Aim During adult cardiac arrest, rescuers frequently provide ventilations at rates exceeding those recommended by the American Heart Association (AHA). Excessive ventilation is associated with worse clinical outcome after adult cardiac arrest. This study is the first to characterize ventilation rate adherence to AHA guidelines during in-hospital pediatric cardiac arrest resuscitation. Patients and methods We prospectively enrolled children and adolescents (≥8 years of age) who suffered a cardiac arrest in a pediatric intensive care unit (PICU) or emergency department (ED) of a tertiary-care pediatric hospital. Ventilation rate (breaths per minute [bpm]) was monitored via changes in chest wall impedance (CWI) recorded by defibrillator electrode pads during cardiopulmonary resuscitation (CPR). Results Twenty-four CPR events were enrolled yielding 588 thirty-second CPR epochs. The proportion of CPR epochs with ventilation rates exceeding AHA guidelines (>10 bpm) was 63% (CI95 59–67%), significantly higher than our a priori hypothesis of 30% (p < 0.01). The proportion of CPR epochs with ventilation rates exceeding 20 bpm was 20% (CI95 17–23). After controlling for location of arrest and initial event rhythm, resuscitations that occurred on nights/weekends were 3.6 times (CI95: 1.6–7.9, p < 0.01) more likely to have a ventilation rate exceeding AHA guidelines. Conclusions During in-hospital pediatric cardiac arrest, rescuers frequently provide artificial ventilations at rates in excess of AHA guidelines, with twenty percent of CPR time having ventilation rates double that recommended. Excessive ventilation was particularly common during CPR events that occurred on nights/weekends.
Thin film bismuth vanadate (BiVO 4 ) photoelectrodes are prepared by aerosol-assisted (AA)CVD for the first time on fluorinedoped tin oxide (FTO) glass substrates. The BiVO 4 photoelectrodes are characterised by X-ray diffraction (XRD), Raman spectroscopy (RS), and energy-dispersive X-ray (EDX) spectroscopy and are found to consist of phase-pure monoclinic BiVO 4 . Scanning electron microscopy (SEM) analysis shows that the thin film is uniform with a porous structure, and consists of particles approximately 75À125 nm in diameter. The photoelectrochemical (PEC) properties of the BiVO 4 photoelectrodes are studied in aqueous 1 M Na 2 SO 4 and show photocurrent densities of 0.4 mA cm À2, and a maximum incident-photon-to-electron conversion efficiency (IPCE) of 19% at 1.23 V vs. the reversible hydrogen electrode (RHE). BiVO 4 photoelectrodes prepared by this method are thus highly promising for use in PEC water-splitting cells.
Aim Performance of high quality CPR is associated with improved resuscitation outcomes. This study investigates code leader ability to recall CPR error during post-event interviews when CPR recording/audiovisual feedback-enabled defibrillators are deployed. Patients and methods Physician code leaders were interviewed within 24 h of 44 in-hospital pediatric cardiac arrests to assess their ability to recall if CPR error occurred during the event. Actual CPR quality was assessed using quantitative recording/feedback-enabled defibrillators. CPR error was defined as an overall average event chest compression (CC) rate <95/min, depth <38 mm, ventilation rate >10/min, or any interruptions in CPR >10 s. We hypothesized that code leaders would recall error when it actually occurred ≥75% of the time when assisted by audiovisual alerts from a CPR recording feedback-enabled defibrillators (analysis by χ2). Results 810 min from 44 cardiac arrest events yielded 40 complete data sets (actual and interview); ventilation data was available in 24. Actual CPR error was present in 3/40 events for rate, 4/40 for depth, 32/40 for interruptions >10 s, and 17/24 for ventilation frequency. In post-event interviews, code leaders recalled these errors in 0/3 (0%) for rate, 0/4 (0%) for depth, and 19/32 (59%) for interruptions >10 s. Code leaders recalled these CPR quality errors less than 75% of the time for rate (p = 0.06), for depth (p < 0.01), and for CPR interruption (p = 0.04). Quantification of errors not recalled: missed rate error median = 94 CC/min (IQR 93–95), missed depth error median = 36 mm (IQR 35.5–36.5), missed CPR interruption >10 s median = 18 s (IQR 14.4–28.9). Code leaders did recall the presence of excessive ventilation in 16/17 (94%) of events (p = 0.07). Conclusion Despite assistance by CPR recording/feedback-enabled defibrillators, pediatric code leaders fail to recall important CPR quality errors for CC rate, depth, and interruptions during post-cardiac arrest interviews.
III-nitride materials have been linked with a vast number of exciting applications from power electronics to solar cells. Herein, polycrystalline InN, GaN and systematically controlled InxGa1−xN composite thin films are fabricated on FTO glass by a facile, low-cost and scalable aerosol assisted chemical vapor deposition technique. Variation of the indium content in the composite films leads to a dramatic shift in the optical absorbance properties, which correlates with the band edges shifting between those of GaN to InN. Moreover, the photoelectrochemical properties are shown to vary with indium content, with the 50% indium composite having an external quantum efficiency of around 8%. Whilst the overall photocurrent is found to be low, the photocurrent stability is shown to be excellent, with little degradation seen over 1 hour. These findings demonstrate a new and low-cost method for fabricating polycrystalline III-nitrides, which have a range of interesting properties that are highly sought after for many applications.
A previously healthy, white 12-year-old girl presented with diffuse body aches and poor perfusion. She developed severe respiratory failure and marked rhabdomyolysis and was mechanically ventilated. Although her CPK peaked at 500,000 IU/L, her renal function was mildly affected and her creatinine did not exceed the 0.8 mg/dL. The rhabdomyolysis was gradually resolved following aggressive fluid hydration. The patient did not require dialysis and made a complete recovery. Genetic studies revealed the diagnosis of McArdle disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.