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Review of Diagnosis and Treatment for a Cardio-pulmonary Resuscitation (PCR) Patient with HELLP Syndrome after Cesarean Section -- The discussion on clinical thinking of post-resuscitation syndrome
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作者 Yan Zhao Qing Song Fei-hu Zhou Hong-jun Kang Xin Hu 《麻醉与监护论坛》 2013年第1期22-26,共5页
关键词 替代治疗 剖宫产术 心肺复苏 临床特点 综合征 患者 诊断 PCR
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Successful rescue of disseminated Nocardia infection with multiple abscesses in a patient with membranous nephropathy after cardiopulmonary resuscitation:A three-year follow-up
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作者 Yili Xu Hanyang Qian +13 位作者 Wen Qian Li Dong Weiying Liu Yan Zhu Yaning Mei Yi Xu Ling Wang Yi Xia Xu Qi Huanping Mei Xueqiang Xu Huijuan Mao Changying Xing Ningning Wang 《Journal of Biomedical Research》 CAS CSCD 2024年第2期189-194,I0019,I0020,共8页
Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membran... Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membranous nephropathy,who underwent treatment with prednisone and cyclosporine in 2016.In early 2017,the patient was diagnosed with a"fungal infection"and discontinued the use of cyclosporine.After one month of anti-infection therapy,a cranial magnetic resonance imaging scan showed multiple abscesses in the right temporal region.The diagnosis of nocardiosis was confirmed based on the presence of metastatic abscess masses,multiple lung and brain lesions,and a positive culture of Nocardia in the drainage.We changed the anti-infection therapy to a combination of trimethoprim-sulfamethoxazole(TMP-SMX),minocycline,and voriconazole.However,the patient experienced a sudden cardiac arrest and subsequently recovered after cardiopulmonary resuscitation.During the five-month follow-up period following the discharge,the patient displayed an enhanced nutritional status and stable renal function.The focal infection ultimately resolved during the subsequent three years.Neuro-infection caused by Nocardia should be considered in immunocompromised patients,and TMP-SMX is the preferred initial therapy;however,because of the high mortality rate,a long-term combination therapy with imipenem,cefotaxime,amikacin,and TMP-SMX is suggested. 展开更多
关键词 Nocardia infection GLOMERULONEPHRITIS membranous nephrology cardiopulmonary resuscitation
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Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit
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作者 Ayman El-Menyar Bianca M Wahlen 《World Journal of Cardiology》 2024年第3期126-136,共11页
The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Maj... The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine. 展开更多
关键词 Cardiac arrest Out-of-hospital cardiac arrest In-hospital cardiac arrest Post-resuscitation Myocardial dysfunction Cardiopulmonary resuscitation Stony heart
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Advances in the Use of Prone Cardiopulmonary Resuscitation During Spinal Surgery in the Prone Position
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作者 Ruigang Zhu Xiaxia Chen +2 位作者 Jing Wang Miaocui Li Xiaolin Wang 《Journal of Clinical and Nursing Research》 2024年第4期316-321,共6页
Spinal surgery is usually performed in the prone position, which is a longer and more difficult procedure and is prone to complications such as circulatory dysfunction and stress injuries. Among them, stress injury is... Spinal surgery is usually performed in the prone position, which is a longer and more difficult procedure and is prone to complications such as circulatory dysfunction and stress injuries. Among them, stress injury is the main complication of prone spine surgery, but the reasons for stress injury in prone spine surgery are not clear, and whether prone cardiopulmonary resuscitation (CPR) can be used needs to be further verified. Supine cardiopulmonary resuscitation is commonly used in posterior spinal surgery, retroperitoneal surgery, and so on, which can effectively improve the patient’s hypoxemia. Such surgeries require a high level of anesthetic management, and cardiopulmonary resuscitation is necessary if a patient in a prone position experiences cardiac arrest. In the process of cardiopulmonary resuscitation, supine cardiopulmonary resuscitation is often used, especially for some obese patients, if they are immediately changed to the supine position, it takes up more time, there may be wound infection, and there is a possibility of missing the optimal rescue and resuscitation time. Based on this, this paper reviews the use of prone-position cardiopulmonary resuscitation for spinal surgery in the prone position. 展开更多
