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1.
Ohne Zusammenfassung 相似文献
2.
Recombinant tissue plasminogen activator during cardiopulmonary resuscitation in 108 patients with out-of-hospital cardiac arrest. 总被引:25,自引:0,他引:25
BACKGROUND: Thrombolytic therapy during cardiopulmonary resuscitation (CPR) is a controversial issue in emergency medicine practice. This study was conducted to determine whether administration of recombinant tissue plasminogen activator (rt-PA) in out-of-hospital cardiac arrest of non-traumatic aetiology improves CPR outcome. METHODS AND RESULTS: A retrospective chart review of 401 patients with out-of-hospital cardiac arrest who were resuscitated by the emergency medical services (EMS) during a 6 year period was performed. A total of 108 patients received rt-PA during CPR and were compared to 216 controls, closely matched according to baseline characteristics, arrival status and ECG findings. Administration of rt-PA was optional. Return of spontaneous circulation (ROSC) occurred in 76 patients under rt-PA treatment (70.4 vs. 51.0% in controls; P=0.001). Fifty-two patients from the lysis group survived the first 24 h (48.1 vs. 32.9% in controls; P=0.003), while 27 (25.9%) survived to discharge. Autopsy reports revealed major bleeding complications in six patients receiving rt-PA treatment. Fulminant intracranial haemorrhage was observed in one patient who received rt-PA and in two cases from the control group. CONCLUSIONS: Thrombolytic therapy may improve frequency of return of spontaneous circulation substantially and increase primary survival in patients with non-traumatic cardiac arrest. Serious bleeding complications are not frequently observed under rt-PA treatment. 相似文献
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R. Plattner W. Schabauer M.A. Baubin Prof. Dr. W. Lederer 《Notfall & Rettungsmedizin》2013,16(6):449-453
Background
Hands-off intervals during cardiopulmonary resuscitation (CPR) diminish the likelihood of success. The influence of voice prompts from an automated external defibrillator (AED) on the length of CPR interruption was investigated.Material and methods
In a randomized, one-way blinded manikin CPR study we prospectively assessed intervals between the start of voice prompting and the start of execution by participants for a shockable and a non-shockable rhythm. Difficulties with executing AED voice prompts were assessed by a questionnaire. The influence on the length of CPR interruptions was evaluated in a post hoc analysis.Results
Mean hands-off intervals measured in 57 voluntary participants accounted for 38.5?% of the total CPR time. Hands-off intervals between defibrillation and chest compressions were significantly shorter when CPR started with a non-shockable rhythm (6.5?±?3.5 s versus 9.0?±?5.5 s, p?<?0.043) and when participants rated the voice prompts as very good or good compared to middle or bad (7.1?±?4.5 s versus 11.3?±?4.7 s, p?<?0.020).Conclusions
Confusing voice prompts that potentially delay CPR need to be identified and modified. 相似文献5.
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In a prospective study of 38 cadavers of patients older than 18 without previous chest injury or cardiopulmonary resuscitation (CPR), active compression-decompression (ACD) resuscitation manoeuvres were performed to determine possible factors influencing sternal and/or rib fractures. ACD was performed for 60 s, with compression and decompression forces being continuously recorded. A stepwise logistic regression analysis was applied. Factors analyzed were age, gender, use of a compression cushion beneath the piston of the ACD device (Ambu CardioPump), and maximal compression and decompression forces. After ACD, the cadavers were autopsied and thoracic injuries were assessed. There was a significant correlation between sternal fractures and gender (P = 0.008), and between rib fractures and age (P = 0.008). Women were found to have a higher risk for sternal fractures, whereas older patients had a higher risk for rib fractures. Maximal compression force was another factor in sternal and/or rib fracture (P = 0.048). Even though a significantly higher incidence of sternal fractures was observed when the compression cushion was used (P = 0.045), inclusion of this variable in the regression analysis only marginally improved the prediction for correct classification of sternal fractures. In conclusion, when well controlled ACD-CPR is performed in cadavers, age is the most important factor determining the incidence of rib fracture. Sternal fractures were more common in female cadavers. 相似文献
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K. Berek Adolf Schinnerl Christian Traweger Peter Lechleitner Michael Baubin Franz Aichner 《Journal of neurology》1997,244(9):556-561
Early determination of outcome after successful prehospital cardiopulmonary resuscitation (CPR) is a common problem with
great ethical, economic, social, and legal consequences. We prospectively investigated 112 adult patients who had been resuscitated
after out-of-hospital cardiac arrest (CA). The aim of our study was to determine whether coma rating by the mobile intensive
care unit (MICU) is a useful tool for outcome prediction. For neurological assessment the Innsbruck Coma Scale (ICS) was used
initially and after return of spontaneous circulation (ROSC) or 20–30 min after the start of CPR, before any sedating drugs
were given. The duration of anoxia and CPR were determined with the automatically recorded emergency call protocol of the
dispatch centre and the protocol of the MICU. For estimation of cerebral outcome at the time of discharge from hospital we
used the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). Restoration of spontaneous circulation was achieved in
42 patients (37%), and 15 (13%) were discharged from hospital. The first coma rating performed immediately at the time of
arrival on scene had no significant prognostic value for prediction of neurological outcome (P = 0.204) and survival (P = 0.103). The second coma rating (performed after ROSC or 20–30 min after the start of CPR), however, demonstrated a significant
correlation with neurological outcome (P = 0.0000) and survival (P = 0.0000), a correlation which was comparable to both duration of anoxia and duration of CPR. In patients with out-of-hospital
cardiac arrest prognostic information could be obtained with the ICS as early as 20– 30 min after the start of cardiopulmonary
resuscitation.
Received: 27 November 1996 Received in revised form: 10 July 1997 Accepted: 26 July 1997 相似文献
9.
Troppmair Teresa Egger J. Krösbacher A. Zanvettor A. Schinnerl A. Neumayr A. Baubin M. 《Der Anaesthesist》2022,71(4):272-280
Die Anaesthesiologie - Die Qualität eines Rettungssystems zeichnet sich auch durch den effizienten Einsatz seiner personellen und Fahrzeugressourcen aus. So können im berechtigten Fall... 相似文献
10.
Kommentar zu den Leitlinien 2010 zur kardiopulmonalen Reanimation des European Resuscitation Council
Wenzel V Russo SG Arntz HR Bahr J Baubin MA Böttiger BW Dirks B Kreimeier U Fries M Eich C 《Der Anaesthesist》2010,59(12):1105-1123