Resuscitation
-
To develop and validate a logistic regression model to identify predictors of death before hospital discharge after in-hospital cardiac arrest. ⋯ Performance of this logistic regression model depends on the cut-off probability chosen to discriminate between predicted survival and predicted death and on whether the estimated probability or the lower 95% C.L. of the estimated probability is used. This model may inform the development of clinical practice guidelines for patients who are at risk of or who experience in-hospital cardiac arrest.
-
To assess the hemodynamic response to repeated doses of epinephrine (EPI) in an animal model of prolonged cardiac arrest and CPR. ⋯ The hemodynamic response to the first dose of EPI determines if the critical CPP needed for ROSC and survival will occur. Repeat doses of EPI do not appear to improve CPP to a degree to affect clinically meaningful measures of outcome, i.e., successful countershock and survival.
-
Attempts at cardiopulmonary resuscitation (CPR) date from antiquity, but it is only in the last 50 years that a scientifically-based methodology has been developed. External chest compressions is the standard method for managing circulatory arrest, however, numerous alterations of this technique have been proposed in attempts to improve outcome from CPR. ⋯ Adrenergic agents used to improve myocardial and cerebral perfusion are also the subject of considerable investigation with new agents entering clinical study. This paper reviews the history, current techniques and pharmacotherapy as well as controversial issues in the management of patients with cardiac arrest.
-
To evaluate the effectiveness of inhalation rewarming in early resuscitative efforts for hypothermic victims. ⋯ The safety and efficacy of inhalation rewarming suggest that it is a viable adjunct of treatment during hypothermic resuscitation. Its routine use may be more appropriate for a field rescue situation where more advanced rewarming modalities may not be available or practicable. Also, its primary value may be to minimize further core temperature loss during early management of accidental hypothermia.
-
To evaluate resuscitation efforts for patients with cardiac and/or pulmonary arrest in our hospital a retrospective study was conducted and compared with available data from other community teaching hospitals. Records of 131 consecutive patients of ages 16-98 who received resuscitation according to Advanced Cardiac Life Support protocols were reviewed. Short-term survival (return of spontaneous circulation) and discharge-from-the hospital survival were measured. ⋯ Post-bypass surgery patients had a better survival than non-surgical patients, but the difference was significant (P > 0.05). Survival in our hospital was comparable to one hospital and worse than another (34.8% vs. 39.6% or 63.0%). Despite success, prognosis after arrest remain poor.