Background: Pauses during chest compressions are thought to have a detrimental effect on resuscitation outcome. The Guidelines 2005 have recently eliminated the post-defibrillation pause. Previous animal studies have shown that multiple pauses of increasing duration decrease resuscitation success. We investigated the effect of varying the characteristics of a single pause near defibrillation on resuscitation outcome.
Methods: Part A: 48 swine were anesthetized, fibrillated for 7min and randomized. Chest compressions were initiated for 90s followed by defibrillation and then resumption of chest compressions. Four groups were studied-G2000: 40s pause beginning 20s before, and ending 20s after defibrillation, A1: a 20s pause just before defibrillation, A2: a 20s pause ending 30s prior to defibrillation, and group A3: a 10s pause ending 30s prior to defibrillation. Part B: 12 swine (Group B) were studied with a protocol identical to Part A but with no pause in chest compressions. Primary endpoint was survival to 4h.
Results: The survival rate was significantly higher for groups A1, A2, A3, and B (5/12, 7/12, 5/12, and 5/12 survived) than for the G2000 group (0/12, p<0.05). Survival did not differ significantly among groups A1, A2, A3, and B.
Conclusions: These results suggest that the Guidelines 2005 recommendation to omit the post-shock pulse check and immediately resume chest compressions may be an important resuscitation protocol change. However, these results also suggest that clinical maneuvers further altering a single pre-shock chest compression pause provide no additional benefit.
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http://dx.doi.org/10.1016/j.resuscitation.2008.11.012 | DOI Listing |
JACC Case Rep
January 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Anomalous aortic origin of coronary artery can lead to ischemia. Due to the limitations of invasive catheterization dobutamine stress testing, an alternative noninvasive approach is desired. A 65-year-old woman with atypical chest pain was referred for coronary computed tomography angiography.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8 - 00168 Rome, Italy.
Background: Cardiac strangulation (CS) from epicardial pacing leads (EPLs) is a rare and potentially lethal mechanical complication associated with epicardial pacemaker (PM) implantation.
Case Summary: We report a case of a 44-year-old-female patient presenting with chest and left shoulder pain in the absence of reported trauma with history of congenital atrioventricular block treated with epicardial PM implantation during the childhood and subsequent transvenous reimplantation over the years. Troponin I resulted within normal values and ECG, transthoracic echocardiography and chest X-ray documented no acute cardiopulmonary findings.
Resuscitation
January 2025
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Health Services, Alberta, Canada; Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada. Electronic address:
Background And Objectives: Advanced neonatal resuscitation interventions (ANRIs) are rarely performed for late preterm and term infants. However, healthcare providers in community hospitals may need to perform ANRIs, while having limited experience and resources. Understanding practice differences between hospitals of different levels of service (LoS) and rural/urban location may inform quality improvement.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Orthopaedic Surgery, AO Spine Fellowship, Clinica Alemana Santiago - Universidad del Desarrollo, Santiago, Chile.
Purpose: There is a growing interest in using computed tomography (CT) scans to opportunistically assess bone mineral density via Hounsfield units (HU). Previous studies have shown lower HU in patients with vertebral compression fractures (VCFs) and that HU can predict pre-existing VCFs. This study evaluated whether HU from CT scans can predict the number of prevalent VCFs.
View Article and Find Full Text PDFCureus
December 2024
Pathological Anatomy, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, PRT.
Sclerosing epithelioid fibrosarcoma (SEF) is a rare and aggressive neoplasm composed of epithelioid cells arranged in strands and nests embedded in a highly sclerotic collagenous stroma. We report a case of a 36-year-old man who started with lumbar pain, with extension to both legs, night sweats, and weight loss. He underwent magnetic resonance imaging (MRI) of the lumbar spine; computed tomography (CT) scan of the chest, abdomen, and pelvis; and [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan.
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