Resuscitation
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To develop and evaluate a practical formula for the optimum ratio of compressions to ventilations in cardiopulmonary resuscitation (CPR). The optimum value of a variable is that for which a desired result is maximized. Here the desired result is assumed to be either oxygen delivery to peripheral tissues or a combination of oxygen delivery and waste product removal. ⋯ Current guidelines overestimate the need for ventilation during standard CPR by two to four-fold. Blood flow and oxygen delivery to the periphery can be improved by eliminating interruptions of chest compression for these unnecessary ventilations.
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Comment Letter Case Reports
Splenic rupture following cardiopulmonary resuscitation.
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(1) To identify risk factors for in-hospital cardiac arrest; (2) to formulate activation criteria to alert a clinical response culminating in attendance by a Medical Emergency Team (MET); (3) to evaluate the sensitivity and specificity of the scoring system. ⋯ Risk factors for cardiac arrest have been identified, quantified and formulated into a table of activation criteria to help predict and avert cardiac arrest by alerting a clinical response. A graded clinical response has resulted in a tool that has both sensitivity and specificity for cardiac arrest.
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Comparative Study
Does veno-arterial bypass without an artificial lung improve the outcome in dogs undergoing cardiac arrest?
We hypothesized that maintaining circulation and blood pressure by veno-arterial bypass (V-A bypass) without oxygenation would improve cardiopulmonary resuscitation (CPR) and survival rates. A total of 32 dogs, divided into four groups, were subjected to normothermic ventricular fibrillation (VF) for 15 min. The method of CPR was the same in the four groups, except for the method and timing of V-A bypass. ⋯ No significant difference in survival rates was demonstrated among the four groups (P = 0.11). We concluded that V-A bypass without oxygenation does not improve the chances for CPR and outcome after cardiac arrest in dogs. Our results suggest that oxygenation is indispensable in CPR.
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The aim of this study was to characterize gene expression following hemorrhagic shock and resuscitation with emphasis on the differences between various resuscitation strategies. ⋯ Cellular response to hemorrhagic shock, even at the level of gene expression, is dependent on the resuscitation strategy. We have discovered altered expression of genes not previously implicated in the physiology of hemorrhagic shock and resuscitation. Gene array technology provides a rapid and efficient means of dissecting the complex genetic regulation of cellular response to shock.