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1.
Background
Current cardiopulmonary resuscitation (CPR) guidelines recommend airway management and ventilation whilst minimising interruptions to chest compressions. We have assessed i-gel™ use during CPR.Methods
In an observational study of i-gel™ use during CPR we assessed the ease of i-gel™ insertion, adequacy of ventilation, the presence of a leak during ventilation, and whether ventilation was possible without interrupting chest compressions.Results
We analysed i-gel™ insertion by paramedics (n = 63) and emergency physicians (n = 7) in 70 pre-hospital CPR attempts. There was a 90% first attempt insertion success rate, 7% on the second attempt, and 3% on the third attempt. Insertion was reported as easy in 80% (n = 56), moderately difficult in 16% (n = 11), and difficult in 4% (n = 3). Providers reported no leak on ventilation in 80% (n = 56), a moderate leak in 17% (n = 12), and a major leak with no chest rise in 3% (n = 2). There was a significant association between ease of insertion and the quality of the seal (r = 0.99, p = 0.02). The i-gel™ enabled continuous chest compressions without pauses for ventilation in 74% (n = 52) of CPR attempts. There was no difference in the incidence of leaks on ventilation between patients having continuous chest compressions and patients who had pauses in chest compressions for ventilation (83% versus 72%, p = 0.33, 95% CI [−0.1282, 0.4037]). Ventilation during CPR was adequate during 96% of all CPR attempts.Conclusions
The i-gel™ is an easy supraglottic airway device to insert and enables adequate ventilation during CPR. 相似文献2.
Joonghee Kim Kyuseok Kim Taeyun Kim Joong Eui Rhee You Hwan Jo Jae Hyuk Lee Yu Jin Kim Chan Jong Park Hea-jin Chung Seung Sik Hwang 《Resuscitation》2014
Objective
Advanced airway management is one of the fundamental skills of advanced cardiac life support (ACLS). A failed initial intubation attempt (FIIA) is common and has shown to be associated with adverse events. We analysed the association between FIIA and the overall effectiveness of ACLS.Methods
Using emergency department (ED) out-of-hospital cardiac arrest (OHCA) registry data from 2008 to 2012, non-traumatic ED-resuscitated adult OHCA patients on whom endotracheal intubation was initially tried were identified. Prehospital and demographic factors and patient outcomes were retrieved from the registry. The presence of a FIIA was determined by reviewing nurse-documented CPR records. The primary outcome was achieving a return of spontaneous circulation (ROSC). The secondary outcomes were time to ROSC and the ROSC rate during the first 30 min of ED resuscitation.Results
The study population (n = 512) was divided into two groups based on the presence of a FIIA (N = 77). Both groups were comparable without significant differences in demographic or prehospital factors. In the FIIA group, the unadjusted and adjusted odds ratios (ORs) for achieving a ROSC were 0.50 (95% confidence interval [CI], 0.31–0.81) and 0.40 (95% CI, 0.23–0.71), respectively. Multivariable median regression analysis revealed that FIIA was associated with an average delay of 3 min in the time to ROSC (3.08; 95% CI, 0.08–5.80). Competing risk regression analysis revealed a significantly slower ROSC rate during the first 15 min (adjusted subhazard ratio, 0.52; 95% CI, 0.35–0.79) in the FIIA group.Conclusion
FIIA is an independent risk factor for the decreased effectiveness of ACLS. 相似文献3.