关键词 Prone position Spinal surgery Cardiopulmonary resuscitation Research progress
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Impact of Optimizing Emergency Nursing Processes on Resuscitation Success in Patients with Acute Chest Pain
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作者 Xiaohan Chen 《Journal of Clinical and Nursing Research》 2024年第5期150-155,共6页
Objective:To analyze the effect of optimizing the emergency nursing process in the resuscitation of patients with acute chest pain and the impact on the resuscitation success rate.Methods:66 patients with acute chest ... Objective:To analyze the effect of optimizing the emergency nursing process in the resuscitation of patients with acute chest pain and the impact on the resuscitation success rate.Methods:66 patients with acute chest pain received by the emergency department of our hospital from January 2022 to December 2023 were selected as the study subjects and divided into two groups according to the differences in the emergency nursing process,i.e.,33 patients receiving routine emergency care were included in the control group,and 33 patients receiving the optimization of emergency nursing process intervention were included in the observation group.Patients’resuscitation effect and satisfaction with nursing care in the two groups were compared.Results:The observation group’s consultation assessment time,reception time,admission to the start of resuscitation time,and resuscitation time were shorter than that of the control group,the resuscitation success rate was higher than that of the control group,and the incidence of adverse events was lower than that of the control group,with statistically significant differences(P<0.05);and the observation group’s satisfaction with nursing care was higher than that of the control group,with statistically significant differences(P<0.05).Conclusion:Optimization of emergency nursing process intervention in the resuscitation of acute chest pain patients can greatly shorten the rescue time and improve the success rate of resuscitation,with higher patient satisfaction. 展开更多
关键词 Chest pain Emergency resuscitation Optimization of emergency nursing process
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Analysis of the Application Value of Virtual Reality Combined with Flipped Classroom Teaching Mode in Cardiopulmonary Resuscitation Teaching
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作者 Hua Liu 《Journal of Contemporary Educational Research》 2024年第5期154-159,共6页
Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly select... Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly selected for the study from September 2022 to September 2023,Class A(52 students,conventional teaching method)and Class B(52 students,virtual reality combined with flipped classroom teaching mode).The assessment scores and independent learning ability scores of the students in the two classes were compared.Results:CPR theory and operation scores,passing rate,and independent learning ability scores of Class B were higher than those of Class A(P<0.05).Conclusion:the use of virtual reality combined with the flipped classroom teaching mode in CPR teaching is conducive to the improvement of students’assessment scores and independent learning ability. 展开更多
关键词 Virtual reality Flipped classroom teaching mode Cardiopulmonary resuscitation Assessment performance Independent learning ability
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The neuro-prognostic value of the ion shift index in cardiac arrest patients following extracorporeal cardiopulmonary resuscitation 被引量:1
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作者 Gannan Wang Zhe Wang +4 位作者 Yi Zhu Zhongman Zhang Wei Li Xufeng Chen Yong Mei 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第5期354-359,共6页
