Resuscitation
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This report illustrates a case of prolonged resuscitation (without hypothermia) with a return of spontaneous circulation (ROSC) after 1 h of resuscitation in a hospital car park and emergency department. Coronary artery stenting was achieved 2 h and 45 min after collapse. Following a 12-week stay in hospital the patient was discharged home making a full recovery within 12 months. Issues regarding prolonged resuscitation and the key predictors of survival are discussed.
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In a study of artifact-free ventricular fibrillation episodes in 54 patients, 28 of whom experienced return of spontaneous circulation (ROSC), the power of different indicators to predict the ROSC was compared. Taking the average of sensitivity, specificity and positive and negative predictive value, the dominant frequency reaches 76%, the mean amplitude 72% and fibrillation power 71%. There is little correlation between the three indicators.
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Noninvasive prediction of defibrillation success after cardiac arrest and cardiopulmonary resuscitation (CPR) may help in determining the optimal time for a countershock, and thus increase the chance for survival. ⋯ We suggest that fibrillation power is an alternative source of information on the status of a fibrillating heart and that it may match the established mean frequency and amplitude analysis of ECG in predicting successful countershock during CPR.