Resuscitation
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Multicenter Study Comparative Study
Development of a data dictionary for the Strategies for Post Arrest Resuscitation Care (SPARC) network for post cardiac arrest research.
The widely accepted Utstein style has standardized data collection and analysis in resuscitation and post resuscitation research. However, collection of many of these variables poses significant practical challenges. In addition, several important variables in post resuscitation research are missing. ⋯ This is the first attempt in the literature to develop a data dictionary as part of a standardized, pragmatic data collection tool for post cardiac arrest research patients. In addition, our dataset defined important variables that were previously missing. This data collection tool can serve as a reference for future trials in post cardiac arrest care.
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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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Induced mild hypothermia after cardiac arrest interferes with clinical assessment of the cardiovascular status of patients. In this situation, non-invasive cardiac output measurement could be useful. Unfortunately, arterial pulse contour is altered by temperature, and the performance of devices using arterial blood pressure contour analysis to derive cardiac output may be insufficient. ⋯ Induced hypothermia was not associated with increased bias or limits of agreement for the comparison of Vigileo and continuous thermodilution, but percentage error was high during normothermia and increased further during hypothermia. Less than 50% of clinically relevant CO changes during hypothermia were concordant.
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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.