Resuscitation
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Comparative Study Clinical Trial
Estimation of central venous pressure by ultrasound.
Increasing blood volume and cardiac output is one of the most commonly needed intervention in the primary care of traumatized and severely ill patients. Although cardiac filling pressures have severe limitations in assessing the preload, central venous pressure (CVP) is the invasive measure most frequently used in clinical practice for the assessment of volume status and cardiac preload. We combined ultrasound and tissue pressure measurement for non-invasive jugular and brachial venous pressure estimation. ⋯ Ultrasound-based, non-invasive measurement of venous pressure provides a relatively easy method rapid estimation of changes in CVP, although absolute values may differ substantially from invasive CVP and between different investigators.
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Induced hypothermia is underused after resuscitation from cardiac arrest: a current practice survey.
Important recent work has demonstrated that the use of induced hypothermia can improve survival and neurologic recovery after cardiac arrest. We wished to ascertain the extent to which physicians were using this treatment, and what opinions are held by clinicians regarding its use. ⋯ Despite compelling data supporting its use, hypothermia has yet to be broadly incorporated into physician practice. This highlights the need for improved awareness and education regarding this treatment option, as well as the need to consider hypothermia protocols for inclusion in future iterations of ACLS.
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Randomized Controlled Trial Comparative Study Clinical Trial
CPR for children: one hand or two?
Current guidelines for chest compressions in CPR advocate a one handed technique in children (1-8 years old) and a two handed technique in adults (>8 years old). No previous study has examined whether these two techniques generate different compression pressures. This study assesses the relative difference in intrathoracic compression pressures generated by one- and two handed chest compression techniques in a paediatric manikin. ⋯ Two handed chest compression CPR seems to be easier to perform on a paediatric resuscitation manikin and produces significantly higher mean and peak pressures. Further work is needed to determine the comparative effects on children and which technique produces better clinical outcomes.
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Randomized Controlled Trial Comparative Study Clinical Trial
The evolution of serum astroglial S-100 beta protein in patients with cardiac arrest treated with mild hypothermia.
To study the effects of mild hypothermia on the 24h concentration of serum astroglial of S-100 beta protein in patients who survived cardiac arrest (CA). ⋯ Induced mild hypothermia reduced the 24h astroglial serum S-100 beta protein concentration and might play a neuroprotective effect after cardiac arrest.
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To determine if 15 min of open-chest cardiac massage (OC-CPR) versus closed-chest compressions (CC-CPR) improves 72-h survival and neurologic outcome (behavioral and histologic) after 5 min of untreated cardiac arrest. ⋯ In our canine model of cardiac arrest, OC-CPR significantly improved 72-h survival and neurologic outcome when compared to CC-CPR.