Andrew D. McInnes Robert M. Sutton Akira Nishisaki Dana Niles Jessica Leffelman Lori Boyle Matthew R. Maltese Robert A. Berg Vinay M. Nadkarni 《Resuscitation》2012
Aim
Performance of high quality CPR is associated with improved resuscitation outcomes. This study investigates code leader ability to recall CPR error during post-event interviews when CPR recording/audiovisual feedback-enabled defibrillators are deployed.Patients and methods
Physician code leaders were interviewed within 24 h of 44 in-hospital pediatric cardiac arrests to assess their ability to recall if CPR error occurred during the event. Actual CPR quality was assessed using quantitative recording/feedback-enabled defibrillators. CPR error was defined as an overall average event chest compression (CC) rate <95/min, depth <38 mm, ventilation rate >10/min, or any interruptions in CPR >10 s. We hypothesized that code leaders would recall error when it actually occurred ≥75% of the time when assisted by audiovisual alerts from a CPR recording feedback-enabled defibrillators (analysis by χ2).Results
810 min from 44 cardiac arrest events yielded 40 complete data sets (actual and interview); ventilation data was available in 24. Actual CPR error was present in 3/40 events for rate, 4/40 for depth, 32/40 for interruptions >10 s, and 17/24 for ventilation frequency. In post-event interviews, code leaders recalled these errors in 0/3 (0%) for rate, 0/4 (0%) for depth, and 19/32 (59%) for interruptions >10 s. Code leaders recalled these CPR quality errors less than 75% of the time for rate (p = 0.06), for depth (p < 0.01), and for CPR interruption (p = 0.04). Quantification of errors not recalled: missed rate error median = 94 CC/min (IQR 93–95), missed depth error median = 36 mm (IQR 35.5–36.5), missed CPR interruption >10 s median = 18 s (IQR 14.4–28.9). Code leaders did recall the presence of excessive ventilation in 16/17 (94%) of events (p = 0.07).Conclusion
Despite assistance by CPR recording/feedback-enabled defibrillators, pediatric code leaders fail to recall important CPR quality errors for CC rate, depth, and interruptions during post-cardiac arrest interviews. 相似文献4.
Paul C. Mullan Elizabeth Wuestner Tarra D. Kerr Daniel P. Christopher Binita Patel 《Resuscitation》2013
Aim
Multiple guidelines recommend debriefing of resuscitations to improve clinical performance. We implemented a novel standardized debriefing program using a Debriefing In Situ Conversation after Emergent Resuscitation Now (DISCERN) tool.Methods
Following the development of the evidence-based DISCERN tool, we conducted an observational study of all resuscitations (intubation, CPR, and/or defibrillation) at a pediatric emergency department (ED) over one year. Resuscitation interventions, patient survival, and physician team leader characteristics were analyzed as predictors for debriefing. Each debriefing's participants, time duration, and content were recorded. Thematic content of debriefings was categorized by framework approach into Team Emergency Assessment Measure (TEAM) elements.Results
There were 241 resuscitations and 63 (26%) debriefings. A higher proportion of debriefings occurred after CPR (p < 0.001) or ED death (p < 0.001). Debriefing participants always included an attending and nurse; the median number of staff roles present was six. Median intervals (from resuscitation end to start of debriefing) & debriefing durations were 33 (IQR 15, 67) and 10 min (IQR 5, 12), respectively. Common TEAM themes included co-operation/coordination (30%), communication (22%), and situational awareness (15%). Stated reasons for not debriefing included: unnecessary (78%), time constraints (19%), or other reasons (3%).Conclusions
Debriefings with the DISCERN tool usually involved higher acuity resuscitations, involved most of the indicated personnel, and lasted less than 10 min. Future studies are needed to evaluate the tool for adaptation to other settings and potential impacts on education, quality improvement programming, and staff emotional well-being. 相似文献5.
Background
Guidelines direct rescuers to minimize CPR interruptions during resuscitation. There is little evidence that evaluates the relationship of increasing CPR fraction among patients with relatively high fractions or prolonged resuscitation.Methods
We conducted an observational study of persons who suffered out-of-hospital ventricular fibrillation arrest and required >5 min of emergency medical services (EMS) CPR for persistent pulselessness. We determined the association between hands-on CPR fraction and outcomes of spontaneous circulation, survival to hospital discharge, and neurologically favorable survival. Analyses were stratified by median hands-on CPR and were conducted for those who required 5, 10, and 20 min of EMS CPR for persistent pulselessness.Results
Of 414 potentially eligible patients, 323 (78%) required >5 min of EMS CPR, 234 (56%) required >10 min of EMS CPR, and 153 (37%) required EMS CPR for >20 min. The median CPR fraction was 81%. We did not observe a significant association for the outcomes of hospital survival and neurologically favorable survival for the 5-min and 10-min groups. When restricted to patients who required >20 min of EMS CPR, the half who received a higher hands-on CPR fraction were more likely to achieve spontaneous circulation (40% versus 18%, p = 0.004), survival to hospital discharge (20% versus 8%, p = 0.03), and neurologically favorable survival (20% versus 7%, p = 0.02).Conclusion
Over one-third required 20 min of persistent EMS CPR. The EMS was able to achieve a high hands-on CPR fraction in the context of advanced therapies. Those who required the most prolonged EMS CPR appeared to benefit from greater hands-on CPR fraction. 相似文献6.
