Resuscitation
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Comparative Study
Lack of a neuroprotective effect from N-acetylcysteine after cardiac arrest and resuscitation in a canine model.
Oxygen free radicals cause brain injury following resuscitation from cardiac arrest. In preclinical trials, some free radical scavenging drugs reduce oxidative neuronal damage after ischemia and reperfusion, but these drugs are generally not yet available for clinical testing or use. N-Acetylcysteine (NAC), a commonly used antidote in acetaminophen poisoning, is also a potent free radical scavenger that can ameliorate oxidative injury following ischemia and reperfusion in neuronal cell culture. We hypothesized that treatment with NAC would improve neurological outcome after cardiac arrest and resuscitation. ⋯ No neuroprotective effect was found from the administration of NAC at currently used clinical dosages, to dogs subjected to 10 min of global cerebral ischemia from cardiac arrest and resuscitation.
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Comparative Study
There is a difference in characteristics and outcome between women and men who suffer out of hospital cardiac arrest.
To evaluate whether there is a difference in characteristics and outcome in relation to gender among patients who suffer out of hospital cardiac arrest. ⋯ Among patients who suffer out of hospital cardiac arrest with attempted CPR women differ from men being older, receive bystander CPR less frequently, have a cardiac etiology less frequently and are found in ventricular fibrillation less frequently. Finally female gender is associated with an increased chance of arriving at hospital alive.
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Randomized Controlled Trial Comparative Study Clinical Trial
The time required to perform different methods for endotracheal drug administration during CPR.
We compared the times necessary to perform different endotracheal drug application techniques during CPR. In a simulated CPR situation with a mannequin 28 paramedics and seven emergency physicians performed different drug instillation techniques in a randomized manner: direct injection into the upper end of the endotracheal tube (group tube), via a suction catheter placed into the bronchial system (group suction catheter), via a flexible venous catheter placed into the bronchial system (group venous catheter), using an EDGAR tube (an endotracheal tube with an injection channel within the wall of the tube (group EDGAR). We measured the time necessary to prepare the drug solution and compared the time necessary to prepare and perform each instillation method and the time the ventilation was interrupted. ⋯ The time of interruption of chest compression's and ventilation: group suction tube (11; 5-19 s) and group catheter (12; 6-18 s) was significant longer than in group tube (5; 2-9 s) (p < 0.05). In group EDGAR the connection ventilator-tube remained intact due to its concept of drug application. The use of special devices such as suction catheters or venous catheters for endotracheal instillation during CPR results in significantly longer preparation and instillation times with a longer interruption of the oxygen supply and chest compression's.
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To assess whether socioeconomic status (SES) or race is associated with adverse outcome after an out-of-hospital cardiac arrest (OHCA). ⋯ In this population, neither race nor SES was independently associated with a worse outcome after OHCA.
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Comparative Study
Improved haemodynamics and restoration of spontaneous circulation with constant aortic occlusion during experimental cardiopulmonary resuscitation.
Continuous balloon occlusion of the descending aorta is an experimental method that may improve blood flow to the myocardium and the brain during cardiopulmonary resuscitation (CPR). The aim of the present investigation was to evaluate the effects of this intervention on haemodynamics and the frequency of restoration of spontaneous circulation. Ventricular fibrillation was induced in 39 anaesthetised piglets, followed by an 8-min non-intervention interval. ⋯ The difference between these two proportions was 0.46, which was statistically significant with a 95% confidence interval from 0.12 to 0.80. In conclusion, balloon occlusion of the descending aorta increased coronary and common carotid artery blood flow and the frequency of restoration of spontaneous circulation. It was also noted that epinephrine appears to augment the redistribution of blood flow caused by the aortic occlusion.