Resuscitation
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Randomized Controlled Trial Comparative Study
Comparison of optic laryngoscope Airtraq(®) and Miller laryngoscope for tracheal intubation during infant cardiopulmonary resuscitation.
Recent resuscitation guidelines for infant cardiopulmonary resuscitation (CPR) emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Miller laryngoscope (Mil) with Airtraq (ATQ) during chest compression in an infant manikin. ⋯ We conclude that ATQ performed better than Mil for endotracheal intubation during chest compression in infant simulations managed by expert doctors.
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Cardiac arrest (CA) and resuscitation are models of whole body ischemia reperfusion injury. Interventions performed prior to (pre-treatment) or after (post-treatment) can result in cardioprotection. Myocardial stunning, characterized by microcirculatory and contractile dysfunction after CA, is an important component of the post-cardiac arrest syndrome. Periodic acceleration (pGz), produced by the cyclical motion of the supine body headward to footward, increases microcirculatory blood flow to vital organs and elicits production of endothelial derived cytoprotective factors in normal animals. We tested the hypothesis that application of pGz 30 min after return of circulation from CA, as a delayed post-treatment strategy, would improve regional microcirculatory blood flow to vital organs and functional indices of myocardial stunning in pigs. ⋯ Delayed post-treatment with pGz as a therapeutic strategy, protects against early myocardial stunning in VF cardiac arrest by improving microcirculatory blood flow to the heart and also protects other vital organs by this mechanism.
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The ability of T-piece resuscitators to deliver consistent peak inspiratory pressure (PIP) and positive end expiratory pressure (PEEP) during real and simulated neonatal resuscitation has been well described. The Neopuff (Fisher & Paykel Healthcare, Auckland, New Zealand) has been the device used for nearly all of these comparisons. ⋯ Based on our single-center experience, a T-piece resuscitation device which has the adjustment for the PEEP level and the orifice which is occluded to deliver a breath in the same location has the potential to cause an inadvertent and potentially toxic increase of PEEP which might not be noticed by the operator.
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Multicenter Study Clinical Trial
Performance of a rectilinear biphasic waveform in defibrillation of presenting and recurrent ventricular fibrillation: a prospective multicenter study.
We tested the hypothesis that shock success differs with initial and recurrent episodes of ventricular fibrillation (VF). ⋯ Presenting VF was terminated with one shock in 87.8% of cases. We observed no significant difference in the frequency of shock success between initial versus recurrent VF. VF recurred in the majority of patients and did not adversely affect shock success, ROSC, or survival.