Resuscitation
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Comparative Study
Ketamine delays mortality in an experimental model of hemorrhagic shock and subsequent sepsis.
In previous studies ketamine was reported to improve survival and decrease serum interleukin-6 (IL-6) concentration after sepsis alone and after burn injury followed by sepsis. The aim of this study was to determine whether ketamine alters survival and/or IL-6 after hemorrhagic shock alone or hemorrhagic shock followed by sepsis. ⋯ Ketamine improved 12h survival and delayed mortality after hemorrhage+sepsis without significantly altering IL-6, and did not alter survival or IL-6 after hemorrhage alone.
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Comparative Study
Factors associated with a change in functional outcome between one month and six months after cardiac arrest: a retrospective cohort study.
The appropriate time point of evaluation of functional outcome in cardiac arrest survivors remains a matter of debate. In this cohort study we posed the hypothesis that there are no significant changes in Cerebral Performance Categories (CPC) between one month and six months after out-of hospital cardiac arrest. If changes were present we aimed to identify reasons for these changes. ⋯ There is a relevant change of functional outcome even one month after out-of hospital cardiac arrest. Especially when studies compare patient groups with unequal arrest times, and an unequal distribution of initial cardiac rhythms a follow-up period longer than one month should be considered for the final outcome evaluation after cardiac arrest.
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Comparative Study
Students insert the laryngeal tube quicker and more often successful than the esophageal-tracheal combitube in a manikin.
Endotracheal intubation remains the standard of airway management. Because intubation skills are difficult to acquire, for medical students teaching of easier to learn techniques should be considered. ⋯ Following different training scenarios in a manikin, students were able to place the LT much faster than the ETC. Even brief training was sufficient to generate short insertion times for the LT.
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Comparative Study
Hospital employees improve basic life support skills and confidence with a personal resuscitation manikin and a 24-min video instruction.
The use of a personal resuscitation manikin with video instruction is reportedly as effective as traditional instructor-led courses in teaching lay people basic life support (BLS). We applied this method to an entire hospital staff to determine its effect on their practical and self-judged BLS skills. ⋯ After distributing a personal resuscitation manikin with video instruction to an entire hospital staff, the median number of correctly performed chest compressions doubled and self-confidence in BLS skills improved significantly. This is a simple and less time-consuming method than instructor-led courses in preparing hospital employees in the basic handling of cardiac arrest.
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Comment Letter Case Reports
Hyperinsulinaemia may impair outcome after hypothermic cardiac arrest.