Resuscitation
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Comparative Study
Outcome of very-low-birth-weight infants who received epinephrine in the delivery room.
In recent years, there has been an increase in the number of very low birth weight (VLBW) infants and an improvement in their survival. However, there are no specific recommendations regarding the use of resuscitative efforts for VLBW infants, and there is scant data in the literature on morbidity and mortality in relation to epinephrine administration. Due to the vulnerability of VLBW infants, studies that examine the effects and consequences of cardiovascular resuscitation and epinephrine administration are needed. ⋯ VLBW infants, who require epinephrine in the delivery room, are smaller in terms of gestational age and birth weight. The requirement of epinephrine in the delivery room during resuscitation may be associated to worst outcomes and decreased survival without severe brain injury. These findings lead to more questions on how aggressive resuscitation efforts should be for these infants.
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Letter Case Reports
Survival after 48 min submersion and 107 min cardiopulmonary resuscitation.
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Multicenter Study Comparative Study
Blood ammonia and lactate levels on hospital arrival as a predictive biomarker in patients with out-of-hospital cardiac arrest.
No reliable predictor for the prognosis of out-of-hospital cardiac arrest (OHCA) on arrival at hospital has been identified so far. We speculate that ammonia and lactate may predict patient outcome. ⋯ Blood ammonia and lactate levels on arrival are independent prognostic factors for OHCA. PPV with the combination of these biomarkers predicting poor outcome is high enough to be useful in clinical settings.
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Randomized Controlled Trial Comparative Study
Quality of resuscitation: flight attendants in an airplane simulator use a new mechanical resuscitation device--a randomized simulation study.
Cardiopulmonary resuscitation (CPR) during flight is challenging and has to be sustained for long periods. In this setting a mechanical-resuscitation-device (MRD) might improve performance. In this study we compared the quality of resuscitation of trained flight attendants practicing either standard basic life support (BLS) or using a MRD in a cabin-simulator. ⋯ Using the MRD resulted in significantly less "absolute hands-off time", but less effective ventilation. The translation of higher chest compression rate into better outcome, as shown in other studies previously, has to be investigated in another human outcome study.
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Comparative Study
How accurately can the aetiology of cardiac arrest be established in an out-of-hospital setting? Analysis by "concordance in diagnosis crosscheck tables".
Several previous studies have focused on establishing the cause of cardiac arrest (CA) during cardiopulmonary resuscitation (CPR) provided in an out-of-hospital setting. ⋯ This study demonstrates the importance of analysing concordance in presumed and definitive diagnosis of individual cases, since an overall comparison in a cohort of cases may be highly misleading. It introduces the method of the crosscheck table for visualization and comparison of presumed and final diagnoses. The two alternative approaches of inclusion rule for applying the thrombolytic therapy in out-of-hospital care were discussed with regard to the recent TROICA study.