Resuscitation
-
We investigated the plasma levels of endothelin 1/2 in patients with acute symptoms relating to a known or newly diagnosed aortic aneurysm in order to investigate the possible role of peptides in the development of the disease. ⋯ Endothelin 1/2 levels are elevated in patients with acute dissection or ruptured aneurysm, but they are not an independent predictor of survival.
-
To study whether two different types of monophasic waveform shocks (i.e. monophasic damped sinusoidal [MDS] and monophasic truncated exponential [MTE] waveform shocks) are of equivalent efficacy. ⋯ Our data suggest disparity in efficacy between MDS waveform shocks and MTE waveform shocks. Furthermore, our findings should be taken into consideration when the issue of the control group(s) in future clinical trials on new waveforms is discussed.
-
As part of a continuous quality assurance process which we instituted in 1999, we review videotapes of selected high-risk deliveries at our hospital. We utilized our reviews to evaluate the occurrence of errors, and to evaluate team and leader functions during neonatal resuscitation. ⋯ We believe that neonatal resuscitation may be improved by the provision of teaching about team and leader functions, encouraging debriefing following complicated resuscitations, developing a minimal form to be completed for any patient requiring compressions or epinephrine within the delivery room, and providing more direct observations regarding the actual conduct of resuscitation.
-
We investigated an electrocardiographic signal analysis technique for predicting whether an electrical shock would reverse ventricular fibrillation (VF) in an effort to minimize the damaging effects of repetitive shocks during CPR. ⋯ AMSA predicted when an electrical shock failed to restore spontaneous circulation during CPR with a high negative predictive value. This method potentially fulfills the need for minimizing ineffective defibrillation attempts and their attendant adverse effects on the myocardium.
-
We report the case of a 45-year-old woman who had ingested 2000 mg of flecainide with suicidal intent. She developed therapy-resistant ventricular fibrillation (VF) with cardiopulmonary arrest. Cardiopulmonary resuscitation and advanced life support were sustained for 64 min. ⋯ She recovered completely after 5 days, leaving the hospital without neurological sequelae. Serum flecainide levels approximately 5 h post-ingestion were 850 mg/l. This case report confirms the value of amiodarone in drug-resistant VF, even when the cause may be another antiarrhythmic drug such as flecainide.