Resuscitation
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Observational Study
A novel technique to assess the quality of ventilation during pre-hospital cardiopulmonary resuscitation.
Devices that measure ventilation in the pre-hospital setting are deficient especially during early cardiopulmonary resuscitation (CPR) before placement of an advanced airway. Consequently, evidence is limited regarding the role of ventilation during early CPR and its effect on outcomes. ⋯ We developed a novel and reliable strategy that enables investigation of ventilation quality during standard CPR using thoracic bioimpedance. This strategy would allow a timely and reliable automatic annotation of large scale resuscitation datasets.
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Resuscitation on in-hospital cardiac arrest (IHCA) is estimated to occur in 200,000 hospitalised patients annually in the US. The duration of the resuscitation attempt, measured as minutes of cardiopulmonary resuscitation (CPR), and its impact on survival remains unknown. ⋯ Resuscitation attempts on IHCA are often short and duration of CPR is associated with 30-day survival among those with ROSC. Still, the 30-day survival is high enough to question the use of CPR duration as a prognostic marker in post-resuscitation care, and ideal duration of resuscitation should remain a bedside decision taking into consideration the whole clinical picture.
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The objectives were: 1) replicate key elements of Head Up (HUP) cardiopulmonary resuscitation (CPR) physiology in a traditional swine model of ventricular fibrillation (VF), 2) compare HUP CPR physiology in pig cadavers (PC) to the VF model 3) develop a new human cadaver (HC) CPR model, and 4) assess HUP CPR in HC. ⋯ HUP CPR decreased ICP while increasing CerPP in pigs in VF as well as in PC and HC CPR models. This first-time demonstration of HUP CPR physiology in humans provides important implications for future resuscitation research and treatment.
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To explore factors associated with health-related quality of life (HRQoL) among cardiac arrest (CA) survivors treated with an implantable cardioverter-defibrillator (ICD) in relation to gender, and to compare their HRQoL with a general population. ⋯ This extensive population-based study showed that most CA survivors living with an ICD rate their HRQoL as acceptable. In addition, their HRQoL is similar to a general population. Women reported worse HRQoL compared to men. Several factors associated with HRQoL were identified, and might be used when screening patients for health problems and when developing health promoting interventions.
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The number of cardiac arrests (CA) in the group of very elderly patients (≥ 90 years) is expected to increase markedly due to the world`s rapidly ageing population. However, only little is known about long term outcome, CA- and intensive care unit (ICU) characteristics of patient's ≥ 90 years (nonagenarians) suffering from CA. ⋯ 46% of successfully resuscitated nonagenarians survived the ICU stay, the majority with favourable neurological outcome at ICU discharge. Resuscitation and post-CA care, in the highly selected group of very elderly patients (≥ 90 years), seems to be justified.