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Article ; Online: Candidacy Assessment for Extracorporeal CPR in Out-of-Hospital Cardiac Arrest: Still Much to Learn.

Grunau, Brian / Bělohlávek, Jan

2023 Volume 165, Issue 4, Page(s) 759–761

MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation ; Learning
Language	English
Publishing date	2023-12-27
Publishing country	United States
Document type	Editorial
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2023.11.032
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Ui III Zs.45: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Trends in out-of-hospital cardiac arrest across the world: Additional data from the CanROC and RéAC national registries.

Heidet, Matthieu / Grunau, Brian / Vaillancourt, Christian / Baert, Valentine

Resuscitation

2023 Volume 187, Page(s) 109786

MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/epidemiology ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation ; Registries ; Emergency Medical Services
Language	English
Publishing date	2023-04-04
Publishing country	Ireland
Document type	Letter ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2023.109786
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Article ; Online: ECPR for in- and out-of-hospital cardiac arrest: Siblings or distant cousins?

Shinar, Zachary / Grunau, Brian

Resuscitation

2021 Volume 171, Page(s) 105–106

MeSH term(s)	Cardiopulmonary Resuscitation ; Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Siblings
Language	English
Publishing date	2021-12-24
Publishing country	Ireland
Document type	Editorial ; Comment
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2021.12.018
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Article ; Online: A goal to transform public access defibrillation to all access defibrillation.

Grunau, Brian / Rea, Thomas

Resuscitation

2021 Volume 162, Page(s) 417–419

MeSH term(s)	COVID-19 ; Canada ; Defibrillators ; Goals ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-02-15
Publishing country	Ireland
Document type	Editorial ; Comment
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2021.02.018
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Article ; Online: Cardiorespiratory Sensors and Their Implications for Out-of-Hospital Cardiac Arrest Detection: A Systematic Review.

Lingawi, Saud / Hutton, Jacob / Khalili, Mahsa / Shadgan, Babak / Christenson, Jim / Grunau, Brian / Kuo, Calvin

Annals of biomedical engineering

2024 Volume 52, Issue 5, Page(s) 1136–1158

Abstract: Out-of-hospital cardiac arrest (OHCA) is a major health problem, with a poor survival rate of 2-11%. For the roughly 75% of OHCAs that are unwitnessed, survival is approximately 2-4.4%, as there are no bystanders present to provide life-saving ... ...

Abstract	Out-of-hospital cardiac arrest (OHCA) is a major health problem, with a poor survival rate of 2-11%. For the roughly 75% of OHCAs that are unwitnessed, survival is approximately 2-4.4%, as there are no bystanders present to provide life-saving interventions and alert Emergency Medical Services. Sensor technologies may reduce the number of unwitnessed OHCAs through automated detection of OHCA-associated physiological changes. However, no technologies are widely available for OHCA detection. This review identifies research and commercial technologies developed for cardiopulmonary monitoring that may be best suited for use in the context of OHCA, and provides recommendations for technology development, testing, and implementation. We conducted a systematic review of published studies along with a search of grey literature to identify technologies that were able to provide cardiopulmonary monitoring, and could be used to detect OHCA. We searched MEDLINE, EMBASE, Web of Science, and Engineering Village using MeSH keywords. Following inclusion, we summarized trends and findings from included studies. Our searches retrieved 6945 unique publications between January, 1950 and May, 2023. 90 studies met the inclusion criteria. In addition, our grey literature search identified 26 commercial technologies. Among included technologies, 52% utilized electrocardiography (ECG) and 40% utilized photoplethysmography (PPG) sensors. Most wearable devices were multi-modal (59%), utilizing more than one sensor simultaneously. Most included devices were wearable technologies (84%), with chest patches (22%), wrist-worn devices (18%), and garments (14%) being the most prevalent. ECG and PPG sensors are heavily utilized in devices for cardiopulmonary monitoring that could be adapted to OHCA detection. Developers seeking to rapidly develop methods for OHCA detection should focus on using ECG- and/or PPG-based multimodal systems as these are most prevalent in existing devices. However, novel sensor technology development could overcome limitations in existing sensors and could serve as potential additions to or replacements for ECG- and PPG-based devices.
MeSH term(s)	Humans ; Cardiopulmonary Resuscitation/methods ; Out-of-Hospital Cardiac Arrest/diagnosis ; Emergency Medical Services ; Electrocardiography ; Photoplethysmography
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	185984-5
ISSN	1573-9686 ; 0191-5649 ; 0090-6964
ISSN (online)	1573-9686
ISSN	0191-5649 ; 0090-6964
DOI	10.1007/s10439-024-03442-y
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Article ; Online: Investigating the Antibody Imprinting Hypothesis among Canadian Paramedics after SARS-CoV-2 Omicron Variant Circulation.

