Resuscitation
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The aim of the present study was to test the hypothesis that balanced crystalloid resuscitation would be better for the kidney than unbalanced crystalloid resuscitation in a rat hemorrhagic shock model. ⋯ Although balanced crystalloid resuscitation seems superior to balanced crystalloid resuscitation in protecting the kidney after hemorrhagic shock and is certainly better than not applying fluid resuscitation, these solutions were not able to correct systemic inflammation or oxidative stress associated with hemorrhagic shock.
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To identify patients who can obtain the full benefit from targeted temperature management (TTM) after out-of-hospital cardiac arrest. ⋯ The prediction protocol using the 5-R score was associated with good neurological outcome of patients treated with TTM. Therefore, it could be helpful in clinical decision making on whether to initiate cooling.
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The role of immediate coronary angiography and percutaneous coronary intervention (angio±PCI), amongst comatose survivors of out-of-hospital cardiac arrest is unclear. This study was undertaken to evaluate if immediate angio±PCI compared to no initial intervention improves neurological outcome at hospital discharge amongst comatose survivors of out-of-hospital pulseless ventricular tachycardia (pVT) or ventricular fibrillation (VF). ⋯ Immediate angio±PCI in comatose survivors of out-of-hospital VF/pVT arrest did not lead to better neurological outcome at hospital discharge.
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Cardiac arrest (CA) in humans causes warm renal ischemia-reperfusion injury, similar to animal models of ischemic acute kidney injury (AKI). We aimed to investigate the incidence and risk associations of AKI after CA, with or without post-resuscitation cardiogenic shock (PRCS). ⋯ In the absence of PRCS, CA in isolation is uncommonly associated with significant AKI. The human kidney may be more resistant to warm ischemia-reperfusion injury than previously thought.