Resuscitation
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Comparative Study
Precordial compression without airway management induces lung injury in the rodent cardiac arrest model with central apnea.
To investigate whether the lung injury induced by precordial compression without ventilation or not, in the cardiac-arrest animal model with central apnea. Thirty male Sprague-Dawley rats were anesthetized with halothane. The cardiac arrest was induced by 100 mg/kg ketamine (IV) and accompanied with central apnea. ⋯ The pathological findings also demonstrated the lung injuries, such as edema, migration, and destruction of structure in group A. The precordial compression alone did not improve CO(2) elimination in the gasping-less cardiac arrest model, as well as maybe inducing more severe lung injury than that with the protective management. This experimental model raises the possibility that chest compressions without airway management might result in lung injury.
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Randomized Controlled Trial Clinical Trial
The effect of differing support surfaces on the efficacy of chest compressions using a resuscitation manikin model.
External chest compression (ECC) efficacy is influenced by factors including the surface supporting the patient. Air-filled support surfaces are deflated for cardiopulmonary resuscitation, with little evidence to substantiate this. We investigated the effect that differing support surfaces had on ECC efficacy using a CPR manikin model. ⋯ The efficacy of ECC is affected by the support surfaces. There seems little evidence to substantiate deflating all air-filled support surfaces for CPR.
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The oesophageal-tracheal Combitube (Kendall-Sheridan Catheter Corp., Argyle, NY) is a device designed for difficult airways and emergency intubation. The manufacturer recommends that the Combitube size 37F SA be used in patients with a height of between 122 and 152 cm. The aim of this study was to evaluate whether ventilation is effective and reliable in anaesthetized patients taller than 152 cm using the size 37F SA in the oesophageal position. ⋯ The trachea could be directly intubated with the Combitube in the oesophageal position in patients with normal airways and in patients involved in trauma. In all patients in the emergency group, blind insertion of the Combitube resulted in the device being placed in the oesophagus. The airway protection appears to be adequate.
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Survival from out-of-hospital resuscitation depends on the strength of each component of the chain of survival. We studied, on the scene, witnessed, nontraumatic resuscitations of patients older than 17 years. The influence of the chain of survival and potential predictors on survival was analyzed by logistic regression modeling. ⋯ Three survival models for witnessed nontraumatic out-of-hospital resuscitation based on the information known by bystanders, first responders and paramedics explained survival with increasing precision. Early defibrillation can restore circulation without the need for advanced CPR. When advanced CPR is needed, its delay leads to a markedly reduced survival.