Heart & lung : the journal of critical care
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Randomized Controlled Trial Comparative Study
Comparison of blind intubation through the I-gel and ILMA Fastrach by nurses during cardiopulmonary resuscitation: a manikin study.
To investigate whether nursing staff can successfully use the I-gel and the intubating laryngeal mask Fastrach (ILMA) during cardiopulmonary resuscitation. ⋯ In this mannequin study, nursing staff can successfully intubate using the I-gel and the ILMA as conduits with comparable success rates, regardless of whether chest compressions are interrupted or not.
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3, 4-methylenedioxymethamphetamine (MDMA), popularly known as "ecstasy" is a synthetic, psychoactive drug used recreationally for its euphoric and "energy increasing" effects. MDMA has been linked to several severe adverse effects including the development of serotonin syndrome and sudden death. ⋯ The patient initially received supportive care including ventilatory support; he eventually needed hemodialysis, but went on to make a full recovery within 3 weeks. This case shows and emphasizes the importance of 'aggressive' supportive care on patient prognosis particularly for patients on the extreme end of the serotonin syndrome.
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Postoperative hypoxemia is a common clinical challenge. The diagnosis of an underlying cause of hypoxemia may not immediately be apparent. Clinically silent and non-functional intracardiac shunt may become apparent and pose significant management problems in the postoperative period. ⋯ This condition was effectively diagnosed by bedside echocardiography, and was effectively treated with nitric oxide.
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Observational Study
Feasibility and inter-rater reliability of the ICU Mobility Scale.
The objectives of this study were to develop a scale for measuring the highest level of mobility in adult ICU patients and to assess its feasibility and inter-rater reliability. ⋯ The IMS is a feasible tool with strong inter-rater reliability for measuring the maximum level of mobility of adult patients in the ICU.
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We report on a 68 years old survivor of an out-of-hospital cardiac arrest with favorable neurological outcome following prolonged cardiopulmonary resuscitation (CPR 59 min) until return of spontaneous circulation (ROSC) due to ST-elevation myocardial infarction (STEMI). The case demonstrates the beneficial effect of an optimal rescue chain including basic life support performed by trained bystanders, short response time of the emergency medical service, uninterrupted CPR during transportation using a mechanical chest compression system (LUCAS®), in combination with optimal intensive care management of cardiogenic shock after ROSC including multivessel emergency percutaneous coronary intervention (PCI) and intravascular therapeutic hypothermia (Coolgard®-System).