Effect of positive end-expiratory pressure during cardiopulmonary resuscitation on short-term survival

Resuscitation ◽  
2019 ◽  
Vol 142 ◽  
pp. e7-e8
Author(s):  
Christophe Duchatelet ◽  
Martha Wolfskeil ◽  
Maxim Vanwulpen ◽  
Said-Hachimi Idrissi
2021 ◽  
Vol 8 ◽  
pp. 100174
Author(s):  
Caitlin E. O'Brien ◽  
Polan T. Santos ◽  
Ewa Kulikowicz ◽  
Shawn Adams ◽  
Jennifer K. Lee ◽  
...  

2013 ◽  
Vol 41 (12) ◽  
pp. 2698-2704 ◽  
Author(s):  
Stuart H. Friess ◽  
Robert M. Sutton ◽  
Utpal Bhalala ◽  
Matthew R. Maltese ◽  
Maryam Y. Naim ◽  
...  

Resuscitation ◽  
2002 ◽  
Vol 53 (2) ◽  
pp. 209-216 ◽  
Author(s):  
Sung Oh Hwang ◽  
Kang Hyun Lee ◽  
Jin Woong Lee ◽  
Seo Young Lee ◽  
Byung Su Yoo ◽  
...  

PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. 395-399
Author(s):  
Mananda S. Bhende ◽  
Ann E. Thompson

Objective. To determine the utility of a disposable colorimetric end-tidal CO2 detector during pediatric cardiopulmonary resuscitation (CPR) for (1) confirming endotracheal tube (ETT) position, and (2) assessing the relationship between end-tidal CO2 recorded by this method and outcome of pediatric CPR. Design/setting. Prospective observations during CPR in a university children's hospital. Participants. Forty children (28 male, 12 female) aged 1 week to 10 years (25 children aged ≤1 year, mean age 27.2 months, median 7 months), weighing 2.5 to 40 kg (31 children weighing ≤15 kg, mean 10.94 kg, median 7 kg) who underwent a total of 48 endotracheal intubations during CPR. Methods. After intubation, ETT position was verified by usual clinical methods including direct visualization. The device was attached between the ETT and ventilation bag, the patient was manually ventilated, and a first reading was obtained. Any color change from purple (Area A, end-tidal CO2 < 0.5%) to tan or yellow (Area B or C, end-tidal CO2 ≥ 0.5%) was considered to be positive for airway intubation. CPR was conducted as pen Pediatric Advanced Life Support guidelines. A second reading was obtained when the decision to discontinue CPR was made. Results. All nine esophageal tube positions were correctly identified by the detector. Thirty-three of 39 tracheal tube positions were correctly identified (P < .001). For verifying ETT position, the device had a sensitivity of 84.6%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 60%. Readings were obtained at the end of CPR in 25 patients. All 13 patients who regained spontaneous circulation and survived to ICU admission had a second reading in the C range, while none of the 12 patients with a second reading in the A or B range survived. Both the first and second end-tidal CO2 readings in the C range correlated significantly with short-term survival (P = .01 and P < .001, respectively). Two patients were eventually discharged from the hospital. Conclusions. During CPR a positive test confirms placement of the ETT within the airway, whereas a negative test indicates either esophageal intubation or airway intubation with poor or absent pulmonary blood flow and requires an alternate means of confirmation of tube position. The detector may be of prognostic value for return of spontaneous circulation and short-term survival.


Author(s):  
Jacob C Jentzer ◽  
Benedikt Schrage ◽  
David R Holmes ◽  
Salim Dabboura ◽  
Nandan S Anavekar ◽  
...  

Abstract Aims Cardiogenic shock (CS) is associated with poor outcomes in older patients, but it remains unclear if this is due to higher shock severity. We sought to determine the associations between age and shock severity on mortality among patients with CS. Methods and results Patients with a diagnosis of CS from Mayo Clinic (2007–15) and University Clinic Hamburg (2009–17) were subdivided by age. Shock severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Predictors of 30-day survival were determined using Cox proportional-hazards analysis. We included 1749 patients (934 from Mayo Clinic and 815 from University Clinic Hamburg), with a mean age of 67.6 ± 14.6 years, including 33.6% females. Acute coronary syndrome was the cause of CS in 54.0%. The distribution of SCAI shock stages was 24.1%; C, 28.0%; D, 33.2%; and E, 14.8%. Older patients had similar overall shock severity, more co-morbidities, worse kidney function, and decreased use of mechanical circulatory support compared to younger patients. Overall 30-day survival was 53.3% and progressively decreased as age or SCAI shock stage increased, with a clear gradient towards lower 30-day survival as a function of increasing age and SCAI shock stage. Progressively older age groups had incrementally lower adjusted 30-day survival than patients aged <50 years. Conclusion Older patients with CS have lower short-term survival, despite similar shock severity, with a high risk of death in older patients with more severe shock. Further research is needed to determine the optimal treatment strategies for older CS patients.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2631
Author(s):  
Kandeepan Karthigesu ◽  
Robert F. Bertolo ◽  
Robert J. Brown

Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.


2021 ◽  
pp. 175857322098784
Author(s):  
Arno A Macken ◽  
Ante Prkić ◽  
Koen LM Koenraadt ◽  
Iris van Oost ◽  
Anneke Spekenbrink-Spooren ◽  
...  

Background This study aims to use the Dutch Arthroplasty Register data to report an overview of the contemporary indications and implant designs, and report the short-term survival of radial head arthroplasty. Methods From the Dutch Arthroplasty Register, data on patient demographics, surgery and revision were extracted for radial head arthroplasties performed from January 2014 to December 2019. Implant survival was calculated using the Kaplan–Meier method. Results Two hundred fifty-eight arthroplasties were included with a median follow-up of 2.2 years. The most common indication was a fracture of the radial head (178, 69%). One hundred thirty-nine (68%) of the prostheses were of bipolar design, and the most commonly used implant type was the Radial Head System (Tornier; 134, 51%). Of the 258 included radial head arthroplasties, 16 were revised at a median of six months after surgery. Reason for revision was predominantly aseptic loosening (9). The overall implant survival was 95.8% after one year, 90.5% after three years and 89.5% after five years. Discussion For radial head arthroplasties, acute trauma is the most common indication and Radial Head System the most commonly used implant. The implant survival is 89.5% after five years.


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