BACKGROUND:The ion shift index(ISI) as a prognostic indicator that can show the severity of hypoxic-ischemic injury.We aimed to evaluate the performance of the ISI in predicting unfavorable neurological outcomes at ho... BACKGROUND:The ion shift index(ISI) as a prognostic indicator that can show the severity of hypoxic-ischemic injury.We aimed to evaluate the performance of the ISI in predicting unfavorable neurological outcomes at hospital discharge in cardiac arrest(CA) patients following extracorporeal cardiopulmonary resuscitation(ECPR) and to compare its performance to other prognostic predictors.METHODS:This was a retrospective observational study including adult CA patients treated with ECPR between January 2018 and December 2022 in a tertiary hospital.Data regarding clinical characteristics and laboratory parameters were collected from medical records.The ISI was determined based on the first available serum electrolyte levels after ECPR.The primary outcome was unfavorable neurological status at hospital discharge,defined as Cerebral Performance Categories 3–5.Comparisons of the characteristics between the two groups were made using the χ2 test for categorical variables and the t-test or non-parametric Mann-Whitney U-test for continuous variables,as appropriate.Correlation analysis was performed using Spearman’s rank correlation coeficient.A two-tailed P-value <0.05 was considered statistically significant.RESULTS:Among the 122 patients involved,46(37.7%) had out-of-hospital CA,and 88 had unfavorable neurological outcomes.The ISI was significantly higher in the unfavorable outcome group than in the favorable outcome group(3.74 [3.15–4.57] vs.2.69 [2.51–3.07],P<0.001).A higher ISI level was independently related to unfavorable outcome(odds ratio=6.529,95% confidence interval 2.239–19.044,P=0.001).An ISI level >3.12 predicted unfavorable outcomes with a sensitivity and specificity of 74.6% and 85.2%,respectively(P<0.001).The prognostic performance of ISI(area under the curve [AUC]=0.887) was similar to that of other predictors,such as gray-to-white matter ratio(AUC=0.850,P=0.433) and neuronspecific enolase(AUC=0.925,P=0.394).CONCLUSION:ISI may be used as a prognostic biomarker to predict neurological outcomes in CA patients following ECPR. 展开更多
关键词 Cardiac arrest Ion shift index Extracorporeal cardiopulmonary resuscitation
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Cardiac arrest and cardiopulmonary resuscitation in“hostile”environments:Using automated compression devices to minimize the rescuers’danger 被引量:1
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作者 George Latsios Marianna Leopoulou +6 位作者 Andreas Synetos Antonios Karanasos Angelos Papanikolaou Pavlos Bounas Evangelia Stamatopoulou Konstantinos Toutouzas Kostas Tsioufis 《World Journal of Cardiology》 2023年第2期45-55,共11页
Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual,“hands-on”,rescuer-delivered chest compressions.The-theoretical-advantages include high-quality non-stop com... Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual,“hands-on”,rescuer-delivered chest compressions.The-theoretical-advantages include high-quality non-stop compressions,thus freeing the rescuer performing the compressions and additionally the ability of the rescuer to stand reasonably away from a potentially“hazardous”victim,or from hazardous and/or difficult resuscitation conditions.Such circumstances involve cardiopulmonary resuscitation(CPR)in the Cardiac Catheterization Laboratory,especially directly under the fluoroscopy panel,where radiation is well known to cause detrimental effects to the rescuer,and CPR during/after land or air transportation of cardiac arrest victims.Lastly,CPR in a coronavirus disease 2019 patient/ward,where the danger of contamination and further serious illness of the health provider is very existent.The scope of this review is to review and present literature and current guidelines regarding the use of mechanical compressions in these“hostile”and dangerous settings,while comparing them to manual compressions. 展开更多
关键词 Automated compression devices Cardiopulmonary resuscitation Cathlab Computed tomography TRANSFER COVID-19
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Vagus nerve stimulation protects against cerebral injury after cardiopulmonary resuscitation by inhibiting inflammation through the TLR4/NF-κB and α7nAChR/JAK2 signaling pathways 被引量:1
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作者 Shuang Xu Lang Guo +7 位作者 Weijing Shao Licai Liang Tingting Shu Yuhan Zhang He Huang Guangqi Guo Qing Zhang Peng Sun 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第6期462-470,共9页
BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a r... BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a rat model, but the underlying mechanism of VNS in neuroprotection after CPR remains unclear.METHODS: In vivo, we established a mouse model of cardiac arrest(CA)/CPR to observe the survival rate, and the changes in inflammatory factors and brain tissue after VNS treatment. In vitro, we examined the effects of α7nAChR agonist on ischemia/reperfusion(I/R)-induced inflammation in BV2 cells under oxygen-glucose deprivation/reoxygenation(OGD/R) conditions. We observed the changes in cell survival rate, the levels of inflammatory factors, and the expressions of α7nAChR/Janus kinase 2(JAK2) and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB).RESULTS: In vivo, VNS preconditioning enhanced functional recovery, improved the survival rate, and reduced hippocampal CA1 cell damage, and the levels of inflammatory mediators after CA/CPR. The application of α7nAChR agonists provided similar effects against cerebral injury after the return of spontaneous circulation(ROSC), while α7nAChR antagonists reversed these neuroprotective impacts. The in vitro results mostly matched the findings in vivo. OGD/R increased the expression of tumor necrosis factor-alpha(TNF-α), TLR4 and NF-κB p65. When nicotine was added to the OGD/R model, the expression of TLR4, NF-κB p65, and TNF-α decreased, while the phosphorylation of JAK2 increased, which was prevented by preconditioning with α7nAChR or JAK2 antagonists.CONCLUSION: The neuroprotective effect of VNS correlated with the activation of α7nAChR. VNS may alleviate cerebral IR injury by inhibiting TLR4/NF-κB and activating the α7nAChR/JAK2 signaling pathway. 展开更多
关键词 Cardiopulmonary resuscitation Vagus nerve stimulation INFLAMMATION Toll-like receptor 4 α7 nicotinic acetylcholine receptor
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The effects of hyperbaric oxygen therapy on paroxysmal sympathetic hyperactivity after cardiopulmonary resuscitation: a case series
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作者 Hongyu Wang Yihao Li +2 位作者 Meng Zhao Caihong Ren Sisen Zhang 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第6期477-480,共4页
The onset of cardiac arrest (CA) is sudden and critical.Due to cerebral ischaemia and hypoxia, the prognosis for post-cardiopulmonary resuscitation (CPR) patients is poor. Paroxysmal sympathetic hyperexcitability (PSH... The onset of cardiac arrest (CA) is sudden and critical.Due to cerebral ischaemia and hypoxia, the prognosis for post-cardiopulmonary resuscitation (CPR) patients is poor. Paroxysmal sympathetic hyperexcitability (PSH) is a potentially life-threatening condition, which is characterized by episodes of increased heart rate and blood pressure,sweating, hypothermia, and forced posture.[1] Hypoxicischaemic encephalopathy post-CPR can lead to PSH,which often indicates a worse prognosis. 展开更多
关键词 SYMPATHETIC resuscitation PROGNOSIS
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Synchronized ventilation during resuscitation in pigs does not necessitate high inspiratory pressures to provide adequate oxygenation
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作者 Miriam Renz Raphael RenéCinto Noack +6 位作者 RenéRissel Katja Mohnke Julian Riedel Bastian Dunges Alexander Ziebart Erik Kristoff er Hartmann Robert Rummler 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第5期393-396,共4页
The optimal ventilation method for patients suffering from cardiac arrest and receiving cardiopulmonary resuscitation(CPR)remains unclear,and the recent guidelines do not provide detailed information.[1-3]During CPR,c... The optimal ventilation method for patients suffering from cardiac arrest and receiving cardiopulmonary resuscitation(CPR)remains unclear,and the recent guidelines do not provide detailed information.[1-3]During CPR,changing thoracic pressures due to chest compressions and ventilation pressure infl uence venous return and cardiac output,respectively.[4-6]Novel mechanical ventilation modes that are synchronized to chest compressions may improve blood flow and oxygenation.[4]In this porcine trial,we investigated the feasibility of a specially designed chest compression synchronized ventilation(CCSV)mode with peak pressures limited to 40 mbar(1 mbar=0.1 kPa)and an experimental synchronized ventilation(SV)limited to 20 mbar,respectively,intended to achieve a more lung-protective ventilation pattern during resuscitation.We evaluated whether the diff erent synchronized pressure levels ameliorate hemodynamics,gas exchange and pulmonary function and compared it to intermittent positive pressure ventilation(IPPV). 展开更多
关键词 resuscitation protective CARDIAC
