AIMS: To describe changes in different factors at resuscitation and survival in a 17-year survey of patients suffering from out-of-hospital cardiac arrest. METHOD: The investigation was carried out in the community of Göteborg with 450 000 inhabitants during 1981-1997 on all patients suffering out-of-hospital cardiac arrest in whom resuscitation was ...

Recently, we have developed several new innovations in the morphometry of vascular trees. These innovations have been used to study the anatomy of the coronary circulation in the pig and have yielded a complete set of morphometric data on the entire coronary vasculature. Since, the innovations are applicable to any ...

Understanding early cardiac morphogenesis, especially the process of cardiac looping, is of fundamental interest for diverse biomedical disciplines. During the past few years, remarkable progress has been made in identifying molecular signaling cascades involved in the control of cardiac looping. Given the rapid accumulation of new data on genetic, molecular, ...

Worldwide about 1 in 1000 adults every year has a sudden cardiac arrest in out-of-hospital. That means 350,000-400,000 persons in the USA alone, 60,000 persons in Italy. Over 70% of times sudden cardiac arrest occurs at home, the remaining 30% in public settings. The chain of survival concept emphasizes four ...

The purpose of this study was to examine the emergency department (ED) management of hypothermic cardiac arrest and its outcome. The medical records of all patients with hypothermic cardiac arrest treated in the ED from January 1, 1988 to January 31, 1999 were retrospectively reviewed. Data collected included initial body ...

Literature review shows many anecdotal case reports of cardiac asystole in ictal recordings of partial seizures. We have reviewed our data from the last five years, of patients who are being assessed for epilepsy surgery and found 2 out of more than 1,500 complex partial seizures, recorded in 589 consecutive ...

The anaesthetic management of an elderly patient with severely impaired left ventricular function undergoing thoracotomy and lobectomy is described. Total intravenous anaesthesia (TIVA) with remifentanil and target-controlled infusion of propofol titrated according to the bispectral index (BIS) was used, with thoracic epidural anaesthesia commenced at the end of surgery providing ...

Resuscitation from cardiac arrest caused by volatile substance abuse is rarely successful. Large doses of catecholamines given during resuscitation, in the presence of butane, may cause recurrent ventricular fibrillation. We report a case of prolonged resuscitation in a young man who had inhaled butane. Cardiac output was restored 10 min ...

AIMS: To evaluate the impact selected risk factors for cardiac death may have on the success rate in a large cohort of subscribers to 'SHAHAL' who were resuscitated from out-of-hospital cardiac arrest. METHODS AND RESULTS: In this medical facility currently serving 50 000 subscribers, data were prospectively gathered from between ...

We report an episode of acute abdominal compartment syndrome, with pulseless electrical activity, in a patient undergoing colonoscopic examination of a recently constructed mucus fistula. Associated clinical features of this acute abdominal compartment syndrome (tension pneumoperitoneum) were abdominal distention, which was very impressive, cardiopulmonary arrest, severe cyanosis, and progressive bradycardia.In ...

Interest has recently been expressed in developing an Australian adult cardiac surgical registry. Complete national registries of adult cardiac surgery have already been established in many European countries, the USA, Canada and elsewhere. Participating centres contributing to a national registry benefit by being able to benchmark themselves against norms for ...

OBJECTIVE: To arrest the advancement of periodontitis. PATIENT: A 17-year-old boy diagnosed with Pierre-Robin sequence at birth exhibited localized juvenile periodontitis. Severe bone loss and mobile teeth were localized in the incisors and molars, which were irregularly positioned, possibly associated with a residual scar from palatoplasty for a soft palate ...

OBJECTIVES: To determine the outcome of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest and to identify risk factors associated with survival to the time of hospital discharge. DESIGN: A 2-year prospective cohort study. SETTING: Foothills Medical Centre, a 700-bed tertiary, academic and regional referral centre for Calgary and southern Alberta. ...

