Resuscitation
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Comparative Study
Feasibility of automated rhythm assessment in chest compression pauses during cardiopulmonary resuscitation.
To demonstrate the feasibility of doing a reliable rhythm analysis in the chest compression pauses (e.g. pauses for two ventilations) during cardiopulmonary resuscitation (CPR). ⋯ Chest compression pauses are frequent and of sufficient duration to launch a high-temporal resolution SAA. During these pauses rhythm analysis was reliable. Pre-shock pauses could be minimised by analysing the rhythm during ventilation pauses when CPR is delivered at 30:2 compression:ventilation ratio.
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When providing advanced life support (ALS) in cardiac arrest, the patient may alternate between four clinical states: ventricular fibrillation/tachycardia (VF/VT), pulseless electrical activity (PEA), asystole, and return of spontaneous circulation (ROSC). At the end of the resuscitation efforts, either death has been declared or sustained ROSC has been obtained. The aim of this study was to describe and analyze the clinical state transitions during ALS among patients experiencing in-hospital cardiac arrest. ⋯ We provide an overall picture of the intensities and patterns of clinical state transitions during in-hospital ALS. The majority of patients who obtained sustained ROSC obtained this state and stabilized within the first 15-20 min of ALS. Those who continued to behave unstably after this time point had a high risk of ultimately being declared dead.
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Comparative Study
Epidemiology and outcomes of in-hospital cardiopulmonary resuscitation in the United States, 2000-2009.
To examine temporal trends in the epidemiology and outcomes of in-hospital cardiopulmonary resuscitation (CPR) recipients at a population level. ⋯ The rate of in-hospital CPR in the U.S. increased, and CPR recipients have become younger and sicker over time. Survival to discharge has improved by 41.3%. Functional outcomes after in-hospital CPR appear to have worsened, with considerable clinical and economic implications.
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Acute coronary lesions are known to be the most common trigger of out of hospital cardiac arrest (OHCA). Aim of the present study was to assess the predictive value of ST-segment changes in diagnosing the presence of acute coronary lesions among OHCA patients ⋯ Electrocardiographic findings after OHCA should not be considered as strict selection criteria for performing emergent CA in patients resuscitated from OHCA without obvious extra-cardiac cause; even in the absence of ST-segment elevation on post-ROSC ECG, acute culprit coronary lesions may be present and considered the trigger of cardiac arrest.
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This is the first clinical trial to evaluate whether successful endotracheal intubation (ETI) using a video-laryngoscope (VL) (GlideScope(®)) can be performed easily without chest compression interruptions during actual cardiopulmonary resuscitation (CPR) after brief VL training, regardless of the physicians' levels of experience with successful ETI in the past. ⋯ In a clinical setting, the use of a VL had a high success rate for the first ETI attempt with notably few chest compression interruptions, regardless of the physicians' varying experience with successful ETI in the past.