Asamoah-Boaheng, Michael / Grunau, Brian / Karim, Mohammad Ehsanul / Kayda, Iryna / Yap, Justin / Bessai, Katherine / Goldfarb, David M

ImmunoHorizons

2024 Volume 8, Issue 2, Page(s) 193–197

Abstract: Recent research has highlighted the Omicron variant's capacity to evade immune protection conferred by wild-type (WT) mRNA vaccines. Despite this observation, the potential involvement of antigenic sin phenomena remains unclear. Our hypothesis posited ... ...

Abstract	Recent research has highlighted the Omicron variant's capacity to evade immune protection conferred by wild-type (WT) mRNA vaccines. Despite this observation, the potential involvement of antigenic sin phenomena remains unclear. Our hypothesis posited that a greater number of prior WT vaccine doses might lead to reduced anti-Omicron neutralization Abs following Omicron infection. To investigate this, we analyzed blood samples from human participants in the COVID-19 Occupational Risk, Seroprevalence, and Immunity among Paramedics (CORSIP) study who had received at least one WT mRNA vaccine before contracting Omicron. The exposure variable was the number of WT mRNA vaccines administered, and the outcome was the angiotensin-converting enzyme 2 (ACE-2) percent inhibition specific to the BA.4/BA.5 Omicron Ag. Contrary to expectations, our findings revealed that more WT-based vaccines were associated with an enhanced Omicron-specific immune response.
MeSH term(s)	Humans ; SARS-CoV-2 ; Paramedics ; Seroepidemiologic Studies ; mRNA Vaccines ; COVID-19 ; Canada/epidemiology ; Antibodies
Chemical Substances	mRNA Vaccines ; Antibodies
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ISSN	2573-7732
ISSN (online)	2573-7732
DOI	10.4049/immunohorizons.2400010
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Article ; Online: Out-of-hospital cardiac arrests occurring at school in France: A nation-wide retrospective cohort study from the RéAC registry.

Lafrance, Martin / Canon, Valentine / Hubert, Hervé / Grunau, Brian / Javaudin, François / Recher, Morgan / Heidet, Matthieu

Resuscitation

2023 Volume 189, Page(s) 109888

Abstract: Aim: We sought to describe the characteristics of at-school out-of-hospital cardiac arrests cases, subsequent basic life support, as well as ultimate patient outcomes.: Methods: This was a nation-wide, multicentre, retrospective cohort study from the ...

Abstract	Aim: We sought to describe the characteristics of at-school out-of-hospital cardiac arrests cases, subsequent basic life support, as well as ultimate patient outcomes. Methods: This was a nation-wide, multicentre, retrospective cohort study from the French national population-based RéAC out-of-hospital cardiac arrest registry (July 2011 - March 2023). We compared the characteristics and outcomes of cases occurring at schools vs. in other public places. Results: Of the 149,088 national out-of-hospital cardiac arrests, 25,071 were public: 86 (0.3%) and 24,985 (99.7%) in schools and other public places, respectively. At-school out-of-hospital cardiac arrests, in comparison to other public places, were: significantly younger (median: 42.5 vs. 58 years, p < 0.001); more commonly of a medical cause (90.7% vs. 63.8%, p < 0.001), more commonly bystander-witnessed (93.0% vs. 73.4%, p < 0.001) and recipients of bystander cardiopulmonary resuscitation (78.8% vs. 60.6%, p = 0.001) with shorter median no-flow durations (2 min. vs. 7 min.); with greater bystander automated external defibrillator application (38.9% vs. 18.4%) and defibrillation (23.6%, vs. 7.9%; all p < 0.001). At-school patients had greater rates of return of spontaneous circulation than out-of-school ones (47.7%, vs. 31.8%; p = 0.002), higher rates of survival at arrival at hospital (60.5% vs. 30.7%; p < 0.001) and at 30-days (34.9% vs. 11.6%; p < 0.001), and survival with favourable neurological outcomes at 30 days (25.9% vs. 9.2%; p < 0.001). Conclusion: At-school out-of-hospital cardiac arrests were rare in France, however demonstrated favourable prognostic features and outcomes. The use of automated external defibrillators in at-school cases, while more common than cases occurring elsewhere, should be improved.
MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/epidemiology ; Out-of-Hospital Cardiac Arrest/therapy ; Retrospective Studies ; Cardiopulmonary Resuscitation ; Defibrillators ; Registries ; Schools ; France/epidemiology ; Emergency Medical Services
Language	English
Publishing date	2023-06-26
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2023.109888
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Article ; Online: One-year survival after out-of- hospital cardiac arrest: Sex-based survival analysis in a Canadian population.