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Establishment of a Rat Model of Capillary Leakage Syndrome Induced by Cardiopulmonary Resuscitation After Cardiac Arrest
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作者 Xiao-lei ZHANG Ye CHENG +4 位作者 Chun-lin XING Jia-yun YING Xue YANG Xiao-di CAI Guo-ping LU 《Current Medical Science》 SCIE CAS 2023年第4期708-715,共8页
Objective:Cardiopulmonary resuscitation(CPR)after cardiac arrest(CA)is one of the main causes of capillary leakage syndrome(CLS).This study aimed to establish a stable CLS model following the CA and cardiopulmonary re... Objective:Cardiopulmonary resuscitation(CPR)after cardiac arrest(CA)is one of the main causes of capillary leakage syndrome(CLS).This study aimed to establish a stable CLS model following the CA and cardiopulmonary resuscitation(CA-CPR)model in Sprague-Dawley(SD)rats.Methods:We conducted a prospective,randomized,animal model study.All adult male SD rats were randomly divided into a normal group(group N),a sham operation group(group S),and a cardiopulmonary resuscitation group(group T).The SD rats of the three groups were all inserted with 24-G needles through their left femoral arteries and right femoral veins.In group S and group T,the endotracheal tube was intubated.In group T,CA induced by asphyxia(AACA)was caused by vecuronium bromide with the endotracheal tube obstructed for 8 min,and the rats were resuscitated with manual chest compression and mechanical ventilation.Preresuscitation and postresuscitation measurements,including basic vital signs(BVS),blood gas analysis(BG),routine complete blood count(CBC),wet-to-dry ratio of tissues(W/D),and the HE staining results after 6 h were evaluated.Results:In group T,the success rate of the CA-CPR model was 60%(18/30),and CLS occurred in 26.6%(8/30)of the rats.There were no significant differences in the baseline characteristics,including BVS,BG,and CBC,among the three groups(P>0.05).Compared with pre-asphyxia,there were significant differences in BVS,CBC,and BG,including temperature,oxygen saturation(SpO_(2)),mean arterial pressure(MAP),central venous pressure(CVP),white blood cell count(WBC),hemoglobin,hematocrit,pH,pCO_(2),pO_(2),SO_(2),lactate(Lac),base excess(BE),and Na+(P<0.05)after the return of spontaneous circulation(ROSC)in group T.At 6 h after ROSC in group T and at 6 h after surgery in groups N and S,there were significant differences in temperature,heart rate(HR),respiratory rate(RR),SpO_(2),MAP,CVP,WBC,pH,pCO_(2),Na+,and K+among the three groups(P<0.05).Compared with the other two groups,the rats in group T showed a significantly increased W/D weight ratio(P<0.05).The HE-stained sections showed consistent severe lesions in the lung,small intestine,and brain tissues of the rats at 6 h after ROSC following AACA.Conclusion:The CA-CPR model in SD rats induced by asphyxia could reproduce CLS with good stability and reproducibility. 展开更多
关键词 cardiac arrest cardiopulmonary resuscitation capillary leakage model
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Cerebral Malaria: Epidemiological, Clinical and Prognosis Aspects in the Anesthesia-Resuscitation Department CHU Ignace Deen
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作者 Abdoulaye Touré Amadou Yalla Camara +3 位作者 Almamy Bangoura M’mah Lamine Camara Mohamed Soumah Saramba Nabe 《Open Journal of Emergency Medicine》 2023年第4期162-173,共12页
Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type s... Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (M/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. Mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality. 展开更多
关键词 Cerebral Malaria Mortality resuscitation
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Do cardiopulmonary resuscitation real-time audiovisual feedback devices improve patient outcomes? A systematic review and metaanalysis
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作者 Nitish Sood Anish Sangari +4 位作者 Arnav Goyal Christina Sun Madison Horinek Joseph Andy Hauger Lane Perry 《World Journal of Cardiology》 2023年第10期531-541,共11页
