Resuscitation
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The ventricular fibrillation (VF) waveform is dynamic and predicts defibrillation success. Quantitative waveform measures (QWMs) quantify these changes. Coronary perfusion pressure (CPP), a surrogate for myocardial perfusion, also predicts defibrillation success. The relationship between QWM and CPP has been preliminarily explored. We sought to further delineate this relationship in our porcine model and to determine if it is different between animals with/without ROSC (return of spontaneous circulation). ⋯ There is a linear relationship between QWM and CPP during chest compressions in our porcine cardiac arrest model that is different between animals with/without ROSC.
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Clinical Trial
A low tilt waveform in the transthoracic defibrillation of ventricular arrhythmias during cardiac arrest.
Most commercially available defibrillators utilise a high tilt waveform. Work in atrial fibrillation has shown improved defibrillation success using low tilt waveforms. We hypothesise that a novel low tilt biphasic waveform will be non-inferior to a standard tilt waveform whilst delivering lower energy for the defibrillation of ventricular arrhythmias. ⋯ The low tilt waveform used in this study demonstrated first shock success rates in keeping with a commercially available high tilt defibrillator which could result in less myocardial damage due to reduced energy requirements.
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This study investigated the incidence of hyperfibrinolysis upon emergency department (ED) admission in patients with out of hospital cardiac arrest (OHCA), and the association of the degree of hyperfibrinolysis with markers of hypoperfusion. ⋯ A substantial part of OHCA patients develop hyperfibrinolysis in association with markers for hypoperfusion. Our data further suggest that the time to the onset of clot lysis may be an important marker for the severity of hyperfibrinolysis and patient outcome.
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To our knowledge, there are no previous reports on the performance of medical equipment in cold conditions. The aim of this study was to evaluate the performance of several plastic, single-use medical equipment exposed to cold outdoor temperature. ⋯ Plastic medical equipment has poor tolerance of cold conditions. Loss of equipment performance and properties could result in relevant harm to the patient. Retaining the equipment, e.g. in a closed backpack slows the rate of temperature decrease.
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Identification of the cause of out-of-hospital cardiac arrest (OHCA) is of paramount importance. We investigated the ability of our imaging strategy to provide an early etiological diagnosis of OHCA and the influence of this strategy on ICU survival. ⋯ The use of an early diagnosis protocol with immediate coronary angiography and/or CT scan provided the etiology of nearly two thirds of OHCA cases. In this large retrospective database, coronary angiography yielded a better diagnostic value than brain and/or chest CT-scan.