Chinese Med J Peking
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Chinese Med J Peking · Jan 2014
Effect of different resuscitation strategies on post-resuscitation brain damage in a porcine model of prolonged cardiac arrest.
The choice of a defibrillation or a cardiopulmonary resuscitation (CPR)-first strategy in the treatment of prolonged cardiac arrest (CA) is still controversial. The purpose of this study was to compare the effects of defibrillation or CPR administered first on neurological prognostic markers in a porcine model of prolonged CA. ⋯ Defibrillation first may result in a shorter time to ROSC and lower biochemical markers of brain injury in a porcine model of 8-minute CA due to VF, but the choice of different resuscitation strategies did not affect the rate of ROSC and 24-hour survival.
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The brain death confirmation tests occupy a different position in each country's diagnostic criteria (or guideline); the choices of tests are also different. China brain death criteria include clinical judgment and confirmation tests. This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests. ⋯ The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death. If the test cannot be completed, whether to increase a confirmatory test is debatable. SEP had an ideal sensitivity, and the specificity will reach 100% after combining with TCD or EEG. When a confirmed test was uncertain, we suggest increasing another confirmatory test.
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Chinese Med J Peking · Jan 2014
Comparative StudyComparison of epinephrine and Shen-Fu injection on resuscitation outcomes in a porcine model of prolonged cardiac arrest.
Epinephrine has been used as a first-choice vasopressor drug for cardiac arrest (CA) since 1974. However, the administration of epinephrine is controversial. This study aims to compare the effects of Shen-Fu injection (SFI) and epinephrine on resuscitation outcomes in a porcine model of prolonged CA. ⋯ SFI shortened the time to ROSC and decreased the number of shocks, similar to epinephrine. However, SFI improved oxygen metabolism, and produced a better hemodynamic status compared with epinephrine. SFI might be a potentially vasopressor drug for the treatment of CA.
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Chinese Med J Peking · Jan 2014
Comparative biomechanical study of reversed less invasive stabilization system and proximal femoral nail antirotation for unstable intertrochanteric fractures.
Unstable intertrochanteric fractures (ITFs) are mostly treated by proximal femoral nail antirotation (PFNA), Inter-Tan, Asian Hip, and other new internal fixation devices. But for complex unstable fractures, such as crushed lateral wall of the greater trochanter, the loss of fixation point on lateral wall slightly reduces the fixing effect. This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system (LISS) and PFNA for treatment of unstable ITFs. ⋯ Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs. This conclusion should be supported by additional large-size research on basic biomechanics and clinical application. This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.
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Chinese Med J Peking · Jan 2014
Evaluation of clinical application of ESICM acute gastrointestinal injury grading system: a single-center observational study.
In 2012, the working group on abdominal problems of the European Society of Intensive Care Medicine (ESICM) proposed a definition and also guidelines for the grading system and treatment of acute gastrointestinal injury (AGI). Until now, clinical reports on this topic have not been available, and the practicality of using the AGI grading system requires further validation in the clinic. Therefore, we conducted this study to evaluate the feasibility of utilizing the current AGI grading system in a clinical environment, and to provide evidence for its usefulness in assessing the severity and prognosis of critically ill patients with gastrointestinal dysfunction. ⋯ The current AGI grading system can be used to identify and evaluate gastrointestinal dysfunction in critically ill patients, and also to provide a preliminary assessment regarding the prognosis for patients with different grades of AGI.