Articles: cardiac-arrest.
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HSR Proc Intensive Care Cardiovasc Anesth · Jan 2011
Use of the LUCAS mechanical chest compression device for percutaneous coronary intervention during cardiac arrest: is it really a game changer?
Cardiopulmonary support including closed chest compression is a mainstay in the management of cardiac arrest. However, traditional means (i.e. manual) chest compression may be logistically challenging, especially in patients requiring emergent invasive procedures such as percutaneous coronary intervention for cardiac arrest due to acute myocardial infarction. The LUCAS mechanical chest compression device provides external and automated closed chest compression, thus enabling even complex invasive procedures without interrupting cardiopulmonary support. Nonetheless, no randomized trial has proved to date its benefit in comparison to standard manual chest compression, and to date only observational studies and consensus opinion support its clinical use.
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Annals of intensive care · Jan 2011
Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review.
Noninvasive positive pressure ventilation (NPPV) refers to the delivery of mechanical respiratory support without the use of endotracheal intubation (ETI). The present review focused on the effectiveness of NPPV in children > 1 month of age with acute respiratory failure (ARF) due to different conditions. ARF is the most common cause of cardiac arrest in children. ⋯ High FiO2 needs or high PaCO2 level on admission or within the first hours after starting NPPV appeared to be the best independent predictive factors for the NPPV failure in children with ARF. However, many important issues, such as the identification of the patient, the right time for NPPV application, and the appropriate setting, are still lacking. Further randomized, controlled trials that address these issues in children with ARF are recommended.
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J Vasc Interv Neurol · Jan 2011
Earlier Hypothermia Attainment is Associated with Improved Outcomes after Cardiac Arrest.
Therapeutic hypothermia (TH, 32-34ºC) reduces mortality and improves neurologic outcomes after ventricular fibrillation cardiac arrest (CA). The relationship between time to achieve TH and outcomes remains undefined. We hypothesized that a shorter interval from CA to achieve TH would be associated with improved neurologic outcome. ⋯ Attaining TH within 6 hours of in or out-of-hospital CA was associated with a greater likelihood of a good neurological outcome at discharge. Time from CA to achieved TH should be included as a clinically important covariate in future studies of predictors of outcome after CA.
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Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. In order to optimize blood flow excellent chest compression technique is critical. ⋯ Unconscious patients with normal breathing are placed in the recovery position. If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity.
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Korean J Anesthesiol · Dec 2010
Pulmonary thromboembolism after tourniquet inflation under spinal anesthesia -A case report-.
Pulmonary thromboembolism is one of the most important causes of morbidity and mortality in patients undergoing lower extremity orthopedic surgery. Early diagnosis and appropriate management are important clinical challenges. ⋯ Resuscitation procedures were initiated and transesophageal echocardiography revealed pulmonary thromboembolism. Patients with high suspicion for the presence of deep vein thrombus must be monitored thoroughly during limb exsanguinations.