The effects of tibial intraosseous versus intravenous amiodarone administration in a hypovolemic cardiac arrest procine model

2016 ◽  
Vol 11 (4) ◽  
pp. 253-260 ◽  
Author(s):  
Kathryn Hampton, BSN ◽  
Eric Wang, BSN ◽  
Jerome Ivan Argame, BSN ◽  
Tom Bateman, BSN ◽  
William Craig, DNP, CRNA ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Analysis Of Variance ◽  
Repeated Measures ◽  
High Performance ◽  
Plasma Concentrations ◽  
Spontaneous Circulation ◽  
Repeated Measures Analysis ◽  
Liquid Chromatography Tandem Mass ◽  
Intravenous Amiodarone ◽  
Over Time

Objective: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model.Design: Prospective, between subjects, randomized experimental design.Setting: TriService Research Facility.Subjects: Yorkshire-cross swine (n = 28).Intervention: Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation (CPR) was initiated. After an additional 2 minute, 300 mg of amiodarone were administered via the TIO or the IV route. Blood samples were collected over 5 minutes. The plasma concentrations were analyzed using high-performance liquid chromatography tandem mass spectrometry.Main Outcome Measurements: ROSC, time to ROSC, Cmax, Tmax, and mean concentrations over time.Results: A multivariate analysis of variance indicated that there were no significant differences in the TIO and IV groups in ROSC (p = 0.515), time to ROSC (p = 0.300), Cmax (p = 0.291), or Tmax (p = 0.475). The mean Cmax of the TIO group was 56,292 ± 11,504 ng/mL compared to 74,258 ± 11,504 ng/mL for the IV group. The Tmax for TIO and IV groups were 120 ± 25 and 94 ± 25, respectively. A repeated measures analysis of variance indicated that there were no significant differences between the groups relative to concentrations over time (p 0.05).Conclusion: The TIO provides rapid and reliable access to administer lifesaving medications during cardiac arrest.

Effects of humerus intraosseous versus intravenous amiodarone administration in a hypovolemic porcine model

2016 ◽  
Vol 11 (4) ◽  
pp. 261-269 ◽  
Author(s):  
Monica M. Holloway, BSN ◽  
Shannan L. Jurina, MSN ◽  
Joshua D. Orszag, BSN ◽  
George R. Bragdon, MS ◽  
Rustin D. Green, BSN, CCRN ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
High Performance ◽  
Spontaneous Circulation ◽  
Maximum Plasma ◽  
Life Saving ◽  
Maximum Plasma Drug Concentration ◽  
Liquid Chromatography Tandem Mass ◽  
Intravenous Amiodarone ◽  
Repeated Analysis ◽  
Over Time

Objective: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model.Design: Prospective, between subjects, randomized experimental design.Setting: TriService Research Facility.Subjects: Yorkshire-cross swine (n = 28).Intervention: Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After an additional 2 minutes, amiodarone 300 mg was administered via the HIO or the IV route. Blood samples were collected over 5 minutes. The samples were analyzed using high-performance liquid chromatography tandem mass spectrometry.Main Outcome Measurements: ROSC, Tmax, Cmax, time to ROSC, and mean concentrations over time.Results: There was no difference in ROSC between the HIO and IV groups; each had five achieve ROSC and two that did not (p = 1). There was no difference in Tmax (p = 0.501) or in Cmax between HIO and IV groups (p = 0.232). Means ± standard deviations in seconds were 94.3 ± 78.3 compared to 115.7 ± 87.3 in the IV versus HIO groups, respectively. The mean ± standard deviation in nanograms per milliliter for the HIO was 49,041 ± 21,107 and 74,258 ± 33,176 for the IV group. There were no significant differences between the HIO and IV groups relative to time to ROSC (p = 0.220). A repeated analysis of variance indicated that there were no significant differences between the groups relative to concentrations over time (p 0.05).Conclusion: The humerus intraosseous provides rapid and reliable access to administer life-saving medications during cardiac arrest.

