Resuscitation
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Randomized Controlled Trial Comparative Study
The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching.
Bystander cardiopulmonary resuscitation (CPR) has shown to significantly improve the survival of cardiac-arrest victims. Dispatcher assistance increases the number of bystanders who perform CPR, but the quality of CPR remains unsatisfactory. This study was conducted to assess the effect of video coaching on the performance of CPR by untrained volunteers when compared with traditional audio instruction in simulated cardiac arrests. ⋯ Instructions from the dispatcher, along with a video demonstration of CPR, improved the time to initiate compression, the compression rate and the correct hand positioning. It also reduced the 'hands-off' events during CPR. However, emphasised instructions by video may be needed to increase the depth of compressions.
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Comparative Study
A rapid, safe, and low-cost technique for the induction of mild therapeutic hypothermia in post-cardiac arrest patients.
The benefits of inducing mild therapeutic hypothermia (MTH) in cardiac arrest patients are well established. Timing and speed of induction have been related to improved outcomes in several animal trials and one human study. We report the results of an easily implemented, rapid, safe, and low-cost protocol for the induction of MTH. ⋯ A protocol using a combination of core and surface cooling modalities was rapid, safe, and low cost in achieving MTH. The cooling rate of 2.6°C/h was superior to most published protocols. This method uses readily available equipment and reduces the need for costly commercial devices.
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Comparative Study
Effects of arterial oxygen content on oxidative stress during resuscitation in a rat hemorrhagic shock model.
To examine whether reactive oxygen species (ROS) production is affected by arterial oxygen content (CaO(2)) in attempted resuscitation to restore blood pressure from hemorrhagic shock (HS) or not. ⋯ In a rat HS model, attempted resuscitation to restore blood pressure increased O(2) UC as well as %CoQ9. However, the magnitude of %CoQ9 increase that represents ROS production is not affected by CaO(2) during resuscitation from HS.
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A reproducible long-term intensive care and outcome cardiac arrest model for exploring new cerebral preservation strategies is needed. We tried to determine effects and limitations of current therapies after different 'no-flow' times. ⋯ This study established a reproducible cardiac arrest and resuscitation model in pigs which will be used to test novel resuscitation strategies to improve neurologic outcome after cardiac arrest.
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Comparative Study
Post-resuscitation myocardial microcirculatory dysfunction is ameliorated with eptifibatide.
The post-cardiac arrest syndrome includes a decline in myocardial microcirculation function. Inhibition of the platelet IIb/IIIa glycoprotein receptor has improved myocardial microvascular function post-percutaneous coronary intervention. Therefore, we evaluated such inhibition with eptifibatide for its effect on myocardial microcirculation function post-cardiac arrest and resuscitation. ⋯ Inhibition of platelet IIb/IIIa glycoprotein receptors with eptifibatide post-resuscitation prevented myocardial microcirculation dysfunction. Left ventricular dysfunction post-resuscitation was not improved with eptifibatide, and perhaps transiently worse at 30min post-resuscitation. Post-cardiac arrest ventricular dysfunction may require a multi-modality treatment strategy for successful prevention or amelioration.