Resuscitation
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The aim of this study was to present new combination of algorithms for rhythm analysis during cardiopulmonary resuscitation (CPR) in automated external defibrillators (AED), called Analyze Whilst Compressing (AWC), designed for decreasing pre-shock pause and early stopping of chest compressions (CC) for treating refibrillation. ⋯ AWC presented similar performances to other AED algorithms during CPR, fulfilling performance goals recommended by standards. AWC provided advances in the challenge for improving CPR quality by: (i) not interrupting chest compressions for prevalent part of non-shockable rhythms (66-83%); (ii) minimizing pre-shock pause for 92.1% of VF patients. AWC required hands-off reconfirmation in 34.4% of cases. Reconfirmation was also common limitation of other reported algorithms (25.7-100%) although following different protocols for triggering chest compression resumption and shock delivery.
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The World Health Organization declared the 2019 coronavirus (COVID-19) a global pandemic on March 12, 2020. However, inadequate attention seems to have been paid to the heart when managing COVID-19 in terms of detection, monitoring and treatment. We are of the opinion that these severe patients may have had myocardial injury or acute myocarditis. ⋯ The use of an intra-aortic balloon pump (IABP) plus extracorporeal membrane oxygenation (ECMO) should be placed earlier if the pneumonia progresses rapidly, the ejection fraction decreases or there is heart failure. Besides, blood purification treatment including continuous kidney substitution treatment (CRRT) is recommended to clear inflammatory factors and block cytokine storm. In addition, the early usage of glucocorticoid and human immunoglobulin has been found to be preferable when acute myocarditis is accompanied by unstable hemodynamics.