Resuscitation
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Comparative Study
Erythropoietin facilitates the return of spontaneous circulation and survival in victims of out-of-hospital cardiac arrest.
Erythropoietin activates potent protective mechanisms in non-hematopoietic tissues including the myocardium. In a rat model of ventricular fibrillation, erythropoietin preserved myocardial compliance enabling hemodynamically more effective CPR. ⋯ Erythropoietin given during CPR facilitates ROSC, ICU admission, 24-h survival, and hospital survival. This effect was consistent with myocardial protection leading to hemodynamically more effective CPR (Trial registration: http://isrctn.org. Identifier: ISRCTN67856342).
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To assess the regional vulnerability to ischemic damage and perfusion/metabolism mismatch of reperfused brain following restoration of spontaneous circulation (ROSC) after cardiac arrest. ⋯ The cortical regions tended most vulnerable to the ischemic insult with an oligaemic pattern and a low CMRO(2) whereas the cerebellum instead showed a pattern of luxury perfusion.
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Recent data have demonstrated potent cardioprotective and neuroprotective effects of the application of growth hormones like erythropoietin (EPO) after focal cardiac or cerebral ischemia. In order to assess possible benefits regarding survival and resuscitation conditions, EPO was tested against placebo in a model of cardiac arrest in the rat. ⋯ EPO, when administrated before cardiac arrest, improved initial resuscitation and increased the duration of post-resuscitation survival.
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The post-cardiac arrest syndrome (period of critical illness following return of spontaneous circulation [ROSC]) is a promising window of opportunity for clinical trials of therapeutic interventions to improve outcome from cardiac arrest. However, the methodological rigor of post-ROSC trials and the ability to compare or pool data on treatment effects across studies requires consistent and appropriate outcome measures. We aimed to determine the current degree of uniformity of outcome measures in clinical trials of post-ROSC interventions. ⋯ Currently there is a lack of uniformity in selection and reporting of outcome measures among trials of post-ROSC interventions. Achieving consensus would be an important advance for resuscitation science.
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Randomized Controlled Trial Comparative Study
The effect of two different counting methods on the quality of CPR on a manikin--a randomized controlled trial.
To compare the quality of cardiopulmonary resuscitation (CPR) and rescuers' exhaustion using different methods of counting, and to establish an appropriate method of counting. ⋯ Counting from 1 to 10 three times in Chinese as opposed to 1-30 results in better quality chest compressions. Counting from 1 to 10 three times was associated with less user feelings of fatigue, and a longer time to peak heart rate. These findings support the teaching of counting compressions 1-10 three times during CPR.