Resuscitation
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Comparative Study
Optimal dosing of dobutamine for treating post-resuscitation left ventricular dysfunction.
This study was designed to determine the optimal dose of dobutamine in the treatment of post-resuscitation left ventricular dysfunction. ⋯ Dobutamine at 5 mcg/kgmin appears optimal for restoring systolic and diastolic function post-resuscitation without adversely affecting myocardial oxygen consumption.
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Comparative Study
Optimizing chest compression to rescue ventilation ratios during one-rescuer CPR by professionals and lay persons: children are not just little adults.
To estimate the optimum ratio of chest compressions to ventilations for one-rescuer CPR that maximizes systemic oxygen delivery in children. ⋯ Compression to ventilation ratios in CPR should be smaller for children than for adults and gradually increase as a function of body weight. Optimal CPR in children requires relatively more ventilation than optimal CPR in adults. A universal compression/ventilation ratio of 50:2, targeted to optimize adult resuscitation, would not be appropriate for infants and young children.
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Review Comparative Study
Role of semiautomatic defibrillators in a general hospital: "Naples Heart Project".
In Italian hospitals, 85% of patients hospitalized in general medical wards who experience cardiac arrest die, while the incidence is much lower in patients in intensive care units. Defibrillation, in Italian hospitals, often occurs very late, either due to a lack of defibrillators, or due to architectural and structural barriers. ⋯ The Naples Heart Project was based on a feasibility study of the in-hospital emergency service to evaluate and analyze problems associated with type of structure, departmental and institutional dislocation, internal practicability (architectural features and preferential ways), staff numbers and distribution, the calling system for emergency, and the equipment available. The Naples Heart Project began in July 2001, since then it has already created 835 BLSD first responders among the hospital staff; 440 were physicians and physicians still in training, 310 were nurses and 85 were administrative staff.
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If sudden cardiac arrest occurs during cardiac catheterization, the underlying coronary condition may be defined immediately by coronary angiography. This may, in turn, allow a lifesaving attempt of percutaneous coronary intervention (PCI). We report on two patients with critical proximal disease of the left coronary artery in whom successful PCI during cardiopulmonary resuscitation (CPR) led to the restoration of a spontaneous circulation and long-term survival.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between over-the-head and standard cardiopulmonary resuscitation.
Standard cardiopulmonary resuscitation (CPR) is performed by kneeling adjacent to the side of the casualty. In certain circumstances it may be difficult or impossible to perform CPR in this position, for example in confined spaces such as a narrow corridor, aircraft or train gangway. The aim of this study was to investigate the technique of over-the-head CPR (OTH CPR), where the CPR provider kneels above the casualty and performs chest compressions OTH of the casualty. ⋯ OTH CPR appears equally effective as standard CPR with some marginal advantages in correct hand placement. We suggest that in situations where it is not possible to perform standard CPR, OTH CPR may be considered as a suitable alternative.