The effects of sternal intraosseous and intravenous administration of amiodarone in a hypovolemic swine cardiac arrest model

2016 ◽  
Vol 11 (4) ◽  
pp. 271-277 ◽  
Author(s):  
Samuel Smith, BSN ◽  
Bradley Borgkvist, BSN ◽  
Teara Kist, BSN ◽  
Jason Annelin, BSN ◽  
Don Johnson, PhD ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
High Performance ◽  
Multivariate Analyses ◽  
Plasma Concentrations ◽  
Spontaneous Circulation ◽  
Blood Samples ◽  
Life Saving ◽  
Concentration Maximum ◽  
Liquid Chromatography Tandem Mass ◽  
Over Time

Objective: This study compared the effects of amiodarone via sternal intraosseous (SIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model.Design: Prospective, between subjects, randomized experimental design.Setting: TriService Research Facility.Subjects: Yorkshire-cross swine (n = 28).Intervention: Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After an additional 2 minutes, amiodarone 300 mg was administered via the tibial intraosseous TIO or the IV route. Blood samples were collected over 5 minutes. The plasma concentrations were analyzed using high-performance liquid chromatography tandem mass spectrometry.Main Outcome Measurements: ROSC, time to ROSC, Cmax, Tmax, and mean concentrations over time.Results: A multivariate analyses of variance indicated that there were no significant differences in the SIO and IV groups in ROSC (p = 0.191), time to ROSC (p 0.05), Tmax mean 88.1 ± 24.8 seconds versus 49.5 ± 21.8 seconds (p = 0.317), or Cmax mean 92,700 ± 161,112 ng/mL versus 64,159.8 ± 14,174.8 ng/mL (p = 0.260). A repeated analyses of variance indicated that there were no significant differences between the groups relative to concentrations over time (p 0.05).Conclusion: The SIO provides rapid and reliable access to administer life-saving medications during cardiac arrest.

Effects of tibial and humerus intraosseous administration of epinephrine in a cardiac arrest swine model

2016 ◽  
Vol 11 (4) ◽  
pp. 243-251 ◽  
Author(s):  
Denise Beaumont, MSN, CRNA ◽  
Asal Baragchizadeh, MS, PhD Candidate ◽  
Charles Johnson, MA ◽  
Don Johnson, PhD
Keyword(s):  
Cardiac Arrest ◽  
Maximum Concentration ◽  
High Performance ◽  
Spontaneous Circulation ◽  
Swine Model ◽  
Epinephrine Administration ◽  
Life Saving ◽  
Significant Difference ◽  
Liquid Chromatography Tandem Mass ◽  
Over Time

Objective: Compare maximum concentration (Cmax), time to maximum concentration (Tmax), mean serum concentration of epinephrine, return of spontaneous circulation (ROSC), time to ROSC, and odds of survival relative to epinephrine administration by humerus intraosseous (HIO), tibial intraosseous (TIO), and intravenous (IV) routes in a swine cardiac arrest model.Design: Prospective, between subjects, randomized experimental design.Setting: TriService Research Facility.Subjects: Yorkshire-cross swine (n = 28).Intervention: Swine were anesthetized and placed into cardiac arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After an additional 2 minutes, a dose of 1 mg of epinephrine was administered by HIO, TIO, or the IV routes. Blood samples were collected over 4 minutes and analyzed by high-performance liquid chromatography tandem mass spectrometry.Main Outcome Measurements: ROSC, time to ROSC, Cmax, Tmax, mean concentrations over time, and odds ratio.Results: There was no significant difference in rate of the ROSC among the TIO, HIO, and IV groups (p 0.05). There were significant differences in Cmax: the HIO group was significantly higher than the TIO group (p = 0.007), but no significant difference between the IV and HIO (p = 0.33) or the IV and TIO group (p = 0.060). The Tmax was significantly shorter for both the IV and HIO versus the TIO group (p 0.05), but no difference between IV and HIO (p = 0.328). The odds of survival were higher in the HIO group compared to all other groups.Conclusion: The TIO and HIO provide rapid and reliable access to administer life-saving medications during cardiac arrest.

