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[PMID]:27771786
[Au] Autor:Osinski A; Vreugdenhil G; de Koning J; van der Hoeven JG
[Ad] Endereço:Department of Internal Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands. aart_osinski@hotmail.com.
[Ti] Título:Do-not-resuscitate orders in cancer patients: a review of literature.
[So] Source:Support Care Cancer;25(2):677-685, 2017 02.
[Is] ISSN:1433-7339
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Discussing do-not-resuscitate (DNR) orders is part of daily hospital practice in oncology departments. Several medical factors and patient characteristics are associated with issuing DNR orders in cancer patients. DNR orders are often placed late in the disease process. This may be a cause for disagreements between doctors and between doctors and patients and may cause for unnecessary treatments and admissions. In addition, DNR orders on itself may influence the rest of the medical treatment for patients. We present recommendations for discussing DNR orders and medical futility in practice through shared decision-making. Prospective studies are needed to investigate in which a patient's cardiopulmonary resuscitation (CPR) is futile and whether or not DNR orders influence the medical care of patients.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/ética
Tomada de Decisões/ética
Neoplasias/psicologia
Ordens quanto à Conduta (Ética Médica)/ética
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Neoplasias/terapia
Estudos Prospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180310
[Lr] Data última revisão:
180310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1007/s00520-016-3459-9


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[PMID]:29444395
[Au] Autor:Wood B; Ismail K
[Ti] Título:A cardiac arrest following the administration of succinylcholine.
[So] Source:Acta Anaesthesiol Belg;67(2):97-99, 2016.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:A twenty-three year old woman, admitted to the intensive care unit (ICU) with a diagnosis of menin- gitis and associated lower limb ischemia suffered a car- diac arrest, due to extreme hyperkalemia, following the administration of succinylcholine in order to replace an endo-tracheal tube. After prolonged cardiopulmonary resuscitation (CPR) lasting 45 minutes, during which 8 mg of epinephrine was administered, cardiac output was restored. Four weeks later the patient left intensive care, having made a full recovery with no neurological deficit. The following case highlights the risks of succinylcholine in the septic patient and that prolonged resuscitation can have a succesfiil outcome.
[Mh] Termos MeSH primário: Parada Cardíaca/induzido quimicamente
Fármacos Neuromusculares Despolarizantes/efeitos adversos
Succinilcolina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Reanimação Cardiopulmonar
Feminino
Seres Humanos
Hiperpotassemia/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Neuromuscular Depolarizing Agents); J2R869A8YF (Succinylcholine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE


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[PMID]:29486014
[Au] Autor:Lewis RJ; Gausche-Hill M
[Ad] Endereço:Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California.
[Ti] Título:Airway Management During Out-of-Hospital Cardiac Arrest.
[So] Source:JAMA;319(8):771-772, 2018 02 27.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Manuseio das Vias Aéreas
Parada Cardíaca Extra-Hospitalar
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar
Serviços Médicos de Emergência
Seres Humanos
Intubação Intratraqueal
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180228
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0155


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[PMID]:29384839
[Au] Autor:Ladny JR; Smereka J; Rodríguez-Núñez A; Leung S; Ruetzler K; Szarpak L
[Ad] Endereço:Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok.
[Ti] Título:Is there any alternative to standard chest compression techniques in infants? A randomized manikin trial of the new "2-thumb-fist" option.