The provision of medical, paramedical and first aid services at major public events is an important concern for pre-hospital emergency medical care providers. Patient outcomes of a cardiac arrest response strategy employed at the Melbourne Cricket Ground (MCG) and the Shrine of Remembrance by St John Ambulance Australia volunteers are ...

The revised guidelines for advanced cardiac life support (ACLS) from the American Heart Association are anticipated in the fall of 2000. Although dramatic changes in the approach to adult basic and ACLS are not anticipated, several controversies and new drugs on the horizon may radically change our approach to emergent ...

In a porcine model of cardiopulmonary resuscitation (CPR), we investigated changes in the plasma levels of 8-iso-PGF(2alpha), a marker for oxidative injury, and 15-keto-dihydro-PGF(2alpha), an inflammatory response indicator during the post-resuscitation period after cardiac arrest. Twelve piglets were subjected to either 2 or 5 min (VF2 and VF5 group) of ...

Myocardial edema has been associated with impaired ventricular compliance and diastolic filling. To determine the sensitivity of high-frequency (40 MHz) ultrasound to myocardial edema, we employed a model in which myocardial edema was induced by immersion of tissue in isotonic saline. The effect of freezing tissue on edema formation was ...

OBJECTIVE: To explore the current use of secondary preventive treatment in survivors of out of hospital cardiac arrest without myocardial infarction (primary ventricular tachycardia/ventricular fibrillation (VT/VF)) in West Yorkshire, and assess the implications of recent studies on the benefits of implantable cardioverter-defibrillators (AICD) in this context. DESIGN: Retrospective analysis of ...

The chance of survival from ventricular fibrillation (VF) is up to ten times higher than those with other cardiac arrest rhythms. To calculate the effect of out-of-hospital resuscitation organisations on survival, it is necessary to know the percentage of cardiac arrest patients initially in VF and the relationship between delay ...

STUDY OBJECTIVE: The Utstein guidelines recommend that emergency medical services (EMS)-witnessed cardiac arrests be considered separately from other out-of-hospital cardiac arrest cases. The objective of this study was to assess EMS-witnessed cardiac arrest and to determine predictors of survival in this group. METHODS: This prospective cohort included all adults with ...

It is established that basic life support (BLS) is performed inadequately by both nursing and medical staff and that the ability to retain these skills, once trained, is low. In addition, the initial success rate from cardiopulmonary arrest is poor. By implementing the advanced life support (ALS) course and providing ...

BACKGROUND AND PURPOSE: Recent animal studies showed that mild resuscitative hypothermia improves neurological outcome when applied after cardiac arrest. In a 3-year randomized, prospective, multicenter clinical trial, we hypothesized that mild resuscitative cerebral hypothermia (32 degrees C to 34 degrees C core temperature) would improve neurological outcome after cardiac arrest. ...

We report a new method of interrogating the surface ECG signal using techniques developed in the field of wavelet transform analysis. Previously unreported structure within the ECG during ventricular fibrillation (VF) is found using a high-resolution decomposition of the signal employing the continuous wavelet transform. We believe that wavelet transform ...

Improvement of organ procurement from non-heart-beating donors (NHBDs) could increase the donor organ pool for liver transplantation. Whether anti-coagulative and anti-vasospastic substances can improve hepatic microvascular preservation from NHBDs is unknown. In donor rats which were pretreated with either heparin (n = 6) or heparin combined with phentolamine (n = ...

BACKGROUND AND PURPOSE: Very few reports are available on changes in the human hippocampus after cardiac arrest. The objective of this study was to investigate if specific hippocampal volume losses can be demonstrated in the human brain following reperfusion after cardiac arrest. METHODS: We assessed the volumes of the hippocampal ...

A 15-year-old female survived a total of 65 minutes cardiac arrest following ingestion of verapamil and selective serotonin re-uptake inhibitors. We consider that the lack of neurological damage, despite evidence of significant renal and myocardial injury, may be related to the possible neuroprotective effect of a large dose of verapamil.

