Resuscitation
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Public access defibrillation (PAD) has shown potential to increase cardiac arrest survival rates. ⋯ We found a definite geographical distribution pattern of cardiac arrest. This study demonstrates the utility of GIS with a national cardiac arrest database and has implications for implementing a PAD program, targeted CPR training, AED placement and ambulance deployment.
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Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model. ⋯ Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.
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The present study was designed to evaluate the effect of conventional fluid resuscitation and small volume resuscitation alone and combined with arginine vasopressin (AVP) on cerebral perfusion pressure (CPP) and protein S100B during experimental haemorrhagic shock. ⋯ HHS+AVP resulted in higher CPP compared to fluid and HHS+NS in the initial phase of therapy, but did not differ thereafter. Haemorrhage-induced hypotension yielded increased S100B levels that were comparable in groups throughout the study period.
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Randomized Controlled Trial Multicenter Study Comparative Study
Strict normoglycaemic blood glucose levels in the therapeutic management of patients within 12h after cardiac arrest might not be necessary.
The admission blood glucose level after cardiac arrest is predictive of outcome. However the blood glucose levels in the post-resuscitation period, that are optimal remains a matter of debate. We wanted to assess an association between blood glucose levels at 12h after restoration of spontaneous circulation and neurological recovery over 6 months. ⋯ There is a strong non-linear association of survival with good neurological outcome and blood glucose levels 12h after cardiac arrest even after adjusting for potential confounders. Not only strict normoglycaemia, but also blood glucose levels from 116 to 143 mg/dl were correlated with survival and good neurological outcome, which might have an important therapeutic implication.
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Randomized Controlled Trial Comparative Study
Instructions to "put the phone down" do not improve the quality of bystander initiated dispatcher-assisted cardiopulmonary resuscitation.
The quality of early bystander CPR appears important in maximizing survival. This trial tests whether explicit instructions to "put the phone down" improve the quality of bystander initiated dispatch-assisted CPR. ⋯ Instructions to "put the phone down" had no effect on the quality of bystander initiated dispatcher-assisted CPR in this trial.