[So] Source:Medicine (Baltimore);97(5):e9386, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pediatric cardiac arrest is a fatal emergent condition that is associated with high mortality, permanent neurological injury, and is a socioeconomic burden at both the individual and national levels. The aim of this study was to test in an infant manikin a new chest compression (CC) technique ("2 thumbs-fist" or nTTT) in comparison with standard 2-finger (TFT) and 2-thumb-encircling hands techniques (TTEHT). METHODS: This was prospective, randomized, crossover manikin study. Sixty-three nurses who performed a randomized sequence of 2-minute continuous CC with the 3 techniques in random order. Simulated systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressures (PP, SBP-DBP) in mm Hg were measured. RESULTS: The nTTT resulted in a higher median SBP value (69 [IQR, 63-74] mm Hg) than TTEHT (41.5 [IQR, 39-42] mm Hg), (P < .001) and TFT (26.5 [IQR, 25.5-29] mm Hg), (P <.001). The simulated median value of DBP was 20 (IQR, 19-20) mm Hg with nTTT, 18 (IQR, 17-19) mm Hg with TTEHT and 23.5 (IQR, 22-25.5) mm Hg with TFT. DBP was significantly higher with TFT than with TTEHT (P <.001), as well as with TTEHT than nTTT (P <.001). Median values of simulated MAP were 37 (IQR, 34.5-38) mm Hg with nTTT, 26 (IQR, 25-26) mm Hg with TTEHT and 24.5 (IQR,23.5-26.5) mm Hg with TFT. A statistically significant difference was noticed between nTTT and TFT (P <.001), nTTT and TTEHT (P <.001), and between TTEHT and TFT (P <.001). Sixty-one subjects (96.8%) preferred the nTTT over the 2 standard methods. CONCLUSIONS: The new nTTT technique achieved higher SBP and MAP compared to the standard CC techniques in our infant manikin model. nTTT appears to be a suitable alternative or complementary to the TFT and TTEHT.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/métodos
Parada Cardíaca/terapia
[Mh] Termos MeSH secundário: Adulto
Análise de Variância
Atitude do Pessoal de Saúde
Pressão Sanguínea
Reanimação Cardiopulmonar/educação
Estudos Cross-Over
Feminino
Parada Cardíaca/fisiopatologia
Seres Humanos
Lactente
Modelos Lineares
Masculino
Manequins
Enfermeiras e Enfermeiros
Polegar
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009386


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[PMID]:29419666
[Au] Autor:Oh TK; Park YM; Do SH; Hwang JW; Jo YH; Kim JH; Jeon YT; Song IA
[Ad] Endereço:Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital.
[Ti] Título:A comparative study of the incidence of in-hospital cardiopulmonary resuscitation on Monday-Wednesday and Thursday-Sunday: Retrospective analysis in a tertiary care hospital.
[So] Source:Medicine (Baltimore);97(6):e9741, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Because most medical staff work from Monday-Friday, it is possible that they are relatively more fatigued and less capable of providing emergency supportive services on Thursday-Sunday (Thu-Sun) than on Monday-Wednesday (Mon-Wed). In this study, we aimed to analyze the incidence of in-hospital cardiopulmonary resuscitation (CPR) to determine if it differed between Thu-Sun and Mon-Wed.This retrospective observational study of in-hospital CPR was performed during 2012 to 2016 among inpatients at the Seoul National University Bundang Hospital. The primary outcome was the incidence of in-hospital CPR per 1000 inpatients in the Mon-Wed and Thu-Sun periods. Secondary outcomes included differences in the CPR incidence by time of day and season.In the study, 1195 cases of in-hospital CPR were included. The incidence of in-hospital CPR per 1000 inpatients was significantly higher on Thu-Sun (mean: 0.595, 95% confidence interval [CI]: 0.564-0.626) than on Mon-Wed (mean: 0.505, 95% CI: 0.474-0.536, P < .001). There were no seasonal variations in the incidence of in-hospital CPR. However, in-hospital CPR was most frequently performed between 16:00 and 24:00, and the return of spontaneous circulation (ROSC) rate was the lowest among cases that occurred between 0:00 and 8:00. In addition, the ROSC rate was lowest among female patients, patients with cardiac arrest, and after in-hospital CPR performed on a Sunday.The incidence of in-hospital CPR per 1000 inpatients was significantly higher on Thu-Sun than on Mon-Wed. No seasonal variations were observed in the incidence of in-hospital CPR, but the data suggest circadian variations and differences in ROSC rates.
