{"id":20222,"date":"2022-10-26T11:02:51","date_gmt":"2022-10-26T16:02:51","guid":{"rendered":"https:\/\/cdtrp.ca\/en\/?post_type=spucpt&p=20222"},"modified":"2022-10-26T11:02:51","modified_gmt":"2022-10-26T16:02:51","slug":"david-zorko-3mt","status":"publish","type":"spucpt","link":"https:\/\/cdtrp.ca\/en\/spucpt\/david-zorko-3mt\/","title":{"rendered":"David Zorko 3MT"},"content":{"rendered":"

David Zorko’s bio<\/strong><\/p>\n

\"\"<\/p>\n

Dr. David Zorko is a Pediatric Critical Care Medicine fellow at The Hospital\u00a0for Sick Children (Toronto, Canada). He obtained his medical degree from the University of Ottawa. He subsequently completed his Pediatrics residency in the Clinician Investigator Program at McMaster University, concurrently obtaining his MSc in Health Research Methodology. Dr. Zorko’s research interests include long-term morbidities experienced by children and families following critical illness, and crowdsourcing and machine-learning methodologies in the conduct of systematic reviews.<\/p>\n

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Autoresuscitation After Circulatory Arrest: An Updated Systematic Review <\/strong><\/p>\n

David J. Zorko; Jonah Shemie; Laura Hornby; Gurmeet Singh; Shauna Matheson; Ryan Sandarage; K Wollny; L Kongkiattikul; Sonny Dhanani<\/em><\/p>\n

Introduction & Objective: In organ donation following death determination by circulatory criteria (DCD), circulation must be determined to have permanently ceased to ensure that death has occurred. Current practice recommends a 5-minute observation period following circulatory arrest to monitor for an unassisted return of circulation, known as autoresuscitation. In light of newer data, the objective of this updated systematic review was to determine if a 5-minute observation time was still adequate in DCD.<\/p>\n

Methods: We searched four electronic databases from inception to August 28, 2021 for studies evaluating or describing autoresuscitation events after circulatory arrest. Citation screening and data abstraction were conducted independently and in duplicate. We assessed certainty in evidence using the GRADE framework.<\/p>\n

Results: Of 3741 unique citations assessed, 136 full texts were reviewed, and 73 studies met eligibility criteria. Of these, 45 studies were included in our previous reviews, leaving 18 new studies identified in this update consisting of 14 case reports and four observational studies. Most studies evaluated adults (n=15, 83%) and patients with unsuccessful resuscitation of cardiac arrest (n=11, 61%). Overall, timing of autoresuscitation after circulatory arrest ranged from 1 to 20 minutes. Across all studies on autoresuscitation identified by our reviews (n=73), seven observational studies have been conducted. When examining studies of withdrawal of life-sustaining measures with or without DCD (n=6), 1037 adult and 12 pediatric patients have been evaluated with 23 total autoresuscitation events (2.2%; 95% CI 1.4-3.3%). All resumptions occurred within 5 minutes of circulatory arrest and all patients with autoresuscitation died.<\/p>\n

Conclusion: In the context of controlled DCD, the current evidence demonstrates that 5 minutes is sufficient observation time for death determination by circulatory criteria (moderate certainty). The findings of this systematic review will be incorporated into a Canadian guideline on death determination.<\/p>\n","protected":false},"author":6,"template":"","class_list":["post-20222","spucpt","type-spucpt","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/spucpt\/20222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/spucpt"}],"about":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/types\/spucpt"}],"author":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/users\/6"}],"wp:attachment":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media?parent=20222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}