scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2020 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Limited Data ◽  
Total N ◽  
Observational Prospective Study ◽  
Glottic View ◽  
Significant Difference ◽  
The Impact ◽  
Good Visibility ◽  
Initial Instruction

Abstract Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2020 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Limited Data ◽  
Total N ◽  
Observational Prospective Study ◽  
Glottic View ◽  
Significant Difference ◽  
The Impact ◽  
Good Visibility ◽  
Initial Instruction

Abstract Background:Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods:In a single Emergency Medical Service (EMS) in Germanywith in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2020 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Limited Data ◽  
Total N ◽  
Observational Prospective Study ◽  
Glottic View ◽  
Significant Difference ◽  
The Impact ◽  
Good Visibility ◽  
Initial Instruction

Abstract Background: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germanywith in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2019 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Medical Service ◽  
Limited Data ◽  
Total N ◽  
Observational Prospective Study ◽  
Significant Difference ◽  
First Pass ◽  
Good Visibility ◽  
Initial Instruction

Abstract Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to show the benefit of VL during CPR performed by German paramedics.We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL.Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by less experienced paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2019 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Successful Intubation ◽  
Limited Data ◽  
Total N ◽  
Popular Method ◽  
Observational Prospective Study ◽  
Significant Difference ◽  
Good Visibility

Abstract Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to show the benefit of VL during CPR performed by non-physicians in a single emergency department in Germany. We investigated in an observational prospective study the superiority of VL for less-experienced paramedics during CPR compared with direct laryngoscopy (DL).Methods: We instructed and equipped paramedics from four ambulances in endotracheal intubation (ETI) with GlideScope® (GVL). The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation.Results: In total n = 97 patients were included, n = 69 using DL (with n = 85 intubation attempts) and n = 28 using VL (with n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63).Conclusions: When used by paramedics during CPR, GVL led to better visibility of the glottis but did not increase the number of successful initial intubation attempts. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

P5280The impact of background phase offset errors in cardiovascular magnetic resonance phase contrast imaging: a multi-scanner study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S C S Minderhoud ◽  
N Van Der Velde ◽  
J J Wentzel ◽  
M Attrach ◽  
P A Wielopolski ◽  
...  
Keyword(s):  
Phase Contrast ◽  
Main Pulmonary Artery ◽  
Flow Quantification ◽  
Flow Measurements ◽  
Total N ◽  
Phase Offset ◽  
Wide Range ◽  
Significant Difference ◽  
Clinically Significant ◽  
The Impact

Abstract Background Phase contrast (PC) CMR flow measurements (FM) are widely used for blood flow assessment, but they suffer from phase offset errors (POE). Stationary phantom correction limits these inaccuracies, however, this adds scan time. Stationary tissue (ST) correction is an alternative method that does not require additional scanning. The aim of this study was to evaluate the impact of POE, to assess interscanner variation, and to evaluate the ST correction usage. Methods We included 166 patients in which both aorta and main pulmonary artery FM were acquired including static gelatin phantom data. Subjects were scanned on three types of 1.5T scanners from the one vendor. Uncorrected and ST corrected FM were compared with phantom corrected FM, our reference value, and corrected for BSA. A difference of >10% in net flow was defined as clinically relevant. Regurgitation fraction was calculated and POE influences were assessed. Regurgitation severity was graded and POE influence on severity grading was assessed. Results Of the 166 cases included, the median age was 27 (5–74) years. Overall, the median difference between no corrected and phantom corrected FM was ≤6%, however, with a wide range of over- and underestimation (−155%–78% change) (figure). ST correction resulted in larger differences compared to no correction (p<0.01). Clinically significant differences were seen in 19% of all FM with no correction and in 30% of with ST correction (p<0.01). Furthermore, there were significant differences between scanners (no correction 10%, p<0.01; ST correction, p<0.01). Regurgitation severity indexing changed in 38 (11%) cases with no correction and in 48 (48%) with ST correction. Magnitude of flow change with and without offset corrections (n=332) Flow (ml/m2) Δ no correction and phantom correction (%) Δ ST correction and phantom correction (%) Clinically significant difference (>10%) Mean ± SD Median IQR Range Median IQR Range No correction, N (%) ST correction , N (%) MRI 1 (n=126) 50±12 3 0 to 6 −8 to 30 5 −3 to 9 −26 to 28 13 (10%) 34 (27%) MRI 2 (n=102) 48±13 −2 −15 to 6 −155 to 78 5 −3 to 11 −74 to 52 50 (49%) 50 (49%) MRI 3 (n=104) 48±12 −1 −1 to 0 −7 to 14 2 −2 to 5 −39 to 29 1 (1%) 16 (15%) Total (n=332) 49±12 0 −2 to 4 −155 to 78 3 −2 to 8 −74 to 52 64 (19%) 100 (30%) Conclusion Background POE have a significant impact on flow quantification and regurgitation severity. Unexpectedly, background correction using ST correction worsens accuracy compared to no correction. POE vary greatly between scanners. Therefore, careful assessment of FM at each scanner is essential to determine if routine phantom scanning is necessary.

