Cardiopulmonary Resuscitation, Brain Blood Flow, and Neurologic Recovery

1985 ◽  
Vol 1 (2) ◽  
pp. 205-222 ◽  
Author(s):  
Raymond C. Koehler ◽  
John R. Michael
2000 ◽  
Vol 39 (02) ◽  
pp. 37-42 ◽  
Author(s):  
P. Hartikainen ◽  
J. T. Kuikka

Summary Aim: We demonstrate the heterogeneity of regional cerebral blood flow using a fractal approach and singlephoton emission computed tomography (SPECT). Method: Tc-99m-labelled ethylcysteine dimer was injected intravenously in 10 healthy controls and in 10 patients with dementia of frontal lobe type. The head was imaged with a gamma camera and transaxial, sagittal and coronal slices were reconstructed. Two hundred fifty-six symmetrical regions of interest (ROIs) were drawn onto each hemisphere of functioning brain matter. Fractal analysis was used to examine the spatial heterogeneity of blood flow as a function of the number of ROIs. Results: Relative dispersion (= coefficient of variation of the regional flows) was fractal-like in healthy subjects and could be characterized by a fractal dimension of 1.17 ± 0.05 (mean ± SD) for the left hemisphere and 1.15 ± 0.04 for the right hemisphere, respectively. The fractal dimension of 1.0 reflects completely homogeneous blood flow and 1.5 indicates a random blood flow distribution. Patients with dementia of frontal lobe type had a significantly lower fractal dimension of 1.04 ± 0.03 than in healthy controls. Conclusion: Within the limits of spatial resolution of SPECT, the heterogeneity of brain blood flow is well characterized by a fractal dimension. Fractal analysis may help brain scientists to assess age-, sex- and laterality-related anatomic and physiological changes of brain blood flow and possibly to improve precision of diagnostic information available for patient care.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hee Soon Lee ◽  
Kicheol You ◽  
Jin Pyeong Jeon ◽  
Chulho Kim ◽  
Sungeun Kim

AbstractWe aimed to investigate whether video-instructed dispatcher-assisted (DA)-cardiopulmonary resuscitation (CPR) improved neurologic recovery and survival to discharge compared to audio-instructed DA-CPR in adult out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city with sufficient experience and facilities. A retrospective cohort study was conducted for adult bystander-witnessed OHCA patients administered DA-CPR due to presumed cardiac etiology between January 1, 2018 and October 31, 2019 in Seoul, Korea. The primary and secondary outcomes were the differences in favorable neurologic outcome and survival to discharge rates in adult OHCA patients in the two instruction groups. Binary logistic regression analysis was performed to identify the outcome predictors after DA-CPR. A total of 2109 adult OHCA patients with DA-CPR were enrolled. Numbers of elderly patients in audio instruction and video instruction were 1260 (73.2%) and 214 (55.3%), respectively. Elderly patients and those outside the home or medical facility were more likely to receive video instruction. Favorable neurologic outcome was observed more in patients who received video-instructed DA-CPR (n = 75, 19.4%) than in patients who received audio-instructed DA-CPR (n = 117, 6.8%). The survival to discharge rate was also higher in video-instructed DA-CPR (n = 105, 27.1%) than in audio-instructed DA-CPR (n = 211, 12.3%). Video-instructed DA-CPR was significantly associated with neurologic recovery (aOR = 2.11, 95% CI 1.48–3.01) and survival to discharge (aOR = 1.81, 95% CI 1.33–2.46) compared to audio-instructed DA-CPR in adult OHCA patients after adjusting for age, gender, underlying diseases and CPR location. Video-instructed DA-CPR was associated with favorable outcomes in adult patients with OHCA in a metropolitan city equipped with sufficient experience and facilities.


1987 ◽  
Vol 15 (4) ◽  
pp. 416
Author(s):  
J. Michael Dean ◽  
Raymond C. Koehler ◽  
Charles L. Schleien ◽  
Ivor D. Berkowitz ◽  
Deborah Atchison ◽  
...  

2007 ◽  
Vol 22 (3) ◽  
pp. 135-148 ◽  
Author(s):  
Daniel S. O'Leary ◽  
Robert I. Block ◽  
Julie A. Koeppel ◽  
Susan K. Schultz ◽  
Vincent A. Magnotta ◽  
...  

1987 ◽  
Vol 21 (4) ◽  
pp. 197A-197A
Author(s):  
Ivor D Berkowitz ◽  
Raymond C Koehler ◽  
Charles L Schleien ◽  
Kenneth Kuboa ◽  
J Michael Dean ◽  
...  

2021 ◽  
Vol 13 (11) ◽  
pp. 448-455
Author(s):  
Tiffany Wai Shan Lau ◽  
Anthony Robert Lim ◽  
Kyra Anne Len ◽  
Loren Gene Yamamoto

Background: Chest compression efficacy determines blood flow in cardiopulmonary resuscitation (CPR) and relies on body mechanics, so resuscitator weight matters. Individuals of insufficient weight are incapable of generating a sufficient downward chest compression force using traditional methods. Aims: This study investigated how a resuscitator's weight affects chest compression efficacy, determined the minimum weight required to perform chest compressions and, for children and adults below this minimum weight, examine alternate means to perform chest compressions. Methods: Volunteers aged 8 years and above were enrolled to perform video-recorded, music-facilitated, compression-only CPR on an audible click-confirming manikin for 2 minutes, following brief training. Subjects who failed this proceeded to alternate modalities: chest compressions by jumping on the lower sternum; and squat-bouncing (bouncing the buttocks on the chest). These methods were assessed via video review. Findings: There were 57 subjects. The 30 subjects above 40kg were all able to complete nearly 200 compressions in 2 minutes. Success rates declined in those who weighed less than 40kg. Below 30 kg, only one subject (29.9 kg weight) out of 14 could achieve 200 effective compressions. Nearly all of the 23 subjects who could not perform conventional chest compressions were able to achieve effective chest compressions using alternate methods. Conclusion: A weight below 40kg resulted in a declining ability to perform standard chest compressions effectively. For small resuscitators, the jumping and squat-bouncing methods resulted in sufficient compressions most of the time; however, chest recoil and injuries are concerns.


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