Resuscitation
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Comparative Study
Usefulness of routine laboratory parameters in the decision to treat refractory cardiac arrest with extracorporeal life support.
To evaluate the usefulness of routine laboratory parameters in the decision to treat refractory cardiac arrest patients with extracorporeal life support (ECLS). ⋯ SpvO₂ is useful to predict the inability of maintaining refractory cardiac arrest victims on ECLS without detrimental capillary leak and multiorgan failure until neurological evaluation.
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The inability to accurately predict acute traumatic coagulopathy (ATC) has been a key factor in the low level of evidence guiding its management. The aim of this study was to develop a tool to accurately identify patients with ATC using pre-hospital variables without the use of pathology or radiological testing. ⋯ The COAST score accurately identified a group of patients with ATC using pre-hospital observations. This predictive tool can be used to select patients for inclusion into prospective studies examining management options for ATC. Mortality in these patients is high, potentially improving feasibility of outcome studies.
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Comparative Study
A sternal accelerometer does not impair hemodynamics during piglet CPR.
To determine whether the residual weight of a 260 g sternal accelerometer/force feedback device (AFFD) adversely affects hemodynamics during cardiopulmonary resuscitation in a piglet model of ventricular fibrillation cardiac arrest. ⋯ The use of a 260 g accelerometer/force feedback device designed for real-time feedback to the rescuer during resuscitation efforts did not adversely affect cardiac output or left ventricular myocardial blood flow during 12 min of chest compressions in a piglet model of ventricular fibrillation cardiac arrest.
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We report the use of out-of-hospital extracorporeal life support (ECLS) in cardiac arrest. We treated a 9-year-old girl with cardiac arrest after warm-water drowning with percutaneous venoarterial extracorporeal membrane oxygenation (ECMO) using a new portable Mini-ECMO system. A beating-heart circulation was reestablished on ECMO, but, unfortunately, our patient did not survive. This case shows that Mini-ECMO support can be used to restore an effective circulation and gas exchange in the out-of-hospital setting.
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The aim of this study was to calculate the incidence of out-of-hospital cardiac arrest (OHCA) in primary health care in Greece and assess general practitioners' (GPs) willingness towards the use of automatic external defibrillator (AED). ⋯ The incidence of OHCA in primary health care in Greece is 15.3/100,000 population per year. Greek GPs may have an important role in managing OHCA victims and are willing to use an AED. This is the first study estimating OHCA in primary health care in Greece.