Resuscitation
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Automated chest-compression devices (ACCDs) have recently been proposed in the management of out-of-hospital cardiac arrest (cardiopulmonary resuscitation, CPR). During CPR, it is still unknown whether the ACCD or intubation is to be first implemented. Knowing the impact of an ACCD on intubation conditions could strongly contribute to determine the best sequence. Therefore, we undertook an experimental study on intubation conditions on a mannequin with or without the use of an ACCD. ⋯ Due to the major role of compression during CPR, we suggest that the ACCD should not be systematically switched off for routine intubation.
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Few studies have focused on the full complement of cardiac arrest cases seen in hospital emergency departments (ED). The aims of our study were to describe cardiac arrest visits in the ED by using a nationally representative sample of U.S. adults. ⋯ From 2001 to 2007, adults in the U.S. made an estimated 600,729,000 ED visits. Of those, 1,001,000 (0.17%) had a primary diagnosis of cardiac arrest. The majority of patients with such visits were dead on arrival or died in the ED (74.0%). The mean age for cardiac arrest visits was 66.7 years (95% confidence interval [CI], 64.6-68.8 years). Women had a lower rate of cardiac arrest visits than men (age-adjusted odds ratio [AOR], 0.6; 95% CI, 0.5-0.8), and the privately insured (AOR, 0.4; 95% CI, 0.2-0.7) and those with government insurance (AOR, 0.5; 95% CI, 0.3-0.9) had a lower proportion of cardiac arrest ED visits than uninsured persons. In addition, increasing age was a significant predictor of cardiac arrest visits. Cardiac arrest visits did not vary significantly by race, geographic region, or metropolitan statistical area. ED visits classified as cardiac arrest represent 1 in 600 visits and these visits differ by age, sex, payment source, and arrival time at the ED.
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Studies show that students, trained to perform compressions between 40 and 50mm deep, often do not achieve sufficient depth at retention testing. We hypothesized that training to achieve depths >50mm would decrease the proportion of students with depth <40mm after 6 months, compared to students trained to a depth interval of 40-50mm. ⋯ The educational strategy to train students to a deeper depth, reduced shallow compressions 6 months after training.
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We recently reported that female sex protects against cerebral and cardiac injury after hypovolemic cardiac arrest (CA), independent of sex hormone effects. As female sex was also associated with a smaller increase in inducible and neuronal nitric oxide synthase (NOS), we hypothesised that nitric oxide inhibition with methylene blue (MB) improves the outcome, primarily in male animals. ⋯ After resuscitation from hypovolemic CA, female sex protects against cardiac injury, independent of sex hormones. Modulation of NO expression with MB does not improve survival or myocardial histological injury in either sex.
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To evaluate the effect of age on heart rate variability (HRV) in a rat model of therapeutic hypothermia. ⋯ This study noted that autonomic regulation determined via HRV, primarily the ratio of LF to HF, was different between different age groups. Additional studies on this topic are needed to achieve a more detailed understanding of therapeutic hypothermia.