Stability of Intravenous Famotidine Stored in Polyvinyl Chloride Syringes

DICP ◽  
1989 ◽  
Vol 23 (7-8) ◽  
pp. 588-590 ◽  
Author(s):  
Linda S. Bullock ◽  
Joseph F. Fitzgerald ◽  
Helen I. Mazur
Keyword(s):  
Polyvinyl Chloride ◽  
Repeated Measures ◽  
High Performance ◽  
Hplc Analysis ◽  
Time Effect ◽  
Sterile Water ◽  
Reverse Phase ◽  
Repeated Measures Analysis ◽  
The Stability ◽  
Over Time

The stability of intravenous famotidine in dextrose 5% injection (D5W), NaCl 0.9% injection (NS), and sterile water for injection stored in polyvinyl chloride (PVC) syringes at 4°C for 14 days was studied. The concentration of famotidine samples was determined at time 0, 7 days, and 14 days by reverse-phase high-performance liquid chromatography. Samples were inspected for visual changes and tested for changes in pH. Results of the HPLC analysis indicated that the famotidine samples remained within 94-100 percent and 99-103 percent of the time 0 concentrations at 7 and 14 days, respectively. Repeated measures analysis of variance demonstrated a significant time effect on famotidine concentration as concentrations changed over time (p<0.01). This change was small in magnitude, however, and concentrations decreased at 7 days and increased at 14 days. Famotidine is stable at a concentration of 2 mg/mL in D5W, NS, and sterile water for injection stored in PVC syringes at 4°C for 14 days.

The effect of vascular access type on intra-access flow volume during hemodialysis

2019 ◽  
Vol 20 (6) ◽  
pp. 746-751
Author(s):  
Hoon Suk Park ◽  
Woo Jeong Kim ◽  
Joonsung Choi ◽  
Hyung Wook Kim ◽  
Jun Hyun Baik ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Analysis Of Variance ◽  
Vascular Access ◽  
Repeated Measures ◽  
Arteriovenous Graft ◽  
Flow Volume ◽  
Upper Arm ◽  
Repeated Measures Analysis ◽  
The Impact ◽  
Over Time

Introduction: Previous studies have revealed that vascular access resistance is constant during hemodialysis, but differs according to vascular access type. It is possible that intra-access flow volume (Qac) variation during hemodialysis may also differ according to vascular access type. We conducted this study to investigate whether there are differences in Qac according to vascular access type during hemodialysis. Methods: A total of 58 lower-arm arteriovenous fistula, 14 lower-arm arteriovenous graft, 27 upper-arm arteriovenous fistula, and 45 upper-arm arteriovenous graft cases were studied. Three consecutive Qac values (at 30, 120, and 240 min after the start of hemodialysis) were measured in each patient by the ultrasound dilution technique. Variations in Qac over time were analyzed using repeated measures analysis of variance and multivariate regression analyses, to assess the impact of different factors on Qac variation. Results: The repeated measures analysis of variance revealed that a significant interaction exists between time and vascular access type (p < 0.001). This suggests that vascular access type affects Qac change (%) variation over time during hemodialysis. In a multivariate analysis, mean arterial pressure change during hemodialysis (p = 0.009), access type (p < 0.001), and access location (p < 0.001) were independent variables causing Qac change variation. Conclusion: This study showed that there is a significant difference in Qac variation according to vascular access type during hemodialysis and that arteriovenous graft (vs arteriovenous fistula) and the lower-arm location (vs upper arm) were associated with a decrease in Qac during hemodialysis. This suggests that consideration of vascular access type is required to minimize Qac variation during hemodialysis.

The comparison of humeral intraosseous and intravenous administration of vasopressin on return of spontaneous circulation and pharmacokinetics in a hypovolemic cardiac arrest swine model

2016 ◽  
Vol 11 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Mark H. Wimmer, BSN ◽  
Kenneth Heffner, BSN ◽  
Michael Smithers, BSN ◽  
Richard Culley, BSN ◽  
Jennifer Coyner, PhD, CRNA ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Analysis Of Variance ◽  
Repeated Measures ◽  
Maximum Concentration ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Control Group ◽  
Swine Model ◽  
Return Of Spontaneous Circulation ◽  
Significant Difference

