Resuscitation
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Comparative Study
Vasopressin versus continuous adrenaline during experimental cardiopulmonary resuscitation.
To evaluate the effects of a bolus dose of vasopressin compared to continuous adrenaline (epinephrine) infusion on vital organ blood flow during cardiopulmonary resuscitation (CPR). ⋯ In this experimental model, vasopressin caused a greater increase in cortical cerebral blood flow and lower cerebral oxygen extraction during CPR compared to continuous adrenaline. Furthermore, vasopressin generated higher coronary perfusion pressure and increased the likelihood of restoring spontaneous circulation.
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We assessed the familiarity of the general public with automated external defibrillators (AEDs) and their willingness to use them. ⋯ Although a substantial number of people in this setting were willing to use an AED, education regarding legal liability and proper use of the machines increased the reported likelihood of use. Further public education may be necessary to provide optimally effective public access defibrillation programs.
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Comparative Study
Percutaneous transcricoid jet ventilation compared with surgical cricothyroidotomy in a sheep airway salvage model.
We developed a large animal model of the "cannot intubate/cannot ventilate" (CNI/V) scenario to compare percutaneous transcricoid manual jet ventilation (MJV) with surgical cricothyroidotomy (SC). ⋯ Using a realistic model of CNI/V we found no difference in respiratory or hemodynamic variables between MJV and SC. Adequate ventilation and perfusion was maintained solely by MJV for up to 20 min.
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Research in patients with life-threatening illness such as cardiac arrest is challenging since they can not consent. The Food and Drug Administration addressed research under emergency conditions by publishing new criteria for exception from informed consent in 1996. We systematically reviewed randomized trials over a 10-year period to assess the impact of these regulations. ⋯ Fewer American cardiac arrest trials were published during the last decade, when federal consent requirements changed. Regulatory requirements for clinical trials may inhibit improvements in care and threaten public health.