[Mh] Termos MeSH primário: Fadiga de Alarmes do Pessoal de Saúde/prevenção & controle
Reanimação Cardiopulmonar
Admissão e Escalonamento de Pessoal
[Mh] Termos MeSH secundário: Adulto
Idoso
Reanimação Cardiopulmonar/efeitos adversos
Reanimação Cardiopulmonar/métodos
Reanimação Cardiopulmonar/estatística & dados numéricos
Serviços Médicos de Emergência/métodos
Feminino
Parada Cardíaca/epidemiologia
Parada Cardíaca/terapia
Seres Humanos
Incidência
Masculino
Meia-Idade
Admissão e Escalonamento de Pessoal/organização & administração
Admissão e Escalonamento de Pessoal/estatística & dados numéricos
República da Coreia/epidemiologia
Estudos Retrospectivos
Centros de Atenção Terciária/organização & administração
Centros de Atenção Terciária/estatística & dados numéricos
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009741


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[PMID]:29381937
[Au] Autor:Moon SH; Kim JW; Byun JH; Kim SH; Kim KN; Choi JY; Jang IS; Lee CE; Yang JH; Kang DH; Park HO
[Ad] Endereço:Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon.
[Ti] Título:Case of a cardiac arrest patient who survived after extracorporeal cardiopulmonary resuscitation and 1.5 hours of resuscitation: A case report.
[So] Source:Medicine (Baltimore);96(47):e8646, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Per the American Heart Association guidelines, extracorporeal cardiopulmonary resuscitation should be considered for in-hospital patients with easily reversible cardiac arrest. However, there are currently no consensus recommendations regarding resuscitation for prolonged cardiac arrest cases. PATIENT CONCERNS AND DIAGNOSIS: We encountered a 48-year-old man who survived a cardiac arrest that lasted approximately 1.5 hours. He visited a local hospital's emergency department complaining of chest pain and dyspnea that had started 3 days earlier. Immediately after arriving in the emergency department, a cardiac arrest occurred; he was transferred to our hospital for extracorporeal membrane oxygenation (ECMO). INTERVENTIONS: Resuscitation was performed with strict adherence to the American Heart Association/American College of Cardiology advanced cardiac life support guidelines until ECMO could be placed. OUTCOMES: On hospital day 7, he had a full neurologic recovery. On hospital day 58, additional treatments, including orthotopic heart transplantation, were considered necessary; he was transferred to another hospital. LESSONS: To our knowledge, this is the first case in South Korea of patient survival with good neurologic outcomes after resuscitation that lasted as long as 1.5 hours. Documenting cases of prolonged resuscitation may lead to updated guidelines and improvement of outcomes of similar cases in future.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos
Parada Cardíaca/terapia
Doenças do Sistema Nervoso
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar/efeitos adversos
Reanimação Cardiopulmonar/métodos
Transplante de Coração/métodos
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Doenças do Sistema Nervoso/etiologia
Doenças do Sistema Nervoso/prevenção & controle
República da Coreia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008646


  7 / 14112 MEDLINE  
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[PMID]:29287074
[Au] Autor:Ko E; Shin JK; Cha WC; Park JH; Lee TR; Yoon H; Lee G; Hwang SY; Shin TG; Sim MS; Jo IJ; Rhee JE; Song KJ; Jeong YK; Shin SD; Choi JH; Cardiac Arrest Pursuit Trial with Unique Registry; Epidemiologic Surveillance investigators
[Ad] Endereço:Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
[Ti] Título:Coronary angiography is related to improved clinical outcome of out-of-hospital cardiac arrest with initial non-shockable rhythm.
