A Five-Year Data Report of Long-Term Central Venous Catheters Focusing on Early Complications.

Background: Long-term venous access has become the standard practice for the administration of chemotherapy, fluid therapy, antibiotics, and parenteral nutrition. The most commonly used methods are percutaneous puncture of the subclavian and internal jugular veins using the Seldinger technique or surgical cutdown of the cephalic vein.

Methods: This study is based on a quality registry including all long-term central venous catheter insertion procedures performed in patients >18 years at our department during a five-year period.

Mechanical chest compressions with trapezoidal waveform improve haemodynamics during cardiac arrest.

Background: During manual chest compressions for cardiac arrest the waveforms of chest compressions are generally sinusoidal, whereas mechanical chest compression devices can have different waveforms, including trapezoidal. We studied the haemodynamic differences of such waveforms in a porcine model of cardiac arrest.

Methods: Eight domestic pigs (weight 31±3kg) were anaesthetised and instrumented to continuously monitor aortic (AP) and right atrial pressure (RAP), carotid (CF) and cerebral cortical microcirculation blood flow (CCF).

Manikins with human-like chest properties--a new tool for chest compression research.

Commercially available training manikins for cardiopulmonary resuscitation (CPR) do not accurately mimic the mechanical properties of human chests. This may limit the usefulness of CPR research performed on such manikins. This paper presents the construction of manikins with chest properties matching those measured in patients during an ongoing CPR.

Arterial blood gases during basic life support of human cardiac arrest victims.

Background: Ventilation with tidal volumes sufficient to raise the victim's chest is an integral part of guidelines for lay-rescuer basic life support, but optimal tidal volume, frequency and ratio to chest compressions are not known.

Methods: Adults with non-traumatic, out-of-hospital cardiac arrest, who were not successfully resuscitated following advanced life support by the staff of a physician-manned ambulance, were included. Advanced life support comprised tracheal intubation and mechanical ventilation with tidal volume of 700 ml and 100% oxygen, 12 times per min.

Transthoracic impedance changes as a tool to detect malpositioned tracheal tubes.

Background: Undetected malpositioned or dislodged ventilation tubes during cardiac arrest have fatal consequences, and no single method can detect the tube position reliably during such low-flow states. We wanted to test the ability of impedance changes as measured across the chest via the standard defibrillation pads to distinguish between oesophageal and tracheal ventilations in non-circulated patients.

Materials And Methods: After the end of futile resuscitation transthoracic impedance was measured with a prototype defibrillator, and ventilation variables were collected with a spirometer-capnography unit during tracheal ventilations and after repositioning of the tube; during oesophageal ventilations for paired comparisons.

Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly.

Bystander cardiopulmonary resuscitation (CPR) increases survival rates. The largest group of cardiac arrest patients are men over the age of 60 in the home, and the most probable potential CPR provider is an older woman who is not likely to have received CPR training. One method to increase the percentage of bystander-initiated CPR in this setting is for CPR instruction to be provided by nurse dispatchers via telephone.

Evaluation of a defibrillator-basic cardiopulmonary resuscitation programme for non medical personnel.

To improve the outcome for out-of-hospital patients with ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), the use of automated external defibrillators (AEDs) by first responders including non-medical personnel with a duty to respond to an emergency is recommended. A special CPR-AED course has been developed. We wanted to test the results (quality and speed of operating an AED and CPR) after completion of such a course and retention after approximately 1-year.