scholarly journals C-MAC Video Laryngoscope versus Conventional Direct Laryngoscopy for Endotracheal Intubation During Cardiopulmonary Resuscitation

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 225 ◽  
Author(s):  
Byeong Chul Min ◽  
Jong Eun Park ◽  
Gun Tak Lee ◽  
Tae Rim Kim ◽  
Hee Yoon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Cardiopulmonary Resuscitation ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Multiple Logistic Regression Analysis ◽  
Video Laryngoscope ◽  
Multiple Logistic Regression ◽  
Total N ◽  
Significant Difference

Background and objectives: To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods: This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate. A multiple logistic regression model was developed to identify factors related to the FPS. Results: A total of 573 ETIs were performed. Of the eligible cases, 263 and 310 patients were assigned to the C-MAC and DL group, respectively. The overall FPS rate was 75% (n = 431/573). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference (total n = 431, 79% compared to 72%, p = 0.075). In the multiple logistic regression analysis, the C-MAC use had higher FPS rate (adjusted odds ratio: 1.80; 95% CI, 1.17–2.77; p = 0.007) than that of the DL use. Conclusions: The C-MAC use on the first ETI attempt during cardiopulmonary resuscitation in the emergency department had a higher FPS rate than that of the DL use.

scholarly journals Kajian Cara Tanam Jagung Bayi (Zea mays L.) dan Rumput Gajah (Pennisetum purpureum) terhadap Besarnya Erosi pada Lahan Miring

2018 ◽  
Vol 20 (1) ◽  
pp. 31
Author(s):  
Supriyadi Supriyadi
Keyword(s):  
P Element ◽  
Pennisetum Purpureum ◽  
Available P ◽  
Total N ◽  
Available N ◽  
Treatment Variation ◽  
Significant Difference ◽  
Planting Method ◽  
The Impact ◽  
Total P

<p>The objective of this research was understanding the impact of planting method to N and P element in the soil (swapt away by erosion) of aslant land, determining the best planting method and plant variety that has best ability to reduce erosion of N and P element. This research employed erosion block for seasonal plants with 30<sup>O</sup> of declivity. Erosion of N and P element examined by analyzing the soil swept away by erotion every 5 days. Analysis of N and P element included available N, total N, available P and total P. Then the data was analyzed with T-test at 95% level confidence.</p><p>Conclusion taken from this research were: 1) Planting method reduce availble P and total P element, respectively as much as 15% and 20%, but there was no significant difference between available N and total P, 2) There was significant difference between available P and total P, when the variety of plant and combination was employed as a treatment variation, 3) Pennisetum purpureum planted by using equidistant method reduce N and P element in the soil, respectively as much as 15% and 20%.</p>

scholarly journals Chemical Properties of Inceptisol and Rice Yields Applied with Mixed Source Fertilizer (MSF)

2018 ◽  
Vol 23 (1) ◽  
pp. 1-9
Author(s):  
Jauhari Syamsiyah ◽  
Sumarno Sumarno ◽  
Suryono Suryono ◽  
Winda Sari ◽  
Muhammad Anwar
Keyword(s):  
Plant Height ◽  
Block Design ◽  
Organic Fertilizer ◽  
Chemical Properties ◽  
Total N ◽  
Organic C ◽  
Exchangeable K ◽  
Significant Difference ◽  
Rice Yields ◽  
The Impact