Introduction: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model.Methods: Twenty-two Yorkshire swine were divided into three groups: HIO (n = 7), IV (n = 8), and a control group (n = 7). The IV and HIO group received vasopressin and cardiopulmonary resuscitation (CPR), while the control group received only CPR. All subjects were exsanguinated 31 percent of their blood volume, placed in cardiac arrest, and resuscitated per ACLS. Subjects that achieved ROSC were then monitored for 20 minutes. Blood samples (10 mL) collected at 0.5, 1, 1.5, 2, 2.5, 3, and 4 minutes after vasopressin injection and analyzed for maximum concentration (Cmax) and time to maximum concentration (Tmax). Data were analyzed using a multivariate analysis of variance (MANOVA) and a Fisher's Exact Test.Results: ROSC was achieved in every subject that received vasopressin via the HIO route. Data analysis using a MANOVA pairwise comparison revealed no difference between mean Cmax (p = 0.601) and Tmax (p = 0.771) of vasopressin administered IV versus HIO routes. Analysis of the mean serum concentrations at time intervals using a repeated measures analysis of variance found no difference (p 0.05). A Fisher's Exact Test revealed no difference in rate of ROSC between HIO and IV groups (p 0.05). Odds ratio determined that there was a 33 times higher chance of survival among HIO subjects versus control (CPR and Defibrillation; p = 0.03) and no difference in the survivability of the HIO or IV groups (p = 0.52). Conclusion: The data from this study strongly suggest that there is no significant difference in ROSC, time to ROSC, hemodynamics, or pharmacokinetics between HIO vasopressin and IV vasopressin. This research reinforces current AHA guidelines recommending the use of HIO route early over delaying care awaiting IV access.

scholarly journals Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

2012 ◽  
Vol 2012 ◽  
pp. 1-12
Author(s):  
Rachel E. Maddux ◽  
Lars-Gunnar Lundh
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Psychological Symptoms ◽  
Self Report ◽  
Treatment Results ◽  
Repeated Measures Analysis ◽  
Depressive Personality ◽  
Symptom Changes ◽  
Psychotherapy Clients ◽  
Over Time

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

Effects of a Combination of Stances and Points of Aim on Putting Accuracy

1988 ◽  
Vol 66 (1) ◽  
pp. 139-143 ◽  
Author(s):  
Erich Gott ◽  
Carl Mc Gown
Keyword(s):  
Analysis Of Variance ◽  
Repeated Measures ◽  
Traditional Method ◽  
Constant Error ◽  
Popular Opinion ◽  
Variable Error ◽  
Repeated Measures Analysis ◽  
Better Than

The purpose of this study was to determine the effects of two putting stances (conventional versus side-saddle) and two points of aim (ball versus hole) on putting accuracy. Subjects (12 men, 4 women) were taught to putt using four methods: (a) conventional stance, eyes on the ball; (b) conventional stance, eyes on the hole; (c) side-saddle stance, eyes on the ball; and (d) side-saddle stance, eyes on the hole. Each subject practiced each method for 2 wk., after which they were tested for purring accuracy by counting putts made, determining constant error, and by calculating variable error. Accuracy was assessed at 5 and 15 ft. A 2 by 2 repeated-measures analysis of variance showed that there was no single combination of stance and point of aim that was significantly better than another at either distance. This suggests that, contrary to popular opinion, the traditional method of putting is not the best method for putting; other methods are equally as good and could be used if individually desired.

scholarly journals Estimating Bayes factors from minimal summary statistics in repeated measures analysis of variance designs

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Thomas Faulkenberry
Keyword(s):  
Analysis Of Variance ◽  
Repeated Measures ◽  
Bayes Factor ◽  
Linear Models ◽  
Repeated Measurements ◽  
Bayes Factors ◽  
Complex Method ◽  
Summary Statistics ◽  
Minimal Set ◽  
Repeated Measures Analysis

In this paper, I develop a formula for estimating Bayes factors directly from minimal summary statistics produced in repeated measures analysis of variance designs. The formula, which requires knowing only the F-statistic, the number of subjects, and the number of repeated measurements per subject, is based on the BIC approximation of the Bayes factor, a common default method for Bayesian computation with linear models. In addition to providing computational examples, I report a simulation study in which I demonstrate that the formula compares favorably to a recently developed, more complex method that accounts for correlation between repeated measurements. The minimal BIC method provides a simple way for researchers to estimate Bayes factors from a minimal set of summary statistics, giving users a powerful index for estimating the evidential value of not only their own data, but also the data reported in published studies.

Sign in / Sign up

Export Citation Format

Share Document