Resuscitation
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Comparative Study
Effects of the AT1-selective angiotensin II antagonist, telmisartan, on hemodynamics and ventricular function after cardiopulmonary resuscitation in pigs.
The purpose of this study was to investigate the effects of the angiotensin II (ANG II) antagonist, telmisartan, on hemodynamics, myocardial function and myocardial blood flow during the postresuscitation phase in a porcine model of CPR and to compare these to saline. After 4 min of ventricular fibrillation and 5 min of closed-chest CPR, defibrillation was performed in 16 domestic pigs to restore spontaneous circulation (ROSC). Ten minutes after ROSC, animals were allocated to receive either the ANG II antagonist, telmisartan, at a dose of 1 mg/kg (n = 8) or saline (n = 8). ⋯ M.), 42 +/- 4 ml, 38 +/- 2%, 2036 +/- 77 mmHg/s in the telmisartan group and 82 +/- 2 ml (P < 0.05), 59 +/- 3 ml (P < 0.01), 28 +/- 2% (P < 0.01), 1596 +/- 82 mmHg/s (P < 0.01) in the control group, at 240 min after ROSC. No significant differences in mean aortic and pulmonary artery pressure, cardiac index or myocardial blood flow between the two groups were found. We conclude that the ANG II antagonist telmisartan administered during the postresuscitation phase in pigs increases myocardial contractility without changing cardiac index, systemic vascular resistance, pulmonary vascular resistance, or myocardial perfusion.
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American Heart Association as well as European Resuscitation Council require the carotid pulse check to determine pulselessness in an unconscious victim and to decide whether or not cardiopulmonary resuscitation (CPR) should be initiated. Recent studies on the ability of health professionals to check the carotid pulse have called this diagnostic tool in question and led to discussions. To contribute to this discussion we performed a study to evaluate skills of lay people in checking the carotid pulse. ⋯ Only 47.4% of the volunteers were able to detect a pulse within 5 s, and 73.7% within 10 s. A level of 95% volunteers detecting the pulse correctly was reached only after 35 s. Based on these findings we conclude that the intervals established for carotid pulse check may be too short and that perhaps the value of pulse check within in the scope of CPR needs to be reconsidered.
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the purpose of this study was to determine the key factors influencing survival from cardiopulmonary resuscitation and to analyse the effectiveness of a resuscitation training programme. ⋯ data collection and analysis of cardiopulmonary resuscitation attempts are essential for the formulation of survival indicators, and the subsequent training of resuscitation teams.