[So] Source:PLoS One;12(12):e0189442, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Coronary angiography (CAG) for survivors of out-of-hospital cardiac arrest (OHCA) enables early identification of coronary artery disease and revascularization, which might improve clinical outcome. However, little is known for the role of CAG in patients with initial non-shockable cardiac rhythm. METHODS: We investigated clinical outcomes of successfully resuscitated 670 adult OHCA patients who were transferred to 27 hospitals in Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES), a Korean nationwide multicenter registry. The primary outcome was 30-day survival with good neurological outcome. Propensity score matching and inverse probability of treatment weighting analyses were performed to account for indication bias. RESULTS: A total of 401 (60%) patients showed initial non-shockable rhythm. CAG was performed only in 13% of patients with non-shockable rhythm (53 out of 401 patients), whereas more than half of patients with shockable rhythm (149 out of 269 patients, 55%). Clinical outcome of patients who underwent CAG was superior to patients without CAG in both non-shockable (hazard ratio (HR) = 3.6, 95% confidence interval (CI) = 2.5-5.2) and shockable rhythm (HR = 3.7, 95% CI = 2.5-5.4, p < 0.001, all). Further analysis after propensity score matching or inverse probability of treatment weighting showed consistent findings (HR ranged from 2.0 to 3.2, p < 0.001, all). CONCLUSIONS: Performing CAG was related to better survival with good neurological outcome of OHCA patients with initial non-shockable rhythms as well as shockable rhythms.
[Mh] Termos MeSH primário: Angiografia Coronária
Parada Cardíaca Extra-Hospitalar/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Reanimação Cardiopulmonar
Eletrocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Parada Cardíaca Extra-Hospitalar/mortalidade
Parada Cardíaca Extra-Hospitalar/terapia
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189442


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[PMID]:29172364
[Au] Autor:McKernon SL; Kaura L; Taylor KH; Reid S; Balmer MC
[Ti] Título:An Update on Current Resuscitation Council (UK) Guidelines.
[So] Source:Dent Update;44(4):341-2, 345-6, 349-50, 2017 Apr.
[Is] ISSN:0305-5000
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:On 15 October 2015, The Resuscitation Council (UK) published new resuscitation guidelines following the review of resuscitation science by the International Liaison Committee on Resuscitation (ILCOR). The 2015 guidelines emphasize the importance of interactions between the emergency medical dispatcher, the bystander who provides cardiopulmonary resuscitation (CPR) and the prompt deployment of an automated external defibrillator (AED); the co-ordination of these three elements is crucial to improving out-of-hospital cardiac arrest survival. Medical emergencies in dental practices are thought to occur on average once every 3−4 years per dentist in primary care. The GDC consider medical emergencies as a highly recommended topic for Continuing Professional Development (CPD) and recommend at least 10 hours in every CPD cycle. Clinical relevance: The publication of the updated guidelines serves as a reminder to the clinical team of the importance of being up to date with recognition and treatment of cardiac arrest and choking and how seamless interaction between members of both the dental and medical teams improves long-term outcomes for patients.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/normas
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar/métodos
Seres Humanos
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
Texto completo
[PMID]:28742911
[Au] Autor:Kirkegaard H; Søreide E; de Haas I; Pettilä V; Taccone FS; Arus U; Storm C; Hassager C; Nielsen JF; Sørensen CA; Ilkjær S; Jeppesen AN; Grejs AM; Duez CHV; Hjort J; Larsen AI; Toome V; Tiainen M; Hästbacka J; Laitio T; Skrifvars MB
[Ad] Endereço:Research Center for Emergency Medicine and Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
[Ti] Título:Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial.
