Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest

Berg, Robert A.; Hilwig, Ronald W.; Kern, Karl B.; Babar, Ijlal; Ewy, Gordon A.

doi:10.1097/00003246-199909000-00030

Cited by 145 publications

(79 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ventilation becomes more important in cases of non-cardiac origin [20,21]. Thus, more efficient airway management, including tracheal suction and ventilation, may be preferable if ventilation is inadequate or adequate ventilation is expected to be difficult with BVMD.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with these previous reports, we found no evidence that ET has beneficial effects on the outcome of OHCA with cardiac origin. In our regional protocol, routine application of ET is not recommended in cases of OHCA with cardiac origin.As shown in Table 4, ET was used less frequently in OHCA with cardiac origin that may be complicated with aspiration and other airway problems.Ventilation becomes more important in cases of non-cardiac origin [20,21]. Thus, more efficient airway management, including tracheal suction and ventilation, may be preferable if ventilation is inadequate or adequate ventilation is expected to be difficult with BVMD.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Tracheal intubation by paramedics under limited indication criteria may improve the short-term outcome of out-of-hospital cardiac arrests with noncardiac origin

et al. 2010

View full text Add to dashboard Cite

excluded from the analysis. The incidence of sustained return of spontaneous circulation (ROSC) was significantly higher in cases of AAM with ET (30%) than in AAM with other devices (20.2%) and in the standard procedure with BVMD (21.3%). The AAM with ET did not significantly affect 1-year survival. Multiple regression analysis indicated that tracheal intubation but not patient management by the certified paramedics is an independent factor associated with sustained ROSC (odds ratio = 1.503, 95% confidence interval 1.081 -2078). Conclusion: Tracheal intubation according to limited indication criteria and well-organised protocol in Japan may improve the short-term outcome of OHCA with non-cardiac origin. The large prospective study is needed to determine universal effects of tracheal intubation on the long-term outcome of OHCA with disturbed ventilation. INTRODUCTIONAdvanced cardiac life support (ACLS), including advanced airway management (AAM) and intravenous drug therapy, may have some benefits on the outcome of out-of-hospital cardiac arrest (OHCA) [1]. It is not clear whether AAM with an endotracheal tube (ET) in the emergency medical service (EMS) provides a better outcome on OHCA than other airway management devices [2,3]. One controlled study in children showed that tracheal intubation does not improve clinical outcome [4]. Outcome was reported to be worsened when AAM with ET was performed in cases of OHCA with shockable rhythms [5,6]. Recently, Garza et al. reported that avoidance of tracheal intubation as an early airway management and an increase in the ratio of chest compression to ventilation improved survival rate in OHCA of cardiac origin [6].In Japan, certified paramedics who have completed training programs for tracheal intubation have used ET in patients with OHCA since July 2004. The program includes 180 hours of lectures and exercises in schools as well as experience with 30 cases in hospital operating rooms. When ET is indicated as an AAM device, the paramedics obtain instruction regarding tracheal intubation from an emergency physician in accordance with a protocol defined by the regional medical control council (MCC).The present population-based cohort study was performed to determine whether airway management with ET according to the indication criteria may affect the outcome of OHCA in comparison with other AAM devices or BVMD and whether patient management by paramedics certified for ET may affect the prognosis in comparison with uncertified paramedics. Furthermore, we investigated whether the origin of OHCA (cardiac or non-cardiac in the Utstein style) modifies the effects. MATERIALS AND METHODSData were collected in accordance to the national guideline of ethics for the epidemiological survey (The Ministry of Health, Labor and Welfare in Japan : http://www.mhlw.go.jp/general/seido/kousei/i-kenkyu/index.html). The study was approved by an institutional review board (#843). Populations and settingIshikawa prefecture encompasses an area of 4,185 km 2 on the Sea of Japan coast, and has a r...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Tracheal intubation by paramedics under limited indication criteria may improve the short-term outcome of out-of-hospital cardiac arrests with noncardiac origin

et al. 2010

View full text Add to dashboard Cite

show abstract

“…seres humanos, animales, maniquíes, o modelos matemáticos para justificar un cambio de la proporción actual de masaje-ventilación de 3:1. [74][75][76][77][78][79][80][81][82][83][84][85] Las estrategias deben tener en cuenta optimizar la calidad del masaje y las ventilaciones con el menor número posible de interrupciones.…”

