Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services ...Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.展开更多
Objective： To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity （PEA） cardiac arrest and pre dicting the resuscitation outcomes. Methods： In this ...Objective： To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity （PEA） cardiac arrest and pre dicting the resuscitation outcomes. Methods： In this prospective interventional study, pa tients presenting with PEA cardiac arrest were randomized into two groups. In Group A, ultrasound trained emergency physicians performed echocardiography evaluating cardiac activity, right ventricle dilation, left ventricle function, peri cardial effusion/tamponade and IVC size along with the ad vanced cardiac life support （ACLS） protocol. Patients in Group B solely underwent ACLS protocol without applying echocardiography. The presence or absence of mechanical ventricular activity （MVA） and evidences of PEA reversible causes were recorded. The return of spontaneous circulation （ROSC） and death were evaluated in both groups. Results： One hundred patients with the mean age of （58±6.1） years were enrolled in this study. Fifty patients（Group A） had echocardiography detected in parallel with cardiopulmonary resuscitation （CPR）. Among them, 7 pa tients （14%） had pericardial effusion, 11 （22%） had hypovolemia, and 39 （78%） were revealed the presence of MVA. In the pseudo PEA subgroup （presence of MVA）, 43% had ROSC （positive predictive value） and in the true PEA subgroup with cardiac standstill （absence of MVA）, there was no recorded ROSC （negative predictive value）. Among patients in Group B, no reversible etiology was detected. There was no significant difference in resuscitation results between Groups A and B observed （P=0.52）. Conclusion： Bedside echocardiography can identify some reversible causes of PEA. However, there are no sig nificant changes in survival outcome between the echo group and those with traditional CPR.展开更多
In this paper, we propose a coordinated pilot reuse(CPR) approach to reduce the pilot overhead for multi-cell massive multi-input multi-output transmission. Unlike the conventional multi-cell pilot reuse approach in w...In this paper, we propose a coordinated pilot reuse(CPR) approach to reduce the pilot overhead for multi-cell massive multi-input multi-output transmission. Unlike the conventional multi-cell pilot reuse approach in which pilots can only be reused among different cells, the proposed CPR approach allows pilots to be reused among both inter-cell and intra-cell user equipments, and thus, pilot overhead can be efficiently reduced. For spatially correlated Rayleigh fading channels, we first present a CPR-based channel estimation method and a low complexity pilot allocation algorithm. Because CPR might lead to additional pilot interference, we develop a statistically robust uplink receiver and downlink precoder that takes channel estimation errors into account. The proposed uplink receiver and downlink precoder are robust to channel state information inaccuracy, and thus, can guarantee a certain transmission performance. Monte-Carlo simulations illustrate the significant performance improvement in net spectral efficiency offered by the proposed CPR approach.展开更多
文摘Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.
文摘Objective： To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity （PEA） cardiac arrest and pre dicting the resuscitation outcomes. Methods： In this prospective interventional study, pa tients presenting with PEA cardiac arrest were randomized into two groups. In Group A, ultrasound trained emergency physicians performed echocardiography evaluating cardiac activity, right ventricle dilation, left ventricle function, peri cardial effusion/tamponade and IVC size along with the ad vanced cardiac life support （ACLS） protocol. Patients in Group B solely underwent ACLS protocol without applying echocardiography. The presence or absence of mechanical ventricular activity （MVA） and evidences of PEA reversible causes were recorded. The return of spontaneous circulation （ROSC） and death were evaluated in both groups. Results： One hundred patients with the mean age of （58±6.1） years were enrolled in this study. Fifty patients（Group A） had echocardiography detected in parallel with cardiopulmonary resuscitation （CPR）. Among them, 7 pa tients （14%） had pericardial effusion, 11 （22%） had hypovolemia, and 39 （78%） were revealed the presence of MVA. In the pseudo PEA subgroup （presence of MVA）, 43% had ROSC （positive predictive value） and in the true PEA subgroup with cardiac standstill （absence of MVA）, there was no recorded ROSC （negative predictive value）. Among patients in Group B, no reversible etiology was detected. There was no significant difference in resuscitation results between Groups A and B observed （P=0.52）. Conclusion： Bedside echocardiography can identify some reversible causes of PEA. However, there are no sig nificant changes in survival outcome between the echo group and those with traditional CPR.
基金supported by the National Natural Science Foundation of China(Grant Nos.6147111361320106003&61201171)+3 种基金the National Hi-Tech Research and Development Program of China("863"Project)(Grant Nos.2015AA01A701&2014AA01A704)the National Science and Technology Major Project of China(Grant No.2014ZX03003006-003)the Program for Jiangsu Innovation TeamYOU Li was supported in part by the China Scholarship Council(CSC)
文摘In this paper, we propose a coordinated pilot reuse(CPR) approach to reduce the pilot overhead for multi-cell massive multi-input multi-output transmission. Unlike the conventional multi-cell pilot reuse approach in which pilots can only be reused among different cells, the proposed CPR approach allows pilots to be reused among both inter-cell and intra-cell user equipments, and thus, pilot overhead can be efficiently reduced. For spatially correlated Rayleigh fading channels, we first present a CPR-based channel estimation method and a low complexity pilot allocation algorithm. Because CPR might lead to additional pilot interference, we develop a statistically robust uplink receiver and downlink precoder that takes channel estimation errors into account. The proposed uplink receiver and downlink precoder are robust to channel state information inaccuracy, and thus, can guarantee a certain transmission performance. Monte-Carlo simulations illustrate the significant performance improvement in net spectral efficiency offered by the proposed CPR approach.
