Resuscitation
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Comparative Study
Incidence of iatrogenic dyscarbia during mild therapeutic hypothermia after successful resuscitation from out-of-hospital cardiac arrest.
To investigate the incidence of iatrogenic dyscarbia in survivors of out-of-hospital cardiac arrest treated with induced mild hypothermia. We performed a retrospective cohort study of the ventilatory management based on blood gas analyses of patients resuscitated from prehospital cardiac arrest. In the pilot phase, we assessed the ventilatory management in the patients treated in one university hospital during a 4-year study period. ⋯ The incidence of hypo- or hyper-carbia (dyscarbia) was high (45%). This may predispose for serious derangements in the cerebral perfusion of the resuscitated patient. These results call for vigilance in adjustment of the ventilatory management to meet the needs of the patients treated with mild hypothermia.
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Comparative Study
Derivation of a prognostic score for identifying critically ill patients in an emergency department resuscitation room.
Several prognostic scores exist for critically ill patients, including APACHE II, Revised Trauma Score (RTS), Rapid Emergency Medicine Score (REMS) and Modified Early Warning Score (MEWS). However, there is no widely used score specifically designed to predict the likelihood of early intensive care unit (ICU) admission or death in undifferentiated emergency department (ED) resuscitation room patients. We aimed to derive such a score and compare it with other similar scores. ⋯ The Prince of Wales Emergency Department Score (PEDS) is a new prognostic score to predict the likelihood of early ICU admission or death in undifferentiated resuscitation room patients. Further studies are needed to validate and refine this potentially useful tool.
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Comparative Study
A national survey of prevalence of cardiopulmonary resuscitation training and knowledge of the emergency number in Ireland.
The aim of this survey was to establish prevalence of cardiopulmonary resuscitation (CPR) training within the last 5 years and reasons preventing training and initiation of CPR in Ireland as well as awareness of the emergency numbers. ⋯ Previous Irish and American population targets for CPR training have been surpassed in Ireland in 2008. New internationally agreed targets are now required. Meanwhile older people and those in lower socio-economic groups should be targeted for training. Awareness of at least one emergency number is very high in Ireland. Some geographical variation was found and this should be studied further.
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Comparative Study
Effect and mechanism of esmolol given during cardiopulmonary resuscitation in a porcine ventricular fibrillation model.
The aim of the study was to investigate the effect on calcium cycling protein and electrical restitution of beta(1)-adrenergic receptor antagonist esmolol administered during cardiopulmonary resuscitation in the porcine ventricular fibrillation model. ⋯ Esmolol given during CPR has significant effects on modulating electrical restitution property and intracellular calcium handling, which contributes the most important reasons why beta(1)-blockade significantly reduced the onset and maintenance of VF.
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Comparative Study
Comparison of efficacy of pulsed biphasic waveform and rectilinear biphasic waveform in a short ventricular fibrillation pig model.
The waveform designs and their relative defibrillation efficacy of external biphasic waveforms may differ remarkably among manufacturers. In this study, we compared pulsed biphasic waveform (PBW) with rectilinear biphasic waveform (RBW) and their effects on terminating ventricular fibrillation (VF). ⋯ In the setting of this experiment, there was no difference in terms of defibrillation efficacy and myocardial injury related to the electrical shocks of the two waveforms.