Awad, Emad / Fordyce, Christopher B / Grunau, Brian / Christenson, Jim / Helmer, Jennie / Humphries, Karin

Journal of the American College of Emergency Physicians open

2023 Volume 4, Issue 3, Page(s) e12957

Abstract: Objective: We investigated sex differences in 1-year survival in a cohort of patients who survived out-of-hospital cardiac arrest (OHCA) to hospital discharge. We hypothesized that female sex is associated with higher 1-year posthospital discharge ... ...

Abstract	Objective: We investigated sex differences in 1-year survival in a cohort of patients who survived out-of-hospital cardiac arrest (OHCA) to hospital discharge. We hypothesized that female sex is associated with higher 1-year posthospital discharge survival. Methods: A retrospective analysis of linked data (2011-2017) from clinical databases in British Columbia (BC) was conducted. We used Kaplan-Meier curves, stratified by sex, to display survival up to 1-year, and the log-rank test to test for significant sex differences. This was followed by multivariable Cox proportional hazards analysis to investigate the association between sex and 1-year mortality. The multivariable analysis adjusted for variables known to be associated with survival, including variables related to OHCA characteristics, comorbidities, medical diagnoses, and in-hospital interventions. Results: We included 1278 hospital-discharge survivors; 284 (22.2%) were female. Females had a lower proportion of OHCA occurring in public locations (25.7% vs. 44.0%, Conclusion: Females have relatively unfavorable prehospital characteristics in OHCA and fewer hospital-based acute coronary diagnoses and interventions. However, among survivors to hospital discharge, we found no significant difference between males and females in 1-year survival, even after adjustment.
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Journal Article
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.12957
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Article: Prehospital initiation of mild therapeutic hypothermia for out-of-hospital cardiac arrest (OHCA): where are we now?

Grunau, Brian E

CJEM

2015 Volume 17, Issue 3, Page(s) 227–230

MeSH term(s)	Cardiopulmonary Resuscitation/methods ; Humans ; Hypothermia, Induced/methods ; Out-of-Hospital Cardiac Arrest/therapy
Language	English
Publishing date	2015-05
Publishing country	England
Document type	Editorial
ZDB-ID	2059217-6
ISSN	1481-8035 ; 1481-8035 ; 1488-1543
ISSN (online)	1481-8035
ISSN	1481-8035 ; 1488-1543
DOI	10.1017/cem.2015.32
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Article ; Online: Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia.

Saczkowski, Richard / Kuzak, Nick / Grunau, Brian / Schulze, Costas

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2020 Volume 59, Issue 3, Page(s) 593–600

Abstract: Objectives: Favourable outcomes have been demonstrated after extracorporeal life support (ECLS) facilitated rewarming for severe accidental hypothermia. The clinical impact of varying rewarming rates however is unclear. We sought to quantify the change ... ...

Abstract	Objectives: Favourable outcomes have been demonstrated after extracorporeal life support (ECLS) facilitated rewarming for severe accidental hypothermia. The clinical impact of varying rewarming rates however is unclear. We sought to quantify the change in the probability of good neurological outcome with ECLS rewarming rate and identify the optimal rewarming rate threshold. Methods: We performed a secondary analysis of the International ACcidental Hypothermia Extracorporeal Life Support Collaborators, an individual patient data data set (n = 658) for ECLS-assisted rewarming for accidental hypothermia. The independent variable of interest was rewarming rate. The primary outcome was survival with good neurological status. We applied an adjusted marginal effects model to quantify the probability of good neurological outcome over clinically observed rewarming rates. We examined strata defined by sex, initial potassium level and history of asphyxiation. Results: Of 658 cases, the median age and initial core temperature were 36 years (22-55) and 24.5°C (22.1-26.2) respectively; 190 (29%) were female, and 547 (83%) had a non-perfusing initial cardiac rhythm. The mean rewarming rate was 7.0°C/h. The median ECLS duration was 5.8 h (range: 0.5-158 h). The overall survival was 46% (n = 303/658), and good neurological outcome was 40% (n = 265/658). The median intensive care unit and hospital length of stay was 5 days (range: 1-35 days) and 18 days (range: 1-106 days), respectively. Marginal effects analysis demonstrated a 1.9% decrease in the probability of survival with good neurological outcome for each 1°C/h increase in rewarming. Across the reported range of rewarming rates (0.05-30.8°C/h), the probability of good neurological outcome declined from 49.6% to 4.1% for an average patient. The relationship was similar within various subgroups. The optimal cut-off threshold for the rate of rewarming to distinguish between a good and poor neurological outcome was ≤5.0°C/h. Conclusions: Among cases with severe accidental hypothermia treated with ECLS, slower rewarming rates are associated with improved survival with good neurological outcomes. Slow rewarming, at rates ≤5.0°C/h, may improve clinical outcomes.
MeSH term(s)	Extracorporeal Membrane Oxygenation ; Female ; Humans ; Hypothermia/therapy ; Rewarming ; Survival Rate
Language	English
Publishing date	2020-11-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezaa385
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