Resuscitation
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As recent clinical data suggest a harmful effect of arterial hyperoxia on patients after resuscitation from cardiac arrest (CA), we aimed to investigate this association during cardiopulmonary resuscitation (CPR), the earliest and one of the most crucial phases of recirculation. ⋯ n/a.
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The VitalPAC™ Early Warning Score (ViEWS) has an area under the receiver operator characteristic curve (AUROC) for death of acute unselected medical patients within 24h of 88% and the UK National Early Warning Scores is based on it. The score's discrimination has been validated on patients in the developed world, but nothing is known of its performance in resource-poor hospitals. ⋯ The discrimination of ViEWS in a resource poor sub-Saharan Africa hospital is the same as in the developed world. Inability to walk without help was found to be an additional independent predictor of mortality.
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To validate an existing theoretical model for the mechanics of chest compression (CC) during constant peak force cardiopulmonary resuscitation (CPR) using experimental human and manikin CC data from the literature. Also, to gain insights into the clinical application of force guided CPR. ⋯ Good quantitative agreement between the experimental data from the literature and the theoretical model suggests that the constant peak force CPR model developed by Boe and Babbs provides reasonable prediction of CC mechanics during CPR over a range of clinically relevant CC rates. The model predictions also suggest that the effectiveness of CC during force guided CPR is highly sensitive to the patient's thoracic stiffness and insensitive to the back support stiffness. Patients having high thoracic stiffness (≥ 100 Ncm(-1)) were found to require higher CC forces, which may exceed the force above which severe chest wall trauma and abdominal injury occurs, in order to achieve the ERC recommended CC depth range. This suggests that the choice of maximum sternal force applied by clinicians during constant peak force CPR ought to be based on a general assessment of the patient's thoracic stiffness.
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This study investigated whether an imbalance in Th1/Th2 cells is involved in the post-resuscitation myocardial immune dysfunction. ⋯ The myocardial immune dysfunction induced by the change in expression levels of the transcription factors GATA-3 and T-bet may be involved in the process of post-resuscitation myocardial injury in a porcine model of cardiac arrest.