Resuscitation
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Comparative Study
Effect of ifenprodil, a polyamine site NMDA receptor antagonist, on brain edema formation following asphyxial cardiac arrest in rats.
Brain edema occurs in experimental and clinical cardiac arrest (CA) and is predictive of a poor neurological outcome. N-Methyl--aspartate (NMDA) receptors contribute to brain edema elicited by focal cerebral ischemia/reperfusion (I/R). Ifenprodil, a NMDA receptor antagonist, attenuates brain edema and injury size in rats after focal cerebral I/R. We assessed the hypothesis that ifenprodil reduces CA-elicited brain edema. ⋯ Ifenprodil reduces CA-elicited brain edema. In addition, we observed significant hemodynamic changes caused by ifenprodil.
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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.
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Randomized Controlled Trial Comparative Study Clinical Trial
Airway management in cardiac arrest--comparison of the laryngeal tube, tracheal intubation and bag-valve mask ventilation in emergency medical training.
Tracheal intubation (ETI) is considered the method of choice for securing the airway and for providing effective ventilation during cardiac arrest. However, ETI requires skills which are difficult to maintain especially if practised infrequently. The laryngeal tube (LT) has been successfully tested and used in anaesthesia and in simulated cardiac arrest in manikins. ⋯ We found that the teams using the LT were able to initiate ventilation more rapidly than those performing ETI (P < 0.0001). The LT and ETI provided equal minute volumes of ventilation, which was significantly higher than that delivered with the BVM (P < 0.0001). Our data suggest that the LT may enable airway control more rapidly and as effectively as ETI, and compared to BVM, may provide better minute ventilation when used by inexperienced personnel.
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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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Comparative Study
The attitude of cardiac care patients towards CPR and CPR education.
The recommended targeting of the elderly, those with heart conditions and their family members for CPR education remains unaccomplished. Little is known about cardiac patients' knowledge of and attitude towards CPR and CPR education. This study aimed to investigate cardiac care patients' attitude towards CPR and interest in CPR education. ⋯ A hospital was the preferred location for the course, often due to the perceived higher competence of the instructors, but sometimes, because it offered a safe environment. The primary health care centre was preferred because of its location near the participants' homes. In order to increase the proportion of people trained in CPR in target groups such as cardiac care patients and their family members, healthcare professionals should provide patients with information and opportunities to attend locally situated, professionally led courses.