0.039). Recovery CPC I–II occurred in 27.1% of CPR-by-FR-cases and 19.2% of non-CPR-by-FR-cases; OR 1.57, CI95% 1.06–2.30, p=0.022). <h3>Conclusion</h3> Basic-CPR by FR slows down metabolic and respiratory acidosis. This entails better outcomes. These data reinforce universal CPR training programs. <h3>References</h3> Shin J, Lim YS, Kim K, Lee HJ, Lee SJ, Jung E, <i>et al</i>. Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicentre observational registry-based study. <i>Critical Care</i> 2017;21:322. Corral E, Casado MI, García-Ochoa MJ, Suárez R. Looking a ‘metabolic watch’. The analytical parameters found at the beginning of the resuscitation are predictors of the neurological prognostic in the prehospital cardiac arrest. <i>Resuscitation</i> 2015;96(Suppl 1);148. <h3>Conflict of interest</h3> None. <h3>Funding</h3> None.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it