Resuscitation
-
Recent data demonstrated potent neuroprotective effects of growth hormones such as granulocyte colony-stimulating factor (G-CSF) after focal cerebral ischaemia. In order to assess possible effects of intracerebroventricular application of G-CSF on cerebral recovery after cardiac arrest (CA) in rats, neurological testing and histological analyses were performed. ⋯ Despite promising experimental data concerning focal cerebral ischaemia, in this model of 6 min of normothermic CA no beneficial effects of G-CSF application could be demonstrated by behavioural testing and histological analyses of the hippocampal CA-1 sector.
-
During cardiopulmonary resuscitation (CPR), advanced life support (ALS) providers have been shown to deliver inadequate CPR with long intervals without chest compressions. Several changes made to the 2005 CPR Guidelines were intended to reduce unnecessary interruptions. We have evaluated if quality of CPR performed by the Oslo Emergency Medical System (EMS) improved after implementation of the modified 2005 CPR Guidelines, and if any such improvement would result in increased survival. ⋯ Quality of CPR improved after implementation of the modified 2005 Guidelines with only a weak trend towards improved survival to hospital discharge.
-
Although ventricular fibrillation waveform characteristics (VFWC) correlate with coronary perfusion pressure and may predict defibrillation outcome, recent animal data indicate that these waveform characteristics are altered in both acute myocardial infarction (AMI) and chronic coronary heart disease (CHD). We wanted to confirm these recent animal data in humans and explore the possibility for such characteristics to identify acute ischemia during cardiac arrest. ⋯ AMI patients have depressed MS and AMSA compared to patients without AMI during VF cardiac arrest. VFWC might be helpful in identifying patients with AMI during cardiac arrest, but prospective clinical studies are warranted to assess its feasibility and clinical benefit.
-
While the outcomes of cardiopulmonary resuscitation (CPR) for pediatric in-hospital cardiac arrest (IHCA) are reported for many regions, none is reported for Asian countries. We report the outcomes of CPR for pediatric IHCA in a tertiary medical center in Taiwan and also identify prognostic factors associated with poor outcome. ⋯ Outcomes of CPR for pediatric patients with IHCA in Taiwan were comparable to corresponding reports in Western countries, but more hematology/oncology patients were included. Long CPR duration, hematologic or oncologic underlying diseases, and vasoactive agent infusion prior IHCA were associated with poor outcomes. The concept of palliative care should be proposed to families of terminally ill cancer patients in order to avoid unnecessary patient suffering. Also, establishing a balanced duty system in the future might increase chances of sustained ROSC.