Medicinska Etika a Bioetika: Casopis Ustavu Medicinskej Etiky a Bioetiky = Medical Ethics & Bioethics: Journal of the Institute of Medical Ethics & Bioethics
Decisions on whether to resuscitate severely premature infants are especially difficult in "borderline viability" cases--those where the probability of survival is slim, and where, if survival is possible, multiple co-morbidities and severe disabilities are likely. The 2000 International Guidelines on Cardiopulmonary Resuscitation are comprehensive, yet leave open some of the more difficult ethical questions that must be addressed by decision-makers.
PURPOSE: To explore the effect of emotion priming and physician communication behaviors on optimism bias. MATERIALS AND METHODS: We conducted a 5 ◊ 2 between-subject randomized factorial experiment using a Web-based interactive video designed to simulate a family meeting for a critically ill spouse/parent. Eligibility included age at least 35 years and self-identifying as the surrogate for a spouse/parent. The primary outcome was the surrogate's election of code status.
Nihon Rinsho. Japanese Journal of Clinical Medicine
This manuscript expresses viewpoints on future pre-hospital care, mainly focusing on basic life support (BLS) by ambulance crew at emergency scenes, following recommendations of G2010. Ambulance workers need to have an ability to decide instantly "what you can do now to others" in every emergency scenes. Also it is necessary to always treat patients with the spirit of "generosity".
American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
BACKGROUND: Rates of bystander cardiopulmonary resuscitation remain low nationwide. Possibly, low rates can be explained by examining the reactions of laypersons who attempt to resuscitate a stranger. OBJECTIVE: To examine the thoughts, feelings, and motivations of laypersons who have attempted to resuscitate a stranger. METHOD: Survey methods were used to do a qualitative study of 12 laypersons who had provided bystander resuscitation.
We report a case during which it was simultaneously recorded usual Bispectral Index (BIS) values and elevated suppression ratio (SR) during resuscitation maneuvers. A 52-year-old woman, scheduled for a suspension laryngoscopy, required cardio-pulmonary resuscitation due to an anaphylactic shock secondary to the administration of succinylcholine. Post-crisis analysis of the BIS trace showed both BIS numbers consistent with an adequate level hypnosis and an increase in SR. Simultaneous hypnotic BIS values and an elevated SR is striking as SR quantifies electroenceph- alographic suppression.
AIM OF THE STUDY: Sudden cardiac arrest (CA) is one of the leading causes of death worldwide. Previously we demonstrated that administration of sodium sulfide (Na(2)S), a hydrogen sulfide (H(2)S) donor, markedly improved the neurological outcome and survival rate at 24 h after CA and cardiopulmonary resuscitation (CPR) in mice. In this study, we sought to elucidate the mechanism responsible for the neuroprotective effects of Na(2)S and its impact on the long-term survival after CA/CPR in mice.
OBJECTIVE: To determine if earlier administration of epinephrine (adrenaline) in patients with non-shockable cardiac arrest rhythms is associated with increased return of spontaneous circulation, survival, and neurologically intact survival. DESIGN: Post hoc analysis of prospectively collected data in a large multicenter registry of in-hospital cardiac arrests (Get With The Guidelines-Resuscitation). SETTING: We utilized the Get With The Guidelines-Resuscitation database (formerly National Registry of Cardiopulmonary Resuscitation, NRCPR).
Prolonged external cardiac massage is often regarded as a contraindication for thrombolytic therapy because of the risk of fatal hemorrhage. The influence of cardiopulmonary resuscitation on complications of thrombolytic bleeding was assessed analyzing data of all patients with myocardial infarction admitted to our clinic during the 10-year period between 1978 and 1987. From the total of 2,147 patients with acute myocardial infarction, 590 received thrombolytic therapy (intracoronary in 229, intravenous in 400).
Compared to standard closed chest CPR, open chest cardiac massage improves vital organ perfusion and survival in animal models of medical cardiac arrest. Yet its use is essentially limited to the treatment of traumatic arrest. Three cases of medical cardiac arrest are presented in which open chest compression was used after failure of external chest compression. These cases illustrate the range of potential outcomes and how this therapy can be optimally applied.
BACKGROUND: Conventional cardiopulmonary resuscitation (CPR) for cardiac arrest after open-heart surgery in children is often unsuccessful despite the ability to perform open-chest massage. The purpose of this study was to review our results with mechanical support as rescue therapy in children with sudden circulatory arrest after cardiac surgery. METHODS AND RESULTS: From 1981 through 1991, we have used mechanical support with an extracorporeal membrane oxygenator (ECMO) circuit for cardiac support in 33 children.