Resuscitation
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Early and accurate prediction of survival to hospital discharge following resuscitation after cardiac arrest (CA) is a major challenge. Our aim was to investigate the levels of ischemia-modified albumin (IMA) and malondialdehyde (MDA) in CA patients and whether IMA levels are valuable early marker of post-cardiopulmonary resuscitation prognosis in CA patients. ⋯ In conclusion, though the result may not be applied clinically in every patient, the ischemia-modified albumin may be a valuable prognostic marker in cardiac arrest patients following CPR.
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Comparative Study
Basic life support with four different compression/ventilation ratios in a pig model: the need for ventilation.
During cardiac arrest the paramount goal of basic life support (BLS) is the oxygenation of vital organs. Current recommendations are to combine chest compressions with ventilation in a fixed ratio of 30:2; however the optimum compression/ventilation ratio is still debatable. In our study we compared four different compression/ventilation ratios and documented their effects on the return of spontaneous circulation (ROSC), gas exchange, cerebral tissue oxygenation and haemodynamics in a pig model. ⋯ During BLS, a compression/ventilation-ratio of 100:5 seems to be equivalent to 30:2, while ratios of 100:2 or compressions-only detoriate peripheral arterial oxygenation and reduce the chance for ROSC.
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Multicenter Study Comparative Study
Rescuer fatigue during actual in-hospital cardiopulmonary resuscitation with audiovisual feedback: a prospective multicenter study.
Rescuer fatigue during cardiopulmonary resuscitation (CPR) is a likely contributor to variable CPR quality during clinical resuscitation efforts, yet investigations into fatigue and CPR quality degradation have only been performed in simulated environments, with widely conflicting results. ⋯ During actual in-hospital CPR with audiovisual feedback, CC depth decay became evident after 90s of CPR, but CC rate did not change. These data provide clinical evidence for rescuer fatigue during actual resuscitations and support current guideline recommendations to rotate rescuers during CC delivery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Alternating providers during continuous chest compressions for cardiac arrest: every minute or every two minutes?
Studies have shown that the quality of chest compressions for cardiac arrest decreases markedly after only a brief time. This is thought to be an important contributor to an adverse outcome of resuscitation, which has led to recommendations to alternate chest compression providers. This study compared alternating rescuers every 1 min versus every 2 min in a manikin simulation. ⋯ Power calculations with these results show that an unfeasibly large number of scenarios would be needed to definitively demonstrate the superiority of one of the scenarios. It seems reasonable to alternate chest compression providers every 2 min, to prevent the loss of effective compressions due to fatigue and to minimise interruptions of chest compressions. The ideal time to do this would be during the rhythm and pulse check as dictated by current guidelines.
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Randomized Controlled Trial Comparative Study
Does Dual Operator CPR help minimize interruptions in chest compressions?
Basic Life Support Guidelines 2005 emphasise the importance of reducing interruptions in chest compressions (no-flow duration) yet at the same time stopped recommending Dual Operator CPR. Dual Operator CPR (where one rescuer does ventilations and one chest compressions) could potentially minimize no-flow duration compared to Single Operator CPR. This study aims to determine if Dual Operator CPR reduces no-flow duration compared to Single Operator CPR. ⋯ Dual Operator CPR with a compression to ventilation rate of 30:2 provides marginal improvement in no-flow duration but CPR quality is otherwise equivalent to Single Operator CPR. There seems little advantage to adding teaching on Dual Operator CPR to lay/trained first responder CPR programs.