Resuscitation
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Randomized Controlled Trial Clinical Trial
A new universal laryngoscope blade: a preliminary comparison with Macintosh laryngoscope blades.
The Dörges universal laryngoscope blade has several features designed to facilitate tracheal intubation. The number of laryngoscope blades may be reduced from four to two, or even one, which indicate less space requirement and costs. This new universal laryngoscope blade, has a lower profile (height 15 vs. 22 mm) than a Macintosh laryngoscope blade size 3 and 4, which may facilitate manoeuvring of the laryngoscope in the mouth. ⋯ Number of intubation failures, the laryngoscopic view according to Cormack and Lehane, and subjective assessment was comparable between groups. Orotracheal intubation of the adult airway management trainer with the Dörges universal laryngoscope blade took significantly less time compared to the Macintosh laryngoscope blades (14 (7-57) vs. 20 (8-43) s; P<0.001); all other intubating times were comparable. In conclusion, in this model, the Dörges universal laryngoscope blade was comparable to the Macintosh laryngoscope blades size 2-4, and may save time, cost and space.
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Comparative Study
Characteristics and outcome among patients suffering from out of hospital cardiac arrest of non-cardiac aetiology.
To describe the epidemiology for out of hospital cardiac arrest of a non-cardiac aetiology. ⋯ Among patients with out of hospital cardiac arrest in whom resuscitation was attempted 25% were judged to be of a non-cardiac aetiology. These patients had a lower survival than patients with a cardiac arrest of cardiac aetiology. However, this was mainly explained by a lower occurrence of ventricular fibrillation and witnessed cardiac arrest.
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Comparative Study
Major bleeding complications in cardiopulmonary resuscitation: the place of thrombolytic therapy in cardiac arrest due to massive pulmonary embolism.
Thrombolytic therapy in patients with massive pulmonary embolism (MPE) and prolonged cardiopulmonary resuscitation (CPR) is subject to debate. This study was performed to determine whether (1) thrombolytic treatment increases the risk of bleeding complications, (2) if the risk of bleeding is influenced by the duration of CPR and if (3) thrombolytic therapy improves outcome. ⋯ Although severe bleeding complications tend to occur more frequently in patients undergoing TL, the benefit of this treatment might outweigh the risk of bleeding.
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Mild resuscitative hypothermia has been shown to improve neurological outcome after cardiac arrest presenting with ventricular fibrillation (VF) due to cardiac causes. We describe the experience of inducing mild hypothermia in three patients with non-cardiac causes of arrest and long delays before a return of spontaneous circulation (ROSC). ⋯ All patients survived to discharge from hospital, and neuropsychological examinations revealed good recovery. It is concluded that mild resuscitative hypothermia may be beneficial also in patients with obvious non-coronary causes for cardiac arrest.
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Comparative Study
Comparison of six clinically used external defibrillators in swine.
External defibrillation has long been practiced with two types of monophasic waveforms, and now four biphasic waveforms are also widely available. Although waveforms and clinical dosing protocols differ among defibrillators, no studies have adequately compared performance of the monophasic or the biphasic waveforms. This is the first study to compare defibrillation efficacy among biphasic external defibrillators, and does so as part of a study comparing all commonly available waveforms using their respective manufacturer-provided and clinically used doses. ⋯ Commonly used MDS and MTE waveforms provide markedly dissimilar efficacies. Despite impedance-compensation schemes in biphasic defibrillators, impedance has an impact on their efficacy. At high-impedance, modest efficacy differences exist among clinically available biphasic defibrillators, reflecting differences in both waveforms and manufacturer-provided doses.