One effort that can be done to improve soil fertility and crop yields is fertilization. Fertilization using a mixed source fertilizer (MSF) is an option to overcome the impact of inorganic fertilizer use and organic fertilizer drawbacks. This study aims to evaluate the effects of MSF application on the chemical properties of Inceptisol and rice yields. A field experiment was conducted using a completely randomized block design (RCBD) with two factors and three replications. The first factor was the three formulas of MSF (F1, F2, F3) and the second factor was MSF doses (0, 2.5, 5, 7.5, 10 Mg ha-1). The results show that there is no significant difference on the total soil N, available soil P, plant height and total number of tillers of rice plants applied with the three MSF formulas. The increased MSF doses applied significantly improve the soil chemical properties of Inceptisol and rice yields. The application of 10 Mg ha-1 MSF increases total- N (57.89%), available-P (29.13%), exchangeable-Ca and -Mg (117% and 250%, respectively), plant height (40%) and total number of tillers (43.2%) in comparison to those without MSF application. There are interaction effects between formulas and doses of MSF on the amount of exchangeable-K, organic-C content, and CEC of the soil and rice yields. The application of 10 Mg ha-1 MSF F3 results in better effects on the amount of exchangeable-K, organic-C content and CEC of the soil, and number of productive tillers and rice yields than the application of other MSF formulas. The MSF can be used as an alternatif fertilizer that can improve Inceptisol productivity.  

scholarly journals Prolonged postoperative ileus after elective colorectal cancer surgery

2018 ◽  
Vol 75 (8) ◽  
pp. 780-786
Author(s):  
Milica Nestorovic ◽  
Goran Stanojevic ◽  
Branko Brankovic ◽  
Vanja Pecic ◽  
Ljiljana Jeremic
Keyword(s):  
Prospective Study ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Postoperative Ileus ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Significant Difference ◽  
Prolonged Postoperative Ileus ◽  
The Impact

Background/Aim. Postoperative ileus is a frequent and frustrating occurence for both, patients and surgeons after abdominal surgery. Besides clinical importance of postoperative ileus, its economic aspect is also important. The aim of this prospective study was to analyze development of prolonged postoperative ileus after elective colorectal surgery for cancer and its impact on early postoperative outcome. Methods. This prospective study included all eligible patients, 18 years or older, scheduled for open colorectal resection for cancer from June, 2015 to February, 2016. Patients with metastatic disease, prior hemoirradiation or any resection other then curative were excluded. The study duration was up to 30 days postoperatively. Primary outcome measure was development of prolonged postoperative ileus according to strict definition. The impact of prolonged postoperative ileus on other outcome measures such as postoperative complications, surgical site infections, anastomotic leakage, reoperations, mortality and length of hospital stay were of great interest, too. Results. This prospective study included 103 patients, 64 (37.9%) men and 39 (62.1%) women, mean age 66 years. Prolonged postoperative ileus developed in 12 (11.3%) patients. One third of the patients had some type of surgical site infection, while 47.6% had complications. Ten (9.7%) patients required reoperation. Comparing the group of patients with prolonged postoperative ileus with those without, there were no statistically significant differences in rates of surgical site infection and anastomotic leakage. There was statistically significant difference in terms of complications (_2 = 34.966; p < 0.001), complications grade III (_2 = 23.43; p < 0.001) and reoperations (_2 = 15.724; p <0.001). Patients who developed prolonged postoperative ileus had statistically significant longer postoperative hospital stay (Z = 2.291, p = 0.022) and longer total length of hospital stay (Z = 2.377, p = 0.015). According to regression analyzes prolonged postoperative ileus represents a risk factor for reoperations [odds ratio (OR) = 12.286; p = 0.001]. Conclusion. Prolonged postoperative ileus, although not life-threatening complication effects recovery, increases length of hospital stay and contributes to poor surgical outcome.

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