Resuscitation
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Randomized Controlled Trial Comparative Study
Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study.
High oxygen concentration in blood may be harmful in the reperfusion phase after cardiopulmonary resuscitation. We compared the effect of 30 and 100% inspired oxygen concentrations on blood oxygenation and the level of serum markers (NSE, S-100) of neuronal injury during the early post-resuscitation period in humans. ⋯ Most patients had acceptable arterial oxygenation when ventilated with 30% oxygen during the immediate post-resuscitation period. There was no indication that 30% oxygen with SpO(2) monitoring and oxygen backup to avoid SpO(2)<95% did worse that the group receiving 100% oxygen. The use of 100% oxygen was associated with increased level of NSE at 24h in patients not treated with therapeutic hypothermia. The clinical significance of this finding is unknown and an outcome-powered study is feasible.
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Randomized Controlled Trial Multicenter Study
Survival from prehospital cardiac arrest is critically dependent upon response time.
This study correlated the delay in initiation of bystander cardiopulmonary resuscitation (ByCPR), basic (BLS) or advanced cardiac (ACLS) life support, and transport time (TT) to survival from prehospital cardiac arrest. This was a secondary endpoint in a study primarily evaluating the effect of bicarbonate on survival. ⋯ Delay to the initiation of BLS and ACLS intervention influenced outcome from prehospital cardiac arrest negatively. There were no survivors after prolonged delay in initiation of ACLS of 30 min or greater or total resuscitation and transport time of 90 min. This result was not influenced by giving bicarbonate, the primary study intervention, except at longer arrest times.
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Randomized Controlled Trial
The quality of chest compressions by trained personnel: the effect of feedback, via the CPREzy, in a randomized controlled trial using a manikin model.
Even after training, the ability to perform effective cardiac compressions has been found to be poor and to decrease rapidly. We assessed this ability with and without a non-invasive feedback device, the CPREzy, during a 270s CPR session in an unannounced, single-blinded manikin study using 224 hospital employees and staff chosen at random and using a non-cross over design. The two groups self-assessed their knowledge and skills as adequate. ⋯ If compressions were effective initially, the time until >50% of compressions were less than 4 cm deep was 75+/-81s in the control group versus 194+/-87 s in the CPREzy group (P=0.0001 [-180 to -57.5]). After a few seconds of training in its use, our candidates used the CPREzy effectively. Against the background knowledge that estimation of compression depth by the rescuer or other team members is difficult, and that performing effective compressions is the cornerstone of any resuscitation attempt, our data suggests that a feedback device such as the CPREzy should be used consistently during resuscitation.