Charlotte Chollet-Xémard Xavier Combes François Soupizet Patricia Jabre Candice Penet Catherine Bertrand Alain Margenet Jean Marty 《Resuscitation》2009
Aim
It has been suggested that out-of-hospital bispectral (BIS) index monitoring during advanced cardiac life support (ACLS) might provide an indication of cerebral resuscitation. The aims of our study were to establish whether BIS values during ACLS might predict return to spontaneous circulation, and whether BIS values on hospital admission might predict survival.Materials and methods
This was a prospective observational study in 92 patients with cardiac arrest who received basic life support from a fire-fighter squad and ACLS on arrival of an emergency medical team on the scene. BIS values, electromyographic activity, and signal quality index were recorded throughout resuscitation and out-of-hospital management.Results
Seven patients had recovered spontaneous cardiac activity by the time the medical team arrived on scene. Of the 92 patients, 62 patients died on scene and 30 patients returned to spontaneous cardiac activity and were admitted to hospital. The correlation between BIS values and end-tidal CO2 during the first minutes of ACLS was poor (r2 = 0.02, P = 0.19). Of the 30 admitted patients, 27 died. Three were discharged with no disabilities. There was no significant difference in BIS values on admission between the group of patients who died and the group who survived (P = 0.78).Conclusions
Although BIS monitoring during resuscitation was not difficult, it did not predict return to spontaneous cardiac activity, nor survival after admission to intensive care. Its use to monitor cerebral function during ACLS is therefore pointless. 相似文献7.
Aim
The reported incidence of injuries due to cardiopulmonary resuscitation using manual chest compressions (manual CPR) varies greatly. Our aim was to elucidate the incidence of CPR-related injuries by manual chest compressions compared to mechanical chest compressions with the LUCAS device (mechanical CPR) in non-survivors after out-of-hospital cardiac arrest.Methods
In this prospective multicentre trial, including 222 patients (83 manual CPR/139 mechanical CPR), autopsies were conducted after unsuccessful CPR and the results were evaluated according to a specified protocol.Results
Among the patients included, 75.9% in the manual CPR group and 91.4% in the mechanical CPR group (p = 0.002) displayed CPR-related injuries. Sternal fractures were present in 54.2% of the patients in the manual CPR group and in 58.3% in the mechanical CPR group (p = 0.56). Of the patients in the manual CPR group, there were 64.6% with at least one rib fracture versus 78.8% in the mechanical CPR group (p = 0.02). The median number of rib fractures among patients with rib fractures was 7 in the manual CPR group and 6 in the mechanical CPR group. No CPR-related injury was considered to be the cause of death.Conclusion
In patients with unsuccessful CPR after out-of-hospital cardiac arrest, rib fractures were more frequent after mechanical CPR but there was no difference in the incidence of sternal fractures. No injury was deemed fatal by the pathologist. 相似文献8.
Aims
Public awareness to cardiopulmonary resuscitation (CPR) and cardiac arrest is influenced by systemic factors including related policies and legislations in the community. Here, we describe and compare the results of the two nationwide CPR surveys in 2007 and 2011 examining public awareness and attitudes to bystander CPR in South Korea along with changes in nationwide CPR policies and systemic factors.Methods
This population-based study used specially designed questionnaires via telephone surveys. We conducted bi-temporal surveys by stratified cluster sampling to assess the impact of age, gender, and geographic regions in 2007 (n = 1029) and in 2011 (n = 1000). Logistic regression analysis was performed to identify factors associated with willingness to perform bystander CPR.Results
Public awareness of automated external defibrillators increased from 3.0% in 2007 to 32.6% in 2011. The proportion of the population that underwent CPR training within the previous 2 years increased significantly from 26.9% to 49.0%. The factors most related with intention of bystander CPR were male gender, younger age, CPR awareness, recent CPR training, and qualified CPR learning. In 2011, 75.8% of respondents were more willing to perform bystander CPR for stranger vs. 68.3% in 2007 (p = 0.002). Additional dispatcher hands-only CPR increased this proportion (85.8%, p < 0.001). However, bystander CPR experience rates remained unchanged (3.6–3.9%).Conclusion
Changes in nationwide CPR policies and systemic factors affected citizens’ awareness and willingness to perform bystander CPR. Additionally, applied dispatcher hands-only CPR and publicity increased public willingness to perform bystander CPR. 相似文献9.