BACKGROUND Cardiac arrest is a leading cause of mortality in America and has increased in the incidence of cases over the last several years.Cardiopulmonary resuscitation(CPR)increases survival outcomes in cases of ca... BACKGROUND Cardiac arrest is a leading cause of mortality in America and has increased in the incidence of cases over the last several years.Cardiopulmonary resuscitation(CPR)increases survival outcomes in cases of cardiac arrest;however,healthcare workers often do not perform CPR within recommended guidelines.Real-time audiovisual feedback(RTAVF)devices improve the quality of CPR performed.This systematic review and meta-analysis aims to compare the effect of RTAVF-assisted CPR with conventional CPR and to evaluate whether the use of these devices improved outcomes in both in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA)patients.AIM To identify the effect of RTAVF-assisted CPR on patient outcomes and CPR quality with in-and OHCA.METHODS We searched PubMed,SCOPUS,the Cochrane Library,and EMBASE from inception to July 27,2020,for studies comparing patient outcomes and/or CPR quality metrics between RTAVF-assisted CPR and conventional CPR in cases of IHCA or OHCA.The primary outcomes of interest were return of spontaneous circulation(ROSC)and survival to hospital discharge(SHD),with secondary outcomes of chest compression rate and chest compression depth.The methodo-logical quality of the included studies was assessed using the Newcastle-Ottawa scale and Cochrane Collaboration’s“risk of bias”tool.Data was analyzed using R statistical software 4.2.0.results were statistically significant if P<0.05.RESULTS Thirteen studies(n=17600)were included.Patients were on average 69±17.5 years old,with 7022(39.8%)female patients.Overall pooled ROSC in patients in this study was 37%(95%confidence interval=23%-54%).RTAVF-assisted CPR significantly improved ROSC,both overall[risk ratio(RR)1.17(1.001-1.362);P=0.048]and in cases of IHCA[RR 1.36(1.06-1.80);P=0.002].There was no significant improvement in ROSC for OHCA(RR 1.04;0.91-1.19;P=0.47).No significant effect was seen in SHD[RR 1.04(0.91-1.19);P=0.47]or chest compression rate[standardized mean difference(SMD)-2.1;(-4.6-0.5);P=0.09].A significant improvement was seen in chest compression depth[SMD 1.6;(0.02-3.1);P=0.047].CONCLUSION RTAVF-assisted CPR increases ROSC in cases of IHCA and chest compression depth but has no significant effect on ROSC in cases of OHCA,SHD,or chest compression rate. 展开更多
关键词 Real-time audiovisual feedback Cardiopulmonary resuscitation Cardiac arrest Return of spontaneous circulation Survival to hospital discharge Cardiopulmonary resuscitation quality
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Complete Neurological Recovery after Prolonged Resuscitation in a Young Patient with Non-Shockable Rhythm
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作者 Youssef Abboud Laila Kalan Sreya Varanasi 《Open Journal of Emergency Medicine》 2023年第1期16-20,共5页
Background: Out-of-hospital cardiac arrest (OHCA) with ongoing CPR on arrival to emergency department still a challenge to decide how long the resuscitation should continue or when to terminate it. Case Summary: A pat... Background: Out-of-hospital cardiac arrest (OHCA) with ongoing CPR on arrival to emergency department still a challenge to decide how long the resuscitation should continue or when to terminate it. Case Summary: A patient with a 1-week history of difficulty in breathing suffered from an OHCA. The electrocardiogram upon arrival to the hospital showed pulseless electrical activity. Cardiopulmonary resuscitation was initiated and continued for a total of 90 minutes without any interruption until return of spontaneous circulation (ROSC) was achieved. Post-cardiac care was offered, and the patient was discharged with complete neurological recovery. Discussion: In non-shockable rhythms, the powerful defibrillator machine is not used during resuscitation. In such cases, identifying the offending cause, performing high quality CPR and administering epinephrine are the only effective tools in resuscitating a patient. 展开更多
关键词 Cardiac Arrest Out of Hospital Cardiac Arrest resuscitation
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Cardiac arrest secondary to pulmonary embolism treated with extracorporeal cardiopulmonary resuscitation:Six case reports
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作者 Min-Shan Qiu Yong-Jin Deng +1 位作者 Xue Yang Han-Quan Shao 《World Journal of Clinical Cases》 SCIE 2023年第17期4098-4104,共7页
