Resuscitation
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Comparative Study Clinical Trial
Prognostic significance of the difference between mixed venous and jugular bulb oxygen saturation in comatose patients resuscitated from a cardiac arrest.
To determine the prognostic significance of the difference between mixed venous and jugular bulb oxygen saturation in survivors and non-survivors of a cardiac arrest, we studied 30 comatose patients (21 non-survivors and 9 survivors) resuscitated from a cardiac arrest. We measured mixed venous oxygen saturation (SmvO2) and jugular bulb oxygen saturation (SjO2) immediately after haemodynamic stabilisation (always within 6 h after cardiac arrest) and 6, 12 and 24 h later. In all patients the SjO2 was about 10% lower than the SmvO2 in the first measurement. ⋯ Sensitivity and specificity are 65 and 89%, respectively. In a previous study we concluded that early jugular bulb oximetry (within 4 h after cardiac arrest) cannot predict cerebral outcome in comatose patients after cardiac arrest. More studies are needed to clarify the role of prolonged monitoring in the prediction of cerebral outcome after cardiac arrest.
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Comparative Study
What are we doing in cardiopulmonary resuscitation training in Europe? An analysis of a survey.
This study has analysed the status of cardiopulmonary resuscitation (CPR) training in Europe in medical schools, cities in the WHO European Healthy Cities network, and hospitals in the WHO European Health Promoting Hospitals network. Three questionnaires tested by a pilot study were sent in 1996-1997: one to medical school deans, one to the WHO Health Promoting Hospitals Network coordinators and one to the focal points of the WHO Healthy Cities Network. The glossary of terms was taken from the Utstein style guidelines. ⋯ The training hours in basic and advanced CPR vary between medical schools and various professional groups trained in hospitals and cities. More time is devoted to training in advanced CPR than in basic CPR and more in theory than practical training. This survey can be an important incentive for European Organisations to identify priorities in their educational efforts.
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Meta Analysis Comparative Study
Effect of active compression-decompression resuscitation (ACD-CPR) on survival: a combined analysis using individual patient data.
Active compression decompression resuscitation (ACD-CPR) has been developed as an alternative to standard cardiopulmonary resuscitation (S-CPR). To determine the effect of ACD-CPR on survival and neurologic outcome in patients with out-of-hospital cardiac arrest, this combined analysis involved individual patient data from 2866 patients from seven separate randomized prospective prehospital studies who had received ACD-CPR or S-CPR after out-of-hospital cardiac arrest in seven international sites. Significant improvement in 1-h survival (odds ratio (OR) = 0.83; confidence interval (CI): 0.695-0.99; P < 0.05) was found with ACD-CPR (n = 1410) versus S-CPR (n = 1456). ⋯ This improvement was largely due to the influence of results from one study site. Neurological outcome and complication rates were comparable between groups. Further study is needed to determine which emergency medical services systems may benefit from out-of-hospital use of ACD-CPR.