Kardiol Pol
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Incompleted ST segment resolution (STR) after primary percutaneous coronary intervention (PCI) is associated with worse clinical outcomes. ⋯ Plasma NT-proBNP level on admission is a strong and independent predictor of no-reflow phenomenon following primary PCI and mid-term cardiovascular mortality in patients with STEMI.
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We describe the management of a young patient who had experienced a cocaine overdose. The patient presented with altered mental status and seizures and subsequently developed a wide complex arrhythmia with a rare alternating bundle branch block pattern. Intravenous lipid emulsion was administered following initial resuscitation and endotracheal intubation, because conservative methods of treating the persistent cardiac arrhythmias failed.
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Therapeutic hypothermia (TH) is one of few interventions that improve survival after a cardiac arrest with good neurological outcome. Current guidelines for cardiopulmonary resuscitation recommend TH in comatose adult patients after return of spontaneous circulation (ROSC) regardless of cardiac arrest location and cardiac rhythm during the event. ⋯ The number of ICUs using TH in Poland increased threefold in the 5 year period of 2005-2010. However, the proportion of ICUs using TH is still low (21.7%) compared to other European countries. Further efforts should be undertaken to reduce barriers to implementation of current resuscitation guidelines.