BACKGROUND Massive pulmonary embolism(PE)results in extremely high mortality rates.Veno-arterial extracorporeal membrane oxygenation(VA-ECMO)can provide circulatory and oxygenation support and rescue patients with mas... BACKGROUND Massive pulmonary embolism(PE)results in extremely high mortality rates.Veno-arterial extracorporeal membrane oxygenation(VA-ECMO)can provide circulatory and oxygenation support and rescue patients with massive PE.However,there are relatively few studies of extracorporeal cardiopulmonary resuscitation(ECPR)in patients with cardiac arrest(CA)secondary to PE.The aim of the present study is to investigate the clinical use of ECPR in conjunction with heparin anticoagulation in patients with CA secondary to PE.CASE SUMMARY We report the cases of six patients with CA secondary to PE treated with ECPR in the intensive care unit of our hospital between June 2020 and June 2022.All six patients experienced witnessed CA whilst in hospital.They had acute onset of severe respiratory distress,hypoxia,and shock rapidly followed by CA and were immediately given cardiopulmonary resuscitation and adjunctive VA-ECMO therapy.During hospitalization,pulmonary artery computed tomography angiography was performed to confirm the diagnosis of PE.Through anticoagulation management,mechanical ventilation,fluid management,and antibiotic treatment,five patients were successfully weaned from ECMO(83.33%),four patients survived for 30 d after discharge(66.67%),and two patients had good neurological outcomes(33.33%).CONCLUSION For patients with CA secondary to massive PE,ECPR in conjunction with heparin anticoagulation may improve outcomes. 展开更多
关键词 Extracorporeal cardiopulmonary resuscitation Cardiac arrest Pulmonary embolism OUTCOMES Shock Case report
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Effi cacy of partial and complete resuscitative endovascular balloon occlusion of the aorta in the hemorrhagic shock model of liver injury
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作者 Yi Shan Yang Zhao +3 位作者 Chengcheng Li Jianxin Gao Guogeng Song Tanshi Li 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第1期10-15,共6页
BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)can temporarily control traumatic bleeding.However,its prolonged use potentially leads to ischemia-reperfusion injury(IRI).Partial REBOA(pREBO... BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)can temporarily control traumatic bleeding.However,its prolonged use potentially leads to ischemia-reperfusion injury(IRI).Partial REBOA(pREBOA)can alleviate ischemic burden;however,its security and eff ectiveness prior to operative hemorrhage control remains unknown.Hence,we aimed to estimate the effi cacy of pREBOA in a swine model of liver injury using an experimental sliding-chamber ballistic gun.METHODS:Twenty Landrace pigs were randomized into control(no aortic occlusion)(n=5),intervention with complete REBOA(cREBOA)(n=5),continuous pREBOA(C-pREBOA)(n=5),and sequential pREBOA(S-pREBOA)(n=5)groups.In the cREBOA and C-pREBOA groups,the balloon was inflated for 60 min.The hemodynamic and laboratory values were compared at various observation time points.Tissue samples immediately after animal euthanasia from the myocardium,liver,kidneys,and duodenum were collected for histological assessment using hematoxylin and eosin staining.RESULTS:Compared with the control group,the survival rate of the REBOA groups was prominently improved(all P<0.05).The total volume of blood loss was markedly lower in the cREBOA group(493.14±127.31 mL)compared with other groups(P<0.01).The pH was significantly lower at 180 min in the cREBOA and S-pREBOA groups(P<0.05).At 120 min,the S-pREBOA group showed higher alanine aminotransferase(P<0.05)but lower blood urea nitrogen compared with the cREBOA group(P<0.05).CONCLUSION:In this trauma model with liver injury,a 60-minute pREBOA resulted in improved survival rate and was effective in maintaining reliable aortic pressure,despite persistent hemorrhage.Extended tolerance time for aortic occlusion in Zone I for non-compressible torso hemorrhage was feasible with both continuous partial and sequential partial measures,and the significant improvement in the severity of acidosis and distal organ injury was observed in the sequential pREBOA. 展开更多
关键词 Non-compressible torso hemorrhage Liver injury Ischemia-reperfusion injury resuscitative endovascular balloon occlusion of the aorta
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Effect of resuscitation after selective cerebral ultraprofound hypothermia on expressions of nerve growth factor and glial cell line-derived neurotrophic factor in the brain of monkey
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作者 黄学才 徐蔚 江基尧 《Neuroscience Bulletin》 SCIE CAS CSCD 2008年第3期150-154,共5页
