Scand J Trauma Resus
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Therapeutic hypothermia, recently termed target temperature management (TTM), is the cornerstone of neuroprotective strategy. Dating to the pioneer works of Fay, nearly 75 years of basic and clinical evidence support its therapeutic value. Although hypothermia decreases the metabolic rate to restore the supply and demand of O₂, it has other tissue-specific effects, such as decreasing excitotoxicity, limiting inflammation, preventing ATP depletion, reducing free radical production and also intracellular calcium overload to avoid apoptosis. ⋯ In this review, we discuss the basic and clinical evidence supporting the use of TTM in critical care for acute brain injury that extends beyond care after cardiac arrest, such as for ischemic and hemorrhagic strokes, subarachnoid hemorrhage, and traumatic brain injury. We review the historical perspectives of TTM, provide an overview of the techniques and protocols and the pathophysiologic consequences of hypothermia. In addition, we include our experience of managing patients with acute brain injuries treated using endovascular hypothermia.
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Scand J Trauma Resus · Jun 2015
Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center.
Penetrating cardiac injuries in Europe have been poorly studied. We present a 10-year outcome for patients with penetrating heart injuries at Oslo University Hospital. ⋯ The outcome of patients with penetrating cardiac injury reaching the emergency department with signs of life was excellent. Hemodynamic instability indicates immediate surgery. Stable patients with penetrating thoracic trauma and possible cardiac injury detected by imaging should be considered for conservative treatment.
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Scand J Trauma Resus · May 2015
Observational StudyConcordance and limits between transcutaneous and arterial carbon dioxide pressure in emergency department patients with acute respiratory failure: a single-center prospective observational study.
Transcutaneous CO₂ (PtCO₂) is a continuous and non-invasive measure recommended by scientific societies in the management of respiratory distress. The objective of this study is to evaluate the correlation between PtCO₂ and blood pressure of CO₂ (PaCOv) by blood gas analysis in emergency patients with dyspnoea and to determine the factors that interfere in this correlation. ⋯ In patients admitted in emergency unit for acute respiratory failure, there is a significant correlation between PaCO₂ and PtCO₂, mainly for values below 60 mm Hg. The two limiting factors of use are hyperthermia and users training.
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Scand J Trauma Resus · May 2015
Observational StudyIncreasing bystander CPR: potential of a one question telecommunicator identification algorithm.
Telecommunicators use a two-question algorithm to identify cardiac arrest: Is the individual conscious? Is the individual breathing normally? Although this approach increases arrest identification and consequently bystander CPR, the strategy does not identify all arrests and requires time to complete. We evaluated the implications of a one-question strategy that inquired only about consciousness. ⋯ A single-question arrest identification algorithm may not achieve a favorable balance of risk and benefit.
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Scand J Trauma Resus · Apr 2015
Randomized Controlled TrialOptimal chest compression technique for paediatric cardiac arrest victims.
The aim of this study was to assess the quality of chest compressions performed by inexperienced rescuers using three different techniques: two-hand, right one-hand, and left one-hand. ⋯ For paediatric cardiopulmonary resuscitation by inexperienced rescuers, the two-hand technique has the advantage of producing deeper compressions than the one-hand technique, but it is accompanied by more frequent residual leaning. For the one-hand techniques, the right and left hand produced chest compressions of similar quality.