A 70-year-old man, who had a laryngeal tumor discovered by otolaryngological examination during admission for suspicion of facial nerve paralysis was found dead in his bed on the seventh hospital day. Clinical doctors aspirated a large amount of mucous sputum from his larynx during their attempt at resuscitation. Although the ...

Nitric oxide (NO) is known as a vasodilatory molecule synthesized by vascular endothelium. The NO-dependent vasodilatory response of coronary artery is impaired after ischemia and reperfusion. In the present study, the release of NO from coronary vasculature was evaluated before and during cardioplegic arrest and after reperfusion. Nine patients undergoing ...

Despite its proven clinical application for protection-preservation of the brain and heart during cardiac surgery, hypothermia research has fallen in and out of favor many times since its inception. Since the 1980s, there has been renewed research and clinical interest in therapeutic hypothermia for resuscitation of the brain after cardiac ...

(1) Phenylpropanolamine, or norephedrine, is a sympathomimetic vasoconstrictor very similar to amphetamine, and carries a risk of potentially severe cardiac, neurological and psychiatric events. (2) One should be aware of the presence of phenylpropanolamine in many non prescription drugs. (3) Pharmacists should pay special attention to the presence of phenylpropanolamine ...

OBJECTIVE: To describe our experience with the use of percutaneous cardiopulmonary bypass as a therapy for cardiac arrest in an adult patient intoxicated with verapamil. DESIGN: Case report. SETTING: Emergency department of a university hospital. PATIENT: A patient with cardiac arrest after severe verapamil intoxication. INTERVENTIONS: Percutaneous cardiopulmonary bypass and ...

BACKGROUND: The survival rate to discharge after a cardiac arrest in a patient in the pediatric intensive care unit is reported to be as low as 7%. The survival rates and markers for survival strictly regarding infants with cardiac arrest after congenital heart surgery are unknown. METHODS AND RESULTS: Infants ...

Prompt cardiopulmonary resuscitation (CPR) and early defibrillation significantly improve the likelihood of successful resuscitation from cardiac arrest and are the key components in the American Heart Association's "chain of survival." Although representing current clinical practice in the United States, there is limited evidence supporting the benefit of acute administration of ...

Although buffer agents alone have failed to improve the success of resuscitation, we now examine the widely held concept that it is the combined effect of alkaline buffer and adrenergic agents that improves outcomes of cardiopulmonary resuscitation. In the present report, the effects of both CO(2)-consuming and CO(2)-generating buffer agents ...

Cardiac surgery involving ischemic arrest and extracorporeal circulation is often associated with alterations in vascular reactivity and permeability due to changes in the expression and activity of isoforms of nitric oxide synthase and cyclooxygenase. These inflammatory changes may manifest as systemic hypotension, coronary spasm or contraction, myocardial failure, and dysfunction ...

Disseminated intravascular coagulation frequently occurs after global ischemia and reperfusion due to cardiac arrest. The present study was performed to demonstrate the role of tissue factor for coagulation pathway activation, as well as to investigate the precise time course of tissue factor pathway inhibitor (TFPI) during and after cardiopulmonary resuscitation ...

Morphometric methods and transmission electron microscopy were used to quantify modifications occurring in the mitochondria of dog myocardium during the first four hours of autolysis. Myocardial fragments were obtained from the outer free wall of the left ventricle, during anesthesia (control-zero) and at 15, 45, 120, and 240 min after ...

Myocardial tagging has shown to be a useful magnetic resonance modality for the assessment and quantification of local myocardial function. Many myocardial tagging techniques suffer from a rapid fading of the tags, restricting their application mainly to systolic phases of the cardiac cycle. However, left ventricular diastolic dysfunction has been ...

