Circulation
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Clinical Trial Controlled Clinical Trial
Successful cardiopulmonary resuscitation after cardiac arrest as a "sepsis-like" syndrome.
We investigated the immunoinflammatory profile of patients successfully resuscitated after cardiac arrest, representing a model of whole-body ischemia/reperfusion syndrome. ⋯ Altogether, the high levels of circulating cytokines, the presence of endotoxin in plasma, and the dysregulated production of cytokines found in these patients recall the immunological profile found in patients with sepsis.
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Multicenter Study Clinical Trial
B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study.
We sought to determine the degree to which B-type natriuretic peptide (BNP) adds to clinical judgment in the diagnosis of congestive heart failure (CHF). ⋯ The evaluation of acute dyspnea would be improved with the addition of BNP testing to clinical judgment in the emergency department.
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Randomized Controlled Trial Comparative Study Clinical Trial
Use of irbesartan to maintain sinus rhythm in patients with long-lasting persistent atrial fibrillation: a prospective and randomized study.
Data from studies of angiotensin-converting enzyme inhibitors provide evidence that the renin-angiotensin-aldosterone system plays a role as a mediator of atrial remodeling in atrial fibrillation. The present study has evaluated the effect of treatment with the angiotensin I type 1 receptor blocker irbesartan on maintaining sinus rhythm after conversion from persistent atrial fibrillation. ⋯ Patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.
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Intermittent positive-pressure ventilation (IPPV) is the "gold standard" of ventilation during cardiopulmonary resuscitation (CPR), but continuous positive airway pressure (CPAP) is increasingly discussed as an alternative. This study investigated hemodynamics and pulmonary gas exchange applying CPAP enhanced with pressure support ventilation (CPAP(PSV)) during CPR. ⋯ CPAP(PSV) provides a straightforward and effective alternative to IPPV or CPAP during CPR that provides significantly higher PaO(2) and VO(2).