Resuscitation
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Comment Letter Case Reports
Survival following cardiac arrest associated with carbon monoxide poisoning.
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Comparative Study
Oxygen requirement during cardiopulmonary resuscitation (CPR) to effect return of spontaneous circulation.
Recent scientific evidence has demonstrated the importance of good quality chest compressions without interruption to improve cardiac arrest resuscitation rates, and suggested that a de-emphasis on minute ventilation is needed. However, independent of ventilation, the role of oxygen and the optimal oxygen concentration during CPR is not known. Previous studies have shown that ventilation with high oxygen concentration after CPR is associated with worse neurologic outcome. We tested the hypothesis that initial ventilation during CPR without oxygen improves resuscitation success. ⋯ In a mild cardiac arrest model with generally good neurologic recovery, initial CPR ventilation with no O2 did not allow for ROSC. In contrast, CPR coupled with room air or higher oxygen levels result in a high rate of ROSC with good neurologic recovery. During CPR, the level of oxygenation must be considered, which if too low may preclude initial ROSC.
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Randomized Controlled Trial Comparative Study
Excellence in performance and stress reduction during two different full scale simulator training courses: a pilot study.
Simulator training is well established to improve technical and non-technical skills in critical situations. Few data exist about stress experienced during simulator training. This study aims to evaluate performance and stress in intensivists before and after two different simulator-based training approaches. ⋯ High fidelity patient simulation produces significant stress. After a 1-day simulator training, stress response measured by salivary alpha-amylase was reduced. Clinical performance and non-technical skills improved after 1 day of simulator training. Neither stress nor performance differed between the groups.