Section: Frecuencia Y Coordinación Entre Masaje Cardíaco Y Ventilaciónunclassified

Recomendaciones en Reanimación Neonatal 2011. 2a parte: Administración de oxígeno. Estrategias ventilatorias. Masaje cardíaco

Castro¹,

Rabasa²,

Capelli³

et al. 2011

Arch Argent Pediat

View full text Add to dashboard Cite

“…Expense is another concern. There are pediatric piglet models [219,[238][239][240][241][242][243][244][245]. More work has been done in pediatric than adult ACA models likely related to the importance of ACA in children.…”

Section: Pig Aca Modelsmentioning

confidence: 99%

“…Once again, piglet CPR-related physiology mimics many aspects of the human condition. Use of piglet ACA models to optimize CPR has had excellent success for direct translation to the clinical condition [219,[238][239][240][241][242][243][244][245]. However, neuropathological targets are less defined than in rodent models and behavioral testing of piglets limited.…”

Section: Pig Aca Modelsmentioning

confidence: 99%

Brain Resuscitation in the Drowning Victim

Warner

Knape

2006

Handbook on Drowning

View full text Add to dashboard Cite

. This manuscript is dedicated to the memory of Peter Safar, M.D. Peter Safar combined genius, incredible purpose, elegance, and humanism to move the collective fields of acute medicine to a new level. His work in resuscitation medicine, critical care, anesthesiology, emergency medicine, and disaster medicine saved countless lives. As a mentor he taught us a great deal. Peter left us with an important message-in both clinical care and research: namely, to always ask, "what is your intervention or research doing for the patient?" Whether physician or scientist, it is a critical message never to forget.Portions of this manuscript are being reproduced in the Handbook of Drowning. Bierens JJ (ed.). Springer, 2nd Edition. NIH Public Access AbstractDrowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide recommendations for management and investigation of the drowning victim. Epidemiology, brain-oriented prehospital and intensive care, therapeutic hypothermia, neuroimaging/monitoring, biomarkers, and neuroresuscitative pharmacology are addressed. When cardiac arrest is present, chest compressions with rescue breathing are recommended due to the asphyxial insult. In the comatose patient with restoration of spontaneous circulation, hypoxemia and hyperoxemia should be avoided, hyperthermia treated, and induced hypothermia (32-34 °C) considered. Arterial hypotension/hypertension should be recognized and treated. Prevent hypoglycemia and treat hyperglycemia. Treat clinical seizures and consider treating nonconvulsive status epilepticus. Serial neurologic examinations should be provided. Brain imaging and serial biomarker measurement may aid prognostication. Continuous electroencephalography and N20 somatosensory evoked potential monitoring may be considered. Serial biomarker measurement (e.g., neuron specific enolase) may aid prognostication. There is insufficient evidence to recommend use of any specific brain-oriented neuroresuscitative pharmacologic therapy other than that required to restore and maintain normal physiology. Following initial stabilization, victims should be transferred to centers with expertise in age-specific postresuscitation neurocritical care. Care should be documented, reviewed, and quality improvement assessment performed. Preclinical research should focus on models of asphyxial cardiac arrest. Clinical research should focus on improved cardiopulmonary resuscitation, re-oxygenation/ reperfusion strategies, therapeutic hypothermia, neuroprotection, neurorehabilitation, and consideration of drowning in advances made in treatment of other central nervous system disorders.

show abstract

Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest

Cited by 145 publications

References 43 publications

Tracheal intubation by paramedics under limited indication criteria may improve the short-term outcome of out-of-hospital cardiac arrests with noncardiac origin

Tracheal intubation by paramedics under limited indication criteria may improve the short-term outcome of out-of-hospital cardiac arrests with noncardiac origin

Recomendaciones en Reanimación Neonatal 2011. 2a parte: Administración de oxígeno. Estrategias ventilatorias. Masaje cardíaco

Brain Resuscitation in the Drowning Victim

Contact Info

Product

Resources

About