Critical care medicine
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Critical care medicine · Dec 1995
Systemic perfusion pressure and blood flow before and after administration of epinephrine during experimental cardiopulmonary resuscitation.
To evaluate instantaneous blood flow variations in the compression and relaxation phases of cardiopulmonary resuscitation (CPR) and the effect of epinephrine administration. ⋯ Open-chest CPR generated greater systemic perfusion pressure and blood flow than closed-chest CPR. Epinephrine increased left anterior descending coronary artery blood flow but decreased total cardiac output, such that cerebral perfusion might be endangered. This problem will be studied separately.
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Critical care medicine · Dec 1995
Comparative StudyA canine study of cold water drowning in fresh versus salt water.
To compare the pathophysiologic changes occurring during drowning in cold fresh water and cold salt water with reference to viability. ⋯ On submersion in cold water, all of the experimental animals developed tachypnea immediately, followed by aspiration with predictable effects. The biochemical and pathophysiologic changes in cold water drowning approximated those changes reported for warm water drowning for both fresh and salt water with one exception and continued aspiration of cold water produced extremely rapid core cooling as long as the circulation remained intact. This process of acute submersion hypothermia may protect the brain temporarily from lethal damage, as reported in cases of cold fresh water drowning. Concentrations of circulating catecholamines increased exponentially in both groups of test animals. Clinically, their acute effects on the circulation, compounded by significant hypothermia and extreme anoxia, must hamper the detection of residual circulation at rescue and may play a role in sudden death from cold water in the absence of drowning.