Current opinion in critical care
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Curr Opin Crit Care · Jun 2004
ReviewQuality of life and prognosis among survivors of out-of-hospital cardiac arrest.
We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. ⋯ The optimal strategy for improving long-term outcomes requires a multifaceted, integrative approach that begins with prehospital care and extends to secondary prevention.
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Curr Opin Crit Care · Jun 2004
ReviewPostresuscitation disease after cardiac arrest: a sepsis-like syndrome?
Despite advances in cardiac arrest resuscitation, neurologic impairments and other organ dysfunctions cause considerable mortality and morbidity after restoration of spontaneous cardiac activity. The mechanisms underlying this postresuscitation disease probably involve a whole-body ischemia and reperfusion syndrome that triggers a systemic inflammatory response. ⋯ Postresuscitation abnormalities after cardiac arrest mimic the immunologic and coagulation disorders observed in severe sepsis. This suggests that therapeutic approaches used recently with success in severe sepsis should be investigated in patients successfully resuscitated after cardiac arrest.
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Curr Opin Crit Care · Jun 2004
ReviewWaveforms for defibrillation and cardioversion: recent experimental and clinical studies.
The advent of biphasic waveforms for external defibrillation has generated extensive experimental and clinical investigation. At the same time, it has led to the development and clinical use of biphasic waveforms of several different designs. Finally, other types of waveforms, primarily triphasic, have entered experimental evaluation. ⋯ Biphasic waveforms have supplanted monophasic waveforms for defibrillation and cardioversion. They include biphasic truncated exponential, rectilinear, and pulsed biphasic versions. At this time, there is no certain evidence of clinical superiority of one waveform over another in terms of either efficacy or myocardial injury.