OBJECTIVE: To describe characteristics and outcomes of patients hospitalized after out-of-hospital cardiac arrest in relation to sex. PATIENTS: All patients in the community of Göteborg who between 1980 and 1996 suffered out-of-hospital cardiac arrest and were hospitalized alive. METHODS: We calculated age-adjusted P values. RESULTS: In all 1038 patients were ...

To determine the prognostic significance of the difference between mixed venous and jugular bulb oxygen saturation in survivors and non-survivors of a cardiac arrest, we studied 30 comatose patients (21 non-survivors and 9 survivors) resuscitated from a cardiac arrest. We measured mixed venous oxygen saturation (SmvO2) and jugular bulb oxygen ...

OBJECTIVES: Cardiac surgery is the first of any therapeutic discipline to attempt to establish a major international registry on a patient-by-patient basis. Being the first necessarily imposes a challenge since no rules or guidelines exist. Possibilities and boundaries must be identified. METHODS: The EACTS database committee established ECSUR (The European ...

AIM: To describe cardiac arrest data from five emergency medical services (EMS) systems in Europe with regard to survival from an out-of-hospital cardiac arrest. METHODS: Based on recommendations from various countries in Europe EMS systems were approached with regard to survival from out-of-hospital cardiac arrest. Five EMS systems were asked ...

STUDY OBJECTIVE: Early countershock of ventricular fibrillation (VF) has been shown to improve immediate and long-term outcome of out-of-hospital cardiac arrest. However, studies indicate that countershock of prolonged VF most commonly results in asystole or a nonperfusing bradyarrhythmia (pulseless electrical activity [PEA]), which rarely respond to current therapy. The cause ...

Cardiopulmonary resuscitation (CPR) provides artificial circulation and ventilation during cardiopulmonary arrest. CPR is further categorised as basic life support (BLS), advanced cardiac life support (ACLS) and postresuscitation support. BLS consists of provision of a patent upper airway, ventilation and circulation of blood by closed chest cardiac compressions. ACLS includes use ...

OBJECTIVE: To determine if the appointment of a Resuscitation Training Officer improves survival to discharge from in-hospital ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. DESIGN: A 22-month prospective study. SETTING: A 1100-bed teaching hospital. SUBJECTS: All inpatients suffering ventricular fibrillation or ventricular tachycardia cardiorespiratory arrests. INTERVENTIONS: Appointment of a Resuscitation Training ...

The objective of this review is to establish a framework about the educational activities of the Cardiopulmonary Resuscitation (CPR) National Committee of the Saudi Heart Association (SHA) and determine if it has had any effect on the survival rate in daily hospital work. Further, the review puts forward recommendations regarding ...

This review focuses on the importance of bradykinin in myocardial preservation during ischemic arrest. Bradykinin is released from the heart spontaneously in response to ischemic stress, which may be viewed as a survival signal of the heart against ischemia. Bradykinin appears to function as a signaling molecule by controlling the ...

PRIMARY OBJECTIVE: To determine if the introduction of intravenous aminophylline, a nonspecific adenosine receptor antagonist, into the resuscitation algorithm of asystole will increase return of spontaneous circulation when used in undifferentiated prehospital cardiac arrest. METHODS: An urban, prehospital, prospective, randomized, double-blind, placebo-controlled trial of nonpregnant normothermic adults suffering nontraumatic out-of-hospital ...

A prospective, randomised out-of-hospital study in a two-tiered system with active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) versus standard (STD) CPR in patients following non-traumatic cardiac arrest was planned to test the hypothesis that ACD-CPR by the first tier may increase the occurrence of ventricular fibrillation as compared with STD-CPR. Furthermore, ...

A 15-year-old boy with Duchenne's muscular dystrophy experienced prolonged cardiac arrest whilst in the prone position for spinal surgery. He was successfully resuscitated without apparent neurological sequelae by internal cardiac massage via a thoracotomy and external and internal direct current cardioversion. Recommendations are suggested for the pre- and peroperative management ...