Resuscitation
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The frequency and duration of interruptions of cardiopulmonary resuscitation (CPR) were evaluated in a hospital to determine whether or not CRP was being performed properly according to American Heart Association (AHA) standards. The frequency of interruptions were 0.41 per min. ⋯ Eighty percent of these interruptions of greater than 20 s duration were of unjustified duration. CPR education should reflect these unjustified deviations and their reasons in an attempt to limit such interruptions in future patient CPR.
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Comparative Study
Treatment of postoperative respiratory distress syndrome.
We have studied 45 patients with postoperative adult respiratory distress syndrome (ARDS) who were treated by mechanical ventilation during the last four years. This period was divided into two periods, and the mortality and progress after treatment were analysed. The overall, mortality was 56%. ⋯ Patients of types 3 and 4 had extremely poor prognoses. Stricter management to avoid infection, specific treatment of multiple organ failure (which was seen frequently) seemed advantageous. High frequency positive pressure ventilation (HFPPV) may have some role in improving the respiratory function of the patients with ARDS.
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Measurements of plasma colloid osmotic pressure (COP) were made during and for 24 h after normothermic continuous flow cardiopulmonary bypass (CPB) in 20 adults exposed to sudden haemodilution by a crystalloid pump prime solution. Haematocrit, albumin and total protein were also measured. Within 5 min of starting bypass the mean COP fell to 45% pre-bypass value and remained at this level until bypass was discontinued. ⋯ This significant difference in fall between plasma protein concentration and directly measured COP is explained by their non-linear relationship. Three patients died soon after bypass. They all showed significantly lower values of COP than the mean for the group as a whole at some stage (P less than 0.05).