Resuscitation
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Comparative Study
Clinical emergencies and outcomes in patients admitted to a surgical versus medical service.
The merit of rapid response systems (RRSs) remains controversial. A tailored approach to specific groups may increase the efficacy of these teams. The purpose of this study was to compare differences in triggers for RRS activation, interventions, and outcomes in patients on medical and surgical services. ⋯ Implementation of a RRS had greater impact on reduction of out of ICU cardiac arrest and mortality in medical inpatients. Triggers for activation and interventions were similar between groups; however, surgical patients demonstrated substantial risk for decompensation within the first 24 h following operation. More research is needed to evaluate the disproportionate benefit observed between cohorts.
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Comparative Study
Effects of timing and duration of hypothermia on survival in an experimental gerbil model of global ischaemia.
Despite the use of animal models to study post-cardiac-arrest resuscitation, the effects of hypothermia on physiological circulatory parameters are still not fully understood. In this study, using a gerbil model of global ischaemia/reperfusion, we aimed to assess the effects of hypothermia on physiological parameters and evaluated the optimal timing for the induction of hypothermia to achieve a better survival rate. ⋯ Hypothermia-induced suppression of post-ischaemic hyperperfusion and the prevention of vasoconstriction of the pial arteriole play an important role in improving the survival rate after global ischaemia/reperfusion, but the time window for induction of hypothermia remains relatively narrow.
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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.