Resuscitation
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Haemorrhagic shock and subsequent resuscitation induce acute lung injury. We elucidated whether bilateral lower limb ischemic pre-conditioning (IP) could mitigate lung injury in haemorrhagic shock/resuscitation rats. The role of heme oxygenase-1 (HO-1) was also elucidated. ⋯ Limb IP mitigates lung injury in haemorrhagic shock/resuscitation rats. The mechanisms may involve HO-1.
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Randomized Controlled Trial
Updated teaching techniques improve CPR performance measures: a cluster randomized, controlled trial.
The first-aid training necessary for obtaining a drivers license in Austria has a regulated and predefined curriculum but has been targeted for the implementation of a new course structure with less theoretical input, repetitive training in cardiopulmonary resuscitation (CPR) and structured presentations using innovative media. ⋯ Motivation and self-confidence as well as skill retention after six months were shown to be dependent on the teaching methods and the time for practical training. Courses may be reorganized and content rescheduled, even within predefined curricula, to improve course outcomes.
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The most popular method of training in basic life support and AED use remains instructor-led training courses. This systematic review examines the evidence for different training methods of basic life support providers (laypersons and healthcare providers) using standard instructor-led courses as comparators, to assess whether alternative method of training can lead to effective skill acquisition, skill retention and actual performance whilst using the AED. ⋯ There is good evidence to support alternative methods of AED training including lay instructors, self directed learning and brief training. There is also evidence to support that no training is needed but even brief training can improve speed of shock delivery and electrode pad placement. Features of AED can have an impact on its use and further research should be directed to making devices user-friendly and robust to untrained layperson.
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Randomized Controlled Trial
Novel target volume marked adult bag to deliver accurate tidal volume for paediatric and adolescent resuscitation.
To overcome limitations of inaccurate tidal volume (TV) delivery by conventional selfinflating paediatric and adult bags during paediatric and adolescent resuscitation, we designed a novel target volume marked bag (TVMB) with four compression points marked on an adult bag surface. The aim of this study was to evaluate the TVMB in delivering preset TV. ⋯ TVMB could deliver accurate TV in various target volume ranges for paediatric and adolescent resuscitation.
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Post-cardiac arrest resuscitated patients often develop a "sepsis-like" syndrome, which may be associated with organ dysfunction. Impaired microcirculatory blood flow is thought to play a key role in sepsis-induced organ failure; however, few data are available on the microcirculation after cardiac arrest. We investigated microvascular density and reactivity in the early phase following cardiac arrest. ⋯ The early post-resuscitation phase is characterised by significant abnormalities in microvascular density and flow, which return to normal within 48 h after cardiac arrest. These changes may be influenced by body temperature. Microvascular reactivity is impaired after cardiac arrest.