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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Multicenter Study Comparative Study
Serum S-100B is superior to neuron-specific enolase as an early prognostic biomarker for neurological outcome following cardiopulmonary resuscitation.
Most patients with cardiac arrest (CA) admitted to hospitals after successful cardiopulmonary resuscitation (CPR) are discharged with various degree of neurological deficits. To determine predictor of neurological outcome early and accurately, and to determine cutoff values, serum levels of protein S-100B and neuron-specific enolase (NSE) within 24h after CA were assessed. ⋯ S-100B is more reliable as an early predictor of poor neurological outcome within 24h after CA than NSE and can be applied clinically.
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Comparative Study
Willingness to perform mouth-to-mouth ventilation by health care providers: a survey.
During cardiopulmonary resuscitation (CPR), mouth-to-mouth ventilation (MTM) is only effective if rescuers are willing to perform it. ⋯ HIV infection is not the only condition for which rescuers hesitate to perform MTM. Bag-valve-mask devices for mechanical ventilation should be available in all locations where health care workers may be called upon to resuscitate apneic patients making the decision to perform MTM moot.
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Multicenter Study
The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest.
Most manikin and clinical studies have found decreased quality of CPR during transport to hospital. We wanted to study quality of CPR before and during transport for out-of-hospital cardiac arrest patients and also whether quality of CPR before initiation of transport was different from the quality in patients only receiving CPR on scene. ⋯ CPR quality was sub-standard both before and during transport. Early decision to transport might have negatively affected CPR quality from the early stages of resuscitation.
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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.