Matthew D. McEvoy Larry C. Field Haley E. Moore Jeremy C. Smalley Paul J. Nietert Sheila H. Scarbrough 《Resuscitation》2014
Aim
Advanced Cardiac Life Support (ACLS) algorithms are the default standard of care for in-hospital cardiac arrest (IHCA) management. However, adherence to published guidelines is relatively poor. The records of 149 patients who experienced IHCA were examined to begin to understand the association between overall adherence to ACLS protocols and successful return of spontaneous circulation (ROSC).Methods
A retrospective chart review of medical records and code team worksheets was conducted for 75 patients who had ROSC after an IHCA event (SE group) and 74 who did not survive an IHCA event (DNS group). Protocol adherence was assessed using a detailed checklist based on the 2005 ACLS Update protocols. Several additional patient characteristics and circumstances were also examined as potential predictors of ROSC.Results
In unadjusted analyses, the percentage of correct steps performed was positively correlated with ROSC from an IHCA (p < 0.01), and the number of errors of commission and omission were both negatively correlated with ROSC from an IHCA (p < 0.01). In multivariable models, the percentage of correct steps performed and the number of errors of commission and omission remained significantly predictive of ROSC (p < 0.01 and p < 0.0001, respectively) even after accounting for confounders such as the difference in age and location of the IHCAs.Conclusions
Our results show that adherence to ACLS protocols throughout an event is correlated with increased ROSC in the setting of cardiac arrest. Furthermore, the results suggest that, in addition to correct actions, both wrong actions and omissions of indicated actions lead to decreased ROSC after IHCA. 相似文献10.
Peter A. Meaney Robert M. Sutton Billy Tsima Andrew P. Steenhoff Nicole Shilkofski John R. Boulet Amanda Davis Andrew M. Kestler Kasey K. Church Dana E. Niles Sharon Y. Irving Loeto Mazhani Vinay M. Nadkarni 《Resuscitation》2012
Objective
Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana.Methods
HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation.Results
Of 214 HCP trained, 40% resuscitate ≥1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p < 0.01; adult 28% vs. 48%, p < 0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p < 0.01) and 6 months (38% vs. 67%, p < 0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p = 0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance.Conclusions
HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. 相似文献11.
J. Ruiz U. Ayala S. Ruiz de Gauna U. Irusta D. González-Otero E. Alonso J. Kramer-Johansen T. Eftestøl 《Resuscitation》2013
Aim
To demonstrate the feasibility of doing a reliable rhythm analysis in the chest compression pauses (e.g. pauses for two ventilations) during cardiopulmonary resuscitation (CPR).Methods
We extracted 110 shockable and 466 nonshockable segments from 235 out-of-hospital cardiac arrest episodes. Pauses in chest compressions were already annotated in the episodes. We classified pauses as ventilation or non-ventilation pause using the transthoracic impedance. A high-temporal resolution shock advice algorithm (SAA) that gives a shock/no-shock decision in 3 s was launched once for every pause longer than 3 s. The sensitivity and specificity of the SAA for the analyses during the pauses were computed.Results
We identified 4476 pauses, 3263 were ventilation pauses and 2183 had two ventilations. The median of the mean duration per segment of all pauses and of pauses with two ventilations were 6.1 s (4.9–7.5 s) and 5.1 s (4.2–6.4 s), respectively. A total of 91.8% of the pauses and 95.3% of the pauses with two ventilations were long enough to launch the SAA. The overall sensitivity and specificity were 95.8% (90% low one-sided CI, 94.3%) and 96.8% (CI, 96.2%), respectively. There were no significant differences between the sensitivities (P = 0.84) and the specificities (P = 0.18) for the ventilation and the non-ventilation pauses.Conclusion
Chest compression pauses are frequent and of sufficient duration to launch a high-temporal resolution SAA. During these pauses rhythm analysis was reliable. Pre-shock pauses could be minimised by analysing the rhythm during ventilation pauses when CPR is delivered at 30:2 compression:ventilation ratio. 相似文献12.
