Resuscitation
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Comparative Study
Echocardiographic comparison of cardiopulmonary resuscitation (CPR) using periodic acceleration (pGz) versus chest compression.
This investigation compared the effects of conventional cardiopulmonary resuscitation (CPR) using an automated Thumper chest compression device to periodic acceleration CPR (pGz-CPR) on early post-resuscitation ventricular function assessed by echocardiography, in an adult pig model of CPR. ⋯ pGz holds promise as a new method for CPR with better left ventricular (LV) function post-CPR than the more traditional chest compression method.
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Randomized Controlled Trial Clinical Trial
Effect of an inspiratory impedance threshold device on hemodynamics during conventional manual cardiopulmonary resuscitation.
In animals in cardiac arrest, an inspiratory impedance threshold device (ITD) has been shown to improve hemodynamics and neurologically intact survival. The objective of this study was to determine whether an ITD would improve blood pressure (BP) in patients receiving CPR for out-of-hospital cardiac arrest. ⋯ Use of the active ITD was found to increase systolic pressures safely and significantly in patients in cardiac arrest compared with sham controls.
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To evaluate the retention of CPR skills 12 months after initial training, using a manikin equipped with a computer-based voice advisory feedback system. ⋯ Computer-based voice advisory feedback can improve the performance of basic life support skills on a manikin with no deterioration in feedback supported performance after 12 months.
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Severe depletion of myocardial energy and antioxidant resources during cardiac arrest culminates in electromechanical dysfunction following recovery of spontaneous circulation (ROSC). A metabolic fuel and natural antioxidant, pyruvate augments myocardial energy and antioxidant redox states in parallel with its enhancement of contractile performance of stunned and oxidant-challenged hearts. This study tested whether pyruvate improves post-arrest cardiac function and metabolism. ⋯ Contractile function stabilized and ECG normalized at 2-3 h ROSC, despite post-infusion pyruvate clearance and waning of its metabolic benefits. In conclusion, intravenous pyruvate therapy increases energy reserves and antioxidant defenses of resuscitated myocardium. These temporary metabolic improvements support post-arrest recovery of cardiac electromechanical performance.
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This post-market, observational study is intended to evaluate reported uses of pediatric pads that reduce the energy delivered by some adult automated external defibrillators (AEDs) so that they may be used with pediatric patients. ⋯ Voluntary reports of the use of attenuated pediatric defibrillation pads indicate the devices performed appropriately. All eight VF patients had termination of VF and five survived to hospital discharge. These data support the rapid deployment of AEDs for young children as well as adolescents and adults. Since the pediatric pads are available and deliver an appropriate dose for children, their use should be strongly encouraged.