Resuscitation
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We tested the hypothesis that the frequency of shock success differs between initial and recurrent episodes of ventricular fibrillation (VF). ⋯ We observed no significant difference in the frequency of shock success between initial and recurrent episodes of VF using this AED with a 150 J fixed-energy protocol. VF recurrence is common and does not adversely affect shock success, ROSC or survival.
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Increased serum concentrations of brain-derived proteins neuron-specific enolase (NSE) and protein S-100beta (S-100b) are used as early predictors of long-term outcome in unconscious survivors after cardiopulmonary resuscitation (CPR). We investigated whether use of short-term Left Ventricular Assist Devices (LVAD) in patients undergoing percutaneous coronary intervention (PCI) effect serum concentrations of NSE and S-100b, because use of such devices in resuscitated cardiogenic shock patients increased during the last years. ⋯ LVAD support after PCI is associated with a significant increase in NSE serum concentration as well as in S-100b. We therefore postulate an overestimation of the extent of hypoxic brain damage in unconscious survivors after CPR if treatment include LVAD support or PCI or both procedures. The increase in NSE can be partly explained by alteration of thrombocytes and other blood cells. However, the increase in S-100b remains unexplained since S-100b does not occur in peripheral blood cells. An additional release of both biomarkers from ischemic myocardium or cerebral microembolism should be drawn into consideration.
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The 2005 revised guidelines for cardiopulmonary resuscitation (CPR) suggest a universal compression-to-ventilation (C:V) ratio of 30:2. The effects of this ratio in a realistic CPR scenario have not been investigated completely. ⋯ Increasing the chest compression ratio from 15:2 to 30:2 resulted in changes in arterial, but not mixed-venous, blood gases; therefore, the advantages of more chest compressions may outweigh a decrease in gas exchange.