Jennifer L. Fang William A. Carey Tara R. Lang Christine M. Lohse Christopher E. Colby 《Resuscitation》2014
Aim
To determine if a real-time audiovisual link with a neonatologist, termed video-assisted resuscitation or VAR, improves provider performance during a simulated neonatal resuscitation scenario.Methods
Using high-fidelity simulation, 46 study participants were presented with a neonatal resuscitation scenario. The control group performed independently, while the intervention group utilized VAR. Time to effective ventilation was compared using Wilcoxon rank sum tests. Providers’ use of the corrective steps for ineffective ventilation per the NRP algorithm was compared using Cochran–Armitage trend tests.Results
The time needed to establish effective ventilation was significantly reduced in the intervention group when compared to the control group (mean time 2 min 42 s versus 4 min 11 s, p < 0.001).In the setting of ineffective ventilation, only 35% of control subjects used three or more of the first five corrective steps and none of them used all five steps. Providers in the control group most frequently neglected to open the mouth and increase positive pressure. In contrast, all of those in the intervention group used all of the first five corrective steps, p < 0.001.All participants in the control group decided to intubate the infant to establish effective ventilation, compared to none in the intervention group, p < 0.001.Conclusion
Using VAR during a simulated neonatal resuscitation scenario significantly reduces the time to establish effective ventilation and improves provider adherence to NRP guidelines. This technology may be a means for regional centers to support local providers during a neonatal emergency to improve patient safety and improve neonatal outcomes. 相似文献13.
14.
Objective
Some observational studies indicate that endotracheal intubation is associated with a worse outcome compared to bag-mask ventilation after out-of-hospital cardiac arrest in emergency medical services (EMS) systems without rapid sequence intubation (RSI). We evaluated the role of RSI in airway management following cardiac arrest.Methods
We conducted a cohort study of all non-traumatic arrest patients treated by a metropolitan EMS system from 2007 to 2011. Advanced airway management information was obtained from a prospective airway registry and linked to a cardiac arrest registry. We used multivariate logistic regression to estimate the association between attempted intubation status and survival to hospital discharge.Results
Of 3133 patients, 82% underwent attempted intubation without RSI, 15% underwent attempted RSI, and 3% experienced no intubation attempt. Survival to hospital discharge differed by attempted intubation status: 11% (n = 291/2576) for intubation without RSI, 48% (n = 226/471) for RSI, and 71% (n = 61/86) for “no intubation.” Compared to the intubation without RSI group, the adjusted odds ratios of survival were 5.6 (95% CI 4.3, 7.2) for the RSI group and 15 (95% CI 9, 27) for the “no intubation” group.Conclusion
In this population-based cohort of out-of-hospital cardiac arrest, RSI was used in 15% of patients and associated with a better prognosis than intubation attempted without paralytics. Because this subset with a favorable prognosis may not be readily intubated in systems without paralytics, these findings could help to explain the adverse relationship between intubation and survival observed in prior studies. 相似文献15.
Georgios Sideris Nikolaos Magkoutis Alok Sharma Jennifer Rees Scott McKnite Emily Caldwell Mohammad Sarraf Patrick Henry Keith Lurie Santiago Garcia Demetris Yannopoulos 《Resuscitation》2014
Background
Survival after out-of-hospital cardiac arrest (OHCA) remains poor. Acute coronary obstruction is a major cause of OHCA. We hypothesize that early coronary reperfusion will improve 24 h-survival and neurological outcomes.Methods
Total occlusion of the mid LAD was induced by balloon inflation in 27 pigs. After 5 min, VF was induced and left untreated for 8 min. If return of spontaneous circulation (ROSC) was achieved within 15 min (21/27 animals) of cardiopulmonary resuscitation (CPR), animals were randomized to a total of either 45 min (group A) or 4 h (group B) of LAD occlusion. Animals without ROSC after 15 min of CPR were classified as refractory VF (group C). In those pigs, CPR was continued up to 45 min of total LAD occlusion at which point reperfusion was achieved. CPR was continued until ROSC or another 10 min of CPR had been performed. Primary endpoints for groups A and B were 24-h survival and cerebral performance category (CPC). Primary endpoint for group C was ROSC before or after reperfusion.Results
Early compared to late reperfusion improved survival (10/11 versus 4/10, p = 0.02), mean CPC (1.4 ± 0.7 versus 2.5 ± 0.6, p = 0.017), LVEF (43 ± 13 versus 32 ± 9%, p = 0.01), troponin I (37 ± 28 versus 99 ± 12, p = 0.005) and CK-MB (11 ± 4 versus 20.1 ± 5, p = 0.031) at 24-h after ROSC. ROSC was achieved in 4/6 animals only after reperfusion in group C.Conclusions
Early reperfusion after ischemic cardiac arrest improved 24 h survival rate and neurological function. In animals with refractory VF, reperfusion was necessary to achieve ROSC. 相似文献16.
