Rev Cardiovasc Med
-
Cardiocerebral resuscitation is a new approach to patients with primary cardiac arrest that has been shown to dramatically increase survival. The term cardiocerebral is used to stress that the issue is immediate and effective support of the central circulation. Cardiocerebral resuscitation consists of continuous chest compressions--without mouth-to-mouth ventilations--administered by bystanders, and a new algorithm for emergency medical services that consists of sets of 200 chest compressions before and immediately after electrocardiographic analysis and, if indicated, a single shock. ⋯ Early establishment of intravenous or intraosseous access for epinephrine is emphasized. Postresuscitation care for comatose patients includes early coronary intervention and 24 hours of mild hypothermia. Studies show marked improvement in prehospital cardiac arrest patients with return of spontaneous circulation who subsequently received specialized postresuscitation care.
-
Obesity is a known risk factor for developing cardiovascular disease, including heart failure. However, the impact of obesity on patients with heart failure is unclear. ⋯ Even more, increases of weight in cachectic heart failure patients might improve survival, although patients with heart failure who are overweight or mildly to moderately obese have better outcomes than patients with heart failure who are at ideal or normal weight. In heart failure patients, weight reduction through diet regulation, moderate exercise, and bariatric surgery can improve quality of life and New York Heart Association functional class, but it is yet unclear if these measures will improve survival.