Resuscitation
-
Studies have suggested that emesis may occur in up to a third of cardiac arrest patients. The goal of this investigation was to characterize the frequency, timing, and outcome association of emesis in persons suffering out-of-hospital cardiac arrest in order to understand the role and care-implications of emesis better. ⋯ Given the frequency of emesis, the potential that some portion of emesis may be related to care, and the adverse association between emesis and survival, approaches that treat or prevent emesis better may improve the chances of survival following out-of-hospital cardiac arrest.
-
No accurate, independent biomarker has been identified that could reliably predict neurological outcome early after cardiac arrest. We speculated that brain natriuretic peptide (BNP) measured at hospital admission may predict patient outcome. ⋯ Brain natriuretic peptide levels on admission predict neurological outcome at 6 months and survival after cardiac arrest.
-
Chest compressions are interrupted during cardiopulmonary resuscitation (CPR) due to human error, for ventilation, for rhythm analysis and for rescue shocks. Earlier data suggest that the recommended 15:2 compression to ventilation (C:V) ratio results in frequent interruptions of compressions during CPR. We evaluated a protocol change from the recommended C:V ratio of 15:2-30:2 during CPR in our municipal emergency medical system. ⋯ Retraining first responders to use a C:V ratio of 30:2 instead of the traditional 15:2 during out-of-hospital cardiac arrest increased the number of compressions delivered per minute and decreased the number of pauses for ventilation. These data are new as they produced persistent and quantifiable changes in practitioner behavior during actual resuscitations.
-
To investigate whether transoesophageal cardiac pacing can induce ventricular fibrillation (VF) and how long the cardiac pacing has to be sustained to prevent the reversion of the VF induced. ⋯ Transoesophageal cardiac pacing can induce VF in rats. However, the cardiac pacing is required for at least 120-180 s to ensure that VF does not spontaneously convert. We can use the technique to establish a new and simpler rat cardiac arrest (CA) model, which may facilitate experimental investigation on CPR.
-
Dexmedetomidine is a highly specific and selective alpha-2 adrenergic agonist that is now widely used in the intensive care setting. Many intensive care unit (ICU) patients are at risk of respiratory or cardiac arrest. This study was conducted to determine whether dexmedetomidine exhibits a cardioprotective effect on global ischaemia and subsequent myocardial infarction. ⋯ Dexmedetomidine exhibited a cardioprotective effect on global ischaemia in the isolated rat heart model, which was mediated by alpha-2 adrenergic stimulation.