Aim
To describe changes in the proportion of bystanders performing cardiopulmonary resuscitation (CPR) in out of hospital cardiac arrest (OHCA) in Sweden and to study the impact of bystander CPR on ventricular fibrillation and on survival during various times.Patients and methods
All patients who suffered from OHCA in Sweden in whom CPR was attempted and who were included in the Swedish cardiac arrest register (SCAR) between 1992 and 2005. Crew witnessed cases were excluded.Results
In all 34,125 patients were included in the survey. Among witnessed OHCA the proportion of patients receiving bystander CPR increased from 40% in 1992 to 55% in 2005 (p < 0.0001). In non-witnessed OHCA the corresponding proportion increased from 22% to 44% (p < 0.0001). There was a significant increase in bystander CPR regardless of age, sex and place. The increase was only found when CPR was performed by lay persons (21% in 1992 to 40% in 2005; p < 0.0001). Bystander CPR was associated with an increased proportion of patients found in a shockable rhythm and a lower number of shocks to receive return of spontaneous circulation. Bystander CPR was associated with a similar increase in survival early and late in the evaluation.Conclusion
There was a marked increase in bystander CPR in OHCA, when performed by lay persons, during the last 14 years in Sweden. Bystander CPR was associated with positive effects both on ventricular fibrillation and survival. 相似文献17.
Georg M. Schmölzer Megan O’Reilly Joseph LaBossiere Tze-Fun Lee Shaun Cowan Jessica Nicoll David L. Bigam Po-Yin Cheung 《Resuscitation》2014
Objective
In contrast to the resuscitation guidelines of children and adults, guidelines on neonatal resuscitation recommend synchronized 90 chest compressions with 30 manual inflations (3:1) per minute in newborn infants. The study aimed to determine if chest compression with asynchronous ventilation improves the recovery of bradycardic asphyxiated newborn piglets compared to 3:1 Compression:Ventilation cardiopulmonary resuscitation (CPR).Intervention and measurements
Term newborn piglets (n = 8/group) were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Piglets were randomized to receive resuscitation with either 3:1 compressions to ventilations (3:1 C:V CPR group) or chest compressions with asynchronous ventilations (CCaV) or sham. Continuous respiratory parameters (Respironics NM3®), cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured.Main results
Piglets in 3:1 C:V CPR and CCaV CPR groups had similar time to return of spontaneous circulation, survival rates, hemodynamic and respiratory parameters during CPR. The systemic and regional hemodynamic recovery in the subsequent 4 h was similar in both groups and significantly lower compared to sham-operated piglets.Conclusion
Newborn piglets resuscitated by CCaV had similar return of spontaneous circulation, survival, and hemodynamic recovery compared to those piglets resuscitated by 3:1 Compression:Ventilation ratio. 相似文献18.
19.
Ning-Ping Foo Jer-Hao Chang Shih-Bin Su Hung-Jung Lin Kow-Tong Chen Ching-Fa Cheng Tsung-Yi Lin Pei-Chung Chen How-Ran Guo 《Resuscitation》2013
Background
The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is suboptimal, and therefore measures that can improve the quality are desirable.Purpose
To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation.Methods
This randomized controlled crossover trial enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 h apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer.Results
The overall effective compressions in 10 min were 87.0 ± 17% for NM, 59.0 ± 19% for MND, and 69.0 ± 23% for MD (p < 0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p < 0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM.Conclusions
The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant. 相似文献20.
Assad Haneya Alois Philipp Claudius Diez Simon Schopka Thomas Bein Markus Zimmermann Matthias Lubnow Andreas Luchner Ayman Agha Michael Hilker Stephan Hirt Christof Schmid Thomas Müller 《Resuscitation》2012