Objective To investigate the expression of nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) in monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood ... Objective To investigate the expression of nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) in monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion. Methods The monkeys were immediately removed brain after death in operation of group A (identical temperature perfusion group) and group B (ultraprofound hypothermia perfusion group). Immunohistochemical technique was used to determine frontal cellular expression of NGF and GDNF. Statistics were analyzed by ANOVA analyses with significance level at P 〈 0.05. Results The expressions of NGF and GDNF in the group B were significantly higher than those in the group A (P 〈 0.05). Conclusion NGF and GDNF increased significantly in the monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion. It may be a protective mechanism for neuron survival and neural function recovery. 展开更多
关键词 nerve growth factor glial cell line-derived neurotrophicfactor ultraprofound hypothermic circulatory arrest resuscitation monkey brain
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Is aggressive intravenous fluid resuscitation beneficial in acute pancreatitis? A meta-analysis of randomized control trials and cohort studies 被引量:23
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作者 Mohamed M Gad C.Roberto Simons-Linares 《World Journal of Gastroenterology》 SCIE CAS 2020年第10期1098-1106,共9页
BACKGROUND There is conflincting evidence on the intravenous fluid(IVF)strategy for acute pancreatitis(AP).We perform a metaanalysis of the available evidence.AIM To investigate if aggressive IVF therapy in AP patient... BACKGROUND There is conflincting evidence on the intravenous fluid(IVF)strategy for acute pancreatitis(AP).We perform a metaanalysis of the available evidence.AIM To investigate if aggressive IVF therapy in AP patients is beneficial to decrease mortality and improve outcomes.METHODS Metaanalysis of available randomized controlled trials and cohort studies comparing aggressive IVF vs non-aggressive IVF resuscitation.RESULTS There was no significant difference in mortality between the aggressive(n=1229)and non-aggressive IVF(n=1397)patients.Patients receiving aggressive IVF therapy had higher risk for acute kidney injury and acute respiratory distress syndrome.There also was no significant difference in the overall incidence of systemic inflammatory response syndrome,persistent organ failure,pancreatic necrosis when comparing both study groups.CONCLUSION Early aggressive IVF therapy did not improve mortality.Moreover,aggressive IVF therapy could potentially increase the risk for acute kidney injury and pulmonary edema leading to respiratory failure and mechanical ventilation.Studies are needed to investigate which subset of AP patients could benefit from aggressive IVF therapy. 展开更多
关键词 Acute pancreatitis Intravenous fluid resuscitation Aggressive fluid resuscitation
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Fluid resuscitation in acute pancreatitis 被引量:14
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作者 Aakash Aggarwal Manish Manrai Rakesh Kochhar 《World Journal of Gastroenterology》 SCIE CAS 2014年第48期18092-18103,共12页
Acute pancreatitis remains a clinical challenge, despite an exponential increase in our knowledge of its complex pathophysiological changes. Early fluid therapy is the cornerstone of treatment and is universally recom... Acute pancreatitis remains a clinical challenge, despite an exponential increase in our knowledge of its complex pathophysiological changes. Early fluid therapy is the cornerstone of treatment and is universally recommended; however, there is a lack of consensus regarding the type, rate, amount and end points of fluid replacement. Further confusion is added with the newer studies reporting better results with controlled fluid therapy. This review focuses on the pathophysiology of fluid depletion in acute pancreatitis, as well as the rationale for fluid replacement, the type, optimal amount, rate of infusion and monitoring of such patients. The basic goal of fluid epletion should be to prevent or minimize the systemic response to inflammatory markers. For this review, various studies and reviews were critically evaluated, along with authors&#x02019; recommendations, for predicted severe or severe pancreatitis based on the available evidence. 展开更多
关键词 Acute pancreatitis Fluid resuscitation Aggressive fluid therapy CRYSTALLOIDS COLLOIDS
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