[So] Source:JAMA;318(4):341-350, 2017 07 25.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended, standard, 24-hour TTM. Design, Setting, and Participants: This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries. Three hundred fifty-five adult, unconscious patients with out-of-hospital cardiac arrest were enrolled from February 16, 2013, to June 1, 2016, with final follow-up on December 27, 2016. Interventions: Patients were randomized to TTM (33 ± 1°C) for 48 hours (n = 176) or 24 hours (n = 179), followed by gradual rewarming of 0.5°C per hour until reaching 37°C. Main Outcomes and Measures: The primary outcome was 6-month neurologic outcome, with a Cerebral Performance Categories (CPC) score of 1 or 2 used to define favorable outcome. Secondary outcomes included 6-month mortality, including time to death, the occurrence of adverse events, and intensive care unit resource use. Results: In 355 patients who were randomized (mean age, 60 years; 295 [83%] men), 351 (99%) completed the trial. Of these patients, 69% (120/175) in the 48-hour group had a favorable outcome at 6 months compared with 64% (112/176) in the 24-hour group (difference, 4.9%; 95% CI, -5% to 14.8%; relative risk [RR], 1.08; 95% CI, 0.93-1.25; P = .33). Six-month mortality was 27% (48/175) in the 48-hour group and 34% (60/177) in the 24-hour group (difference, -6.5%; 95% CI, -16.1% to 3.1%; RR, 0.81; 95% CI, 0.59-1.11; P = .19). There was no significant difference in the time to mortality between the 48-hour group and the 24-hour group (hazard ratio, 0.79; 95% CI, 0.54-1.15; P = .22). Adverse events were more common in the 48-hour group (97%) than in the 24-hour group (91%) (difference, 5.6%; 95% CI, 0.6%-10.6%; RR, 1.06; 95% CI, 1.01-1.12; P = .04). The median length of intensive care unit stay (151 vs 117 hours; P < .001), but not hospital stay (11 vs 12 days; P = .50), was longer in the 48-hour group than in the 24-hour group. Conclusions and Relevance: In unconscious survivors from out-of-hospital cardiac arrest admitted to the ICU, targeted temperature management at 33°C for 48 hours did not significantly improve 6-month neurologic outcome compared with targeted temperature management at 33°C for 24 hours. However, the study may have had limited power to detect clinically important differences, and further research may be warranted. Trial Registration: clinicaltrials.gov Identifier: NCT01689077.
[Mh] Termos MeSH primário: Hipotermia Induzida
Parada Cardíaca Extra-Hospitalar/terapia
[Mh] Termos MeSH secundário: Idoso
Temperatura Corporal
Encefalopatias/etiologia
Reanimação Cardiopulmonar/métodos
Feminino
Seres Humanos
Hipotermia Induzida/efeitos adversos
Masculino
Meia-Idade
Parada Cardíaca Extra-Hospitalar/complicações
Parada Cardíaca Extra-Hospitalar/mortalidade
Fatores de Tempo
Inconsciência/etiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; PRAGMATIC CLINICAL TRIAL; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.8978


  10 / 14112 MEDLINE  
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[PMID]:29267300
[Au] Autor:Yamanaka S; Huh JY; Nishiyama K; Hayashi H
[Ad] Endereço:Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan.
[Ti] Título:The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial.
[So] Source:PLoS One;12(12):e0189412, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Long durational chest compression (CC) deteriorates cardiopulmonary resuscitation (CPR) quality. The appropriate number of CC personnel for minimizing rescuer's fatigue is mostly unknown. OBJECTIVE: We determined the optimal number of personnel needed for 30-min CPR in a rescue-team. METHODS: We conducted a randomized, manikin trial on healthcare providers. We divided them into Groups A to D according to the assigned different rest period to each group between the 2 min CCs. Groups A, B, C, and D performed CCs at 2, 4, 6, and 8 min rest period. All participants performed CCs for 30 min with a different rest period; participants allocated to Groups A, B, C, and D performed, eight, five, four, and three cycles, respectively. We compared a quality change of CCs among these groups to investigate how the assigned rest period affects the maintenance of CC quality during the 30-min CPR. RESULTS: This study involved 143 participants (male 58 [41%]; mean age, 24 years,) for the evaluation. As participants had less rest periods, the quality of their CCs such as sufficient depth ratio declined over 30-min CPR. A significant decrease in the sufficient CC depth ratio was observed in the second to the last cycle as compared to the first cycle. (median changes; A: -4%, B: -3%, C: 0%, and D: 0% p < 0.01). CONCLUSIONS: A 6 min rest period after 2 min CC is vital in order to sustain the quality of CC during a 30-min CPR cycle. At least four personnel may be needed to reduce rescuer's fatigue