Resuscitation
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Comparative Study
Efficacy of bystander CPR: intervention by lay people and by health care professionals.
Early cardiopulmonary resuscitation (CPR) by bystanders prior to the arrival of the rescue team has been shown to be associated with increased survival after out-of-hospital cardiac arrest. The aim of this survey was to evaluate the impact on survival of no bystander CPR, lay bystander CPR and professional bystander CPR. ⋯ Among patients suffering an out-of-hospital cardiac arrest, bystander CPR by lay persons (excluding health care professionals) is associated with an increased chance of survival. Furthermore, there is a distinction between lay persons and health care providers; survival is higher when the latter perform bystander CPR. However, these results may not be explained by differences in the quality of CPR.
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Comparative Study
The first year after successful cardiac resuscitation: function, activity, participation and quality of life.
To assess cognitive function, activities of daily living (ADL) and living situation longitudinally up to 1 year after cardiac arrest. ⋯ Most of the improvement resulting in the independence of ADL occurred during the first 45 days. It is important to give the next of kin information about the patient's progress and need for assistance in order to enable them to plan for the future before discharge.
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Epinephrine (adrenaline) and vasopressin have been by far the most commonly studied vasopressors in experimental cardiac arrest. Despite animal experimental studies suggesting improved outcomes in experimental cardiac arrest, clinical trials of pressor agents have failed to show clear cut benefit from either vasopressin or epinephrine, although few, if any, trials compared pressor agents to a placebo. ⋯ The combination of epinephrine and vasopressin may be effective, but has been incompletely studied. Clinical trials of vasopressor agents, which minimize direct myocardial effects are needed.
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Comparative Study
Comparison of effects of different hand positions during cardiopulmonary resuscitation.
The technique of chest compression recommended in the recent international guidelines is different from that which was traditionally used in Hungary. While compression force, location, frequency and duty cycle are all identical, the position of the hand on the chest is different. The aim of our study was to compare these two methods concerning the area and location of the surface compressed on the chest wall. ⋯ Comparing the two different methods of chest compressions, the hand position recommended by the recent international guidelines seems to be more safe as it compresses a smaller area which might cause injury.
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Cardiac arrest induces severe mesenteric ischaemia. The objective of this study was to assess the frequency of gut dysfunction and endoscopic lesions following resuscitation after cardiac arrest, and to evaluate the potential value of gut endoscopy performance in these circumstances. ⋯ The frequent occurrence of endoscopic lesions in the presence of gut dysfunction following a cardiac arrest could suggest systematic gut endoscopy in such patients. However, an alternative recommendation would be to watch these patients very closely, treat all with prophylactic proton pump inhibitors, and endoscope only those with evidence of bleeding.