Current opinion in critical care
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Curr Opin Crit Care · Jun 2004
ReviewQuality of life and prognosis among survivors of out-of-hospital cardiac arrest.
We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. ⋯ The optimal strategy for improving long-term outcomes requires a multifaceted, integrative approach that begins with prehospital care and extends to secondary prevention.
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Curr Opin Crit Care · Jun 2004
ReviewWaveforms for defibrillation and cardioversion: recent experimental and clinical studies.
The advent of biphasic waveforms for external defibrillation has generated extensive experimental and clinical investigation. At the same time, it has led to the development and clinical use of biphasic waveforms of several different designs. Finally, other types of waveforms, primarily triphasic, have entered experimental evaluation. ⋯ Biphasic waveforms have supplanted monophasic waveforms for defibrillation and cardioversion. They include biphasic truncated exponential, rectilinear, and pulsed biphasic versions. At this time, there is no certain evidence of clinical superiority of one waveform over another in terms of either efficacy or myocardial injury.
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Currently, no neuroprotective therapies have been shown to reduce the secondary neuronal damage occurring after traumatic brain injury. Recent studies have addressed the potentiality of hyperoxia to ameliorate brain metabolism after traumatic brain injury. In this article, we present the principles of oxygen transport to the brain, the effects of hyperoxia on cerebral metabolism, and the role of lactate in brain metabolism after traumatic brain injury. ⋯ At present, there is no evidence supporting any clinical benefit of hyperoxia in brain-injured patients, and the meaning of posttraumatic brain extracellular lactate accumulation should be further investigated.
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To review and examine the efficacy of recently described medical and surgical interventions after acute ischaemic stroke using data from well conducted, clinical trials and systematic reviews. This review will consider recently published or updated articles. ⋯ It is estimated that there will be 8.5 million patients with acute ischaemic stroke in the European Union and the USA over the next decade, and of these, about one and a half million will die within six months of stroke onset. Of those who survive, about one third will depend on other people for help with their activities of daily living. Future treatment strategies are likely to involve agents that re-canalise vessels and minimise further neuronal damage.