Resuscitation
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Comparative Study
Detrended fluctuation analysis predicts successful defibrillation for out-of-hospital ventricular fibrillation cardiac arrest.
Repeated failed shocks for ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OOHCA) can worsen the outcome. It is very important to rapidly distinguish between early and late VF. We hypothesised that VF waveform analysis based on detrended fluctuation analysis (DFA) can help predict successful defibrillation. ⋯ The VF waveform analysis based on DFA could help predict first-shock defibrillation success in patients with OOHCA. The clinical utility of the approach deserves further investigation.
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Total liquid ventilation (TLV) with cooled perfluorocarbons has been demonstrated to induce an ultrafast cardioprotective cooling in rabbits. However, it remains unknown whether this technically challenging strategy would be actually more potent than a conventional external cooling after a prolonged ischemia inducing transmural myocardial infarction. ⋯ Cooling induced by TLV afforded a potent cardioprotection and prevented transmural infarction following prolonged and severe ischemia, even when started later than a surface cooling in rabbits.
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Comparative Study
Increase in pre-shock pause caused by drug administration before defibrillation: an observational, full-scale simulation study.
The importance of circulation during cardiopulmonary resuscitation has led to efforts to decrease time without chest compressions ("no-flow time"). The no-flow time from the interruption of chest compressions until defibrillation is referred to as the "pre-shock pause". A shorter pre-shock pause increases the chance of successful defibrillation. It is unclear whether drug administration affects the length of the pre-shock pause. Our study compares pre-shock pause with and without drug administration in a full-scale simulation. ⋯ Drug administration prior to defibrillation was associated with significant increases in pre-shock pauses in this full-scale simulation study.
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To assess the reliability and validity of scoring instruments designed to measure clinical performance during simulated resuscitations requiring the use of Pediatric Advanced Life Support (PALS) algorithms. ⋯ The instruments assessed in this study measure clinical performance during PALS scenarios in a reliable and valid manner. Measurement error could be minimized further through the use of additional scenarios but additional raters, for a given scenario, would not improve reliability. Further studies should assess validity of measurement with respect to actual clinical performance during resuscitations.
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The purpose of this study was to investigate whether the takeover by Advanced Life Support [ALS] trained ambulance paramedics from rescuers using an automated external defibrillator [AED] delays shocks and if this delay is associated with decreased survival after out-of-hospital cardiac arrest [OHCA]. ⋯ ALS takeover delays the next shock delivery in almost two-third of cases. This delay is associated with decreased survival.