Resuscitation
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Comparative Study
Female sex is not associated with improved rates of ROSC or short term survival following prolonged porcine ventricular fibrillation.
There may be a survival benefit in female patients experiencing cardiac arrest, which could affect the interpretation of in vivo animal studies. We hypothesized that sex predicts return of spontaneous circulation (ROSC) and short-term survival (SURV) in porcine studies of prolonged ventricular fibrillation (VF). ⋯ Sex predicts neither ROSC nor SURV in a swine model of prolonged VF.
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Cardiopulmonary resuscitation (CPR) using extracorporeal life support (ECLS) system has been successfully used to support patients with in- and out-of-hospital cardiac arrest (IHCA, OHCA) when conventional measures have failed. The purpose of the current study is to report on our experience with extracorporeal CPR in non-postcardiotomy patients. ⋯ CPR using modern miniaturized ECLS systems should be established in the treatment of prolonged cardiac arrest and unsuccessful conventional CPR in selected patients. CPR with ECLS for OHCA has worse outcomes compared to IHCA. Duration of CPR was independent risk factor for mortality after extracorporeal CPR.
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Absence or inhibition of Toll-like receptor 2 (TLR2) signalling during murine myocardial ischaemia/reperfusion (MI/R) decreases myocardial necrosis and inflammation, thereby ameliorating cardiac dysfunction and improving survival. In the present study, we provide evidence for the involvement of the phosphoinositide-3-kinase/Akt pathway in TLR2-dependent reperfusion injury. ⋯ Akt is an important mediator of cardioprotection in TLR2(-/-) animals during MI/R. The effect is, however, likely mediated by its genomic overexpression in the heart of TLR2(-/-) animals whilst Akt activation by phosphoinositide-3-kinase is unaltered.
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Public access automated external defibrillator (PAD) programs have been shown to be successful in several municipalities. This study sought to determine the usage of and survival rate from a large, urban PAD program in the first 10 years since its implementation. ⋯ While the majority of PAD cases occurred at an airport, there were also survivors from other public locations. AEDs deployed as part of a large PAD program resulted in a very high survival rate for patients with cardiac arrest.
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Ischemic postconditioning (PC) with "stuttering" reintroduction of blood flow after prolonged ischemia has been shown to offer protection from ischemia reperfusion injury to the myocardium and brain. We hypothesized that four 20-s pauses during the first 3 min of standard CPR would improve post resuscitation cardiac and neurological function, in a porcine model of prolonged untreated cardiac arrest. ⋯ Ischemic postconditioning with four 20-s pauses during the first 3 min of SCPR improved post resuscitation cardiac function and facilitated neurological recovery after 15 min of untreated cardiac arrest in pigs.