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Prabal Khanal, Akshay Vankipuram, Aaron Ashby, Mithra Vankipuram, Ashish Gupta, Denise Drumm-Gurnee, Karen Josey, Linda Tinker, Marshall Smith
BACKGROUND: Advanced Cardiac Life Support (ACLS) is a series of team-based, sequential and time constrained interventions, requiring effective communication and coordination of activities that are performed by the care provider team on a patient undergoing cardiac arrest or respiratory failure. The state-of-the-art ACLS training is conducted in a face-to-face environment under expert supervision and suffers from several drawbacks including conflicting care provider schedules and high cost of training equipment...
October 2014: Journal of Biomedical Informatics
Marc Eckstein, Lorien Hatch, Jennifer Malleck, Christian McClung, Sean O Henderson
OBJECTIVE: The objective of this study was to evaluate initial end-tidal CO2 (EtCO2) as a predictor of survival in out-of-hospital cardiac arrest. METHODS: This was a retrospective study of all adult, non-traumatic, out-of-hospital, cardiac arrests during 2006 and 2007 in Los Angeles, California. The primary outcome variable was attaining return of spontaneous circulation (ROSC) in the field. All demographic information was reviewed and logistic regression analysis was performed to determine which variables of the cardiac arrest were significantly associated with ROSC...
June 2011: Prehospital and Disaster Medicine
Angelo Salvucci
No abstract text is available yet for this article.
December 2010: JEMS: a Journal of Emergency Medical Services
Jiří Janáček, Erika Cvetko, Lucie Kubínová, Ludvik Travnik, Ida Eržen
A well developed capillary bed is essential for proper function of skeletal muscles. We present for the first time a triple immunofluorescent method suitable for staining capillaries and muscle fibre outlines in thick sections of human skeletal muscle, applying antibodies against collagen IV (in red) and F8 (in green) as well as Ulex europaeus lectin, visualized in green fluorescence. Further, we present possibilities for quantitative evaluation of the capillary network which implies the length of capillaries per unit volume of muscle tissue (Lcap/Vmuscle) and the length of capillaries supplying individual muscle fibres per unit fibre length (Lcap/Lfib), per surface area (Lcap/Sfib) and per volume (Lcap/Vfib) as well as the course of capillaries in the muscle...
March 2011: Microvascular Research
Jarrod Mosier, Ajit Itty, Arthur Sanders, Jane Mohler, Christopher Wendel, Jacob Poulsen, Jeff Shellenberger, Lani Clark, Bentley Bobrow
BACKGROUND: Recent studies have shown that a new emergency medical services (EMS) protocol for treating patients who suffer out-of-hospital cardiac arrest (OHCA), cardiocerebral resuscitation (CCR), significantly improves survival compared to standard advanced life support (ALS). However, due to their different physiology, it is unclear if all elders, or any subsets of elders who are OHCA victims, would benefit from the CCR protocol. OBJECTIVES: The objectives of this analysis were to compare survival by age group for patients receiving CCR and ALS, to evaluate their neurologic outcome, and to determine what other factors affect survival in the subset of patients who do receive CCR...
March 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Lars Pape, Karen Olsson, Claus Petersen, Reinhard von Wasilewski, Michael Melter
Biliary atresia (BA) is the leading indication for liver transplantation (LTx) during childhood. Predictive markers for progression are lacking. We investigated the correlation between quantified fibrosis of the liver at the time of Kasai hepatic portoenterostomy (KPE) and the clinical course. Liver tissue was obtained at the time of KPE in 53 children and stained with Picrosirius red. The mean volume of fibrosis per number of periportal fields (Vfib) and the Ishak score were calculated. Vfib was 3.9%. Transplant-free survival was significantly higher in those patients with Vfib < 2...
August 2009: Liver Transplantation
Jirí Janácek, Vita Cebasek, Lucie Kubínová, Samo Ribaric, Ida Erzen
The aim of this study was to determine whether capillarity in the denervated and reinnervated rat extensor digitorum longus muscle (EDL) is scaled by muscle fiber oxidative potential. We visualized capillaries adjacent to a metabolically defined fiber type and estimated capillarity of fibers with very high oxidative potential (O) vs fibers with very low oxidative potential (G). Capillaries and muscle fiber types were shown by a combined triple immunofluorescent technique and the histochemical method for NADH-tetrazolium reductase...
May 2009: Journal of Histochemistry and Cytochemistry: Official Journal of the Histochemistry Society
Vita Cebasek, Lucie Kubínová, Jirí Janácek, Samo Ribaric, Ida Erzen
We postulated that, in rat extensor digitorum longus muscle (EDL), the length of capillaries per fibre surface area (Lcap/Sfib) and per fibre volume (Lcap/Vfib) could reflect fibre-type transformations accompanied by changes in oxidative metabolic profile and selective fibre-type atrophy. We excised rat EDL muscle 2 weeks after the sciatic nerve was cut (acute denervation; DEDL) and 4 weeks after the nerve was crushed (early reinnervation; REDL) and characterised muscle fibre-type transformation by the expression of myosin heavy-chain isoforms and by succinate dehydrogenase (SDH) and nicotinoamide adenine dinucleotide-tetrazolium reductase (NADH-TR) reactions...
November 2007: Cell and Tissue Research
Antoine Beuchat, Steven Taub, Jean-Damien Saby, Vincent Dierick, Gianmarco Codeluppi, Antonio F Corno, Ludwig K von Segesser
OBJECTIVE: Head-up displays allow the surgeons to simultaneously view the patient and the patient's vital parameters (ECG, blood pressure, etc.) using vision-through over a wireless net, potentially enhancing the speed, accuracy and safety of surgical decisions. The aim was to assess surgical reaction time to AFIB, bigeminy, trigeminy, VTACH, and VFIB and concentration during a surgical intervention comparing standard and cyber tools monitoring. METHODS: Using a patient simulator for beating heart surgery able to emulate heart signals and motion (arrhythmias) a group of surgeons performed coronary bypass procedures...
February 2005: European Journal of Cardio-thoracic Surgery
Mikhail Vaynblat, Murali K. Pagala, Wellington J. Davis, Dinesh Bhaskaran, Rafael Fazylov, Chaya Gelbstein, Alvin Greengart, Joseph N. Cunningham
A model of chronic heart failure has been induced in dogs by repeated intracoronary infusion of doxorubicin, which is an antineoplastic medication that has dose-limiting cardiotoxic side effects. Although many of the dogs receiving doxorubicin develop typical signs of dilated cardiomypathy over 4-6 weeks, some of them suddenly die before completing the four weekly infusions of the drug. The present study was undertaken to determine whether such sudden death may be caused by the development of fatal arrhythmias during doxorubicin treatment...
September 2003: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Jose A Adams, Jorge Bassuk, Dongmei Wu, Paul Kurlansky
BACKGROUND: We showed previously that whole body periodic acceleration along the spinal axis (pGz) is a novel method of cardiopulmonary resuscitation (CPR). The ultimate assessment of the value of any CPR technique is the neurological outcome after using such a technique. In this study, we determined the neurological outcome in pigs after prolonged pGz-CPR, with administration of vasopressin immediately prior to defibrillation. Neurological outcome after pGz-CPR was compared to a control group where no intervention occurred for the same time period (C-NoInterv)...
February 2003: Resuscitation
M M Kurrek, J H Devitt, M Cohen
PURPOSE: While advanced cardiac life support (ACLS) training is widely available, it is not mandatory for all anaesthetists. We hypothesised that adherence to ACLS guidelines during resuscitation of ventricular fibrillation (VFib) as assessed in a simulator environment would be poor by anaesthetists not trained in ACLS compared with those who had received training. METHODS: With approval by the ethics review board, 89 subjects participated in the study. The simulation system consisted of a computer controlled mannequin with lifelike qualities set in a mock operating room...
February 1998: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
A J Schneider, W B Murray, S C Mentzer, F Miranda, S Vaduva
OBJECTIVE: The medical practitioner is faced with an increasing list of protocols and algorithms related to patient care. These recommendations are often difficult to recall, particularly in stressful emergency situations. Using advanced cardiac life support (ACLS) protocols, we built a computer-based system to exhibit precompiled response plans for medical emergencies. To validate the usefulness of this prompting device, we tested application of two of the nine ACLS algorithms, pulseless ventricular fibrillation/ventricular tachycardia (Vfib/Vtach) and bradycardia, in a simulated operating room (OR) environment...
November 1995: Journal of Clinical Monitoring
G Krumpl, H Todt, S Schunder-Tatzber, G Raberger
The hemodynamic and electrophysiologic variables and the inducibility of arrhythmias were studied before coronary artery occlusion (CAO, 4h) and on days 4, 14, and 28 of the late reperfusion phase in conscious, chronically instrumented dogs. Despite a lack of significant changes in the hemodynamic and the electrophysiologic variables, the response to programmed electrical stimulation (PES) before and after CAO with subsequent reperfusion varied substantially. Before intervention arrhythmias such as sustained ventricular tachycardia (SVT) or ventricular fibrillation (VFib) could not be induced by PES via ultrasonic crystals located subendocardially (LAD and LCX region) or via common stimulation electrodes (right ventricle) in any of six instrumented animals...
April 1990: Journal of Pharmacological Methods
R L Minor, P K Chandran, C L Williams
A 50-year-old man suffered an MI with VFIB at work, and efforts at resuscitation were initiated immediately. Ninety minutes of CPR and 14 cardioversions were given by trained personnel before VFIB converted to sinus rhythm. Reversible myoglobinuric renal failure ensued, requiring two weeks of hemodialysis. Scanning with technetium-99m pyrophosphate revealed extensive muscle injury in the regions of cardioversion and a large anterolateral MI. Prolonged resuscitative efforts involving repeated cardioversion may predispose to myoglobinuric renal failure...
February 1990: Chest
R Goldberg, M Szklo, J Tonascia, H L Kennedy
We performed a community-wide study in metropolitan Baltimore to examine the prognostic role of length of time between hospital admission and ventricular fibrillation or cardiac arrest (VFib/CA) complicating acute myocardial infarction (MI). Risk of developing VFib/CA was particularly marked in the first few hours after admission to the hospital. We compared 128 patients experiencing VFib/CA within 48 hours of admission and 80 patients developing these complications after more than 48 hours. Patients with "early" VFib/CA exhibited a lower in-hospital case-fatality rate than those with "late" VBib/CA (67% versus 88%; p less than ...
November 1979: Johns Hopkins Medical Journal
R Goldberg, M Szklo, J A Tonascia, H L Kennedy
A community-wide study was conducted in metropolitan Baltimore in which the prognosis of 330 patients hospitalized with an acute myocardial infarction (MI) complicated by ventricular fibrillation or cardiac arrest (VFib/CA) was compared with that of 1,071 patients hospitalized with acute MI not complicated by VFib/CA. As expected, the in-hospital case-fatality rate among patients with MI complicated by VFib/CA was significantly higher than that in patients without VFib/CA. However, for patients discharged alive from the hospital, no significant differences in long-term survival were found between patients with MI with or without VFib/CA...
May 11, 1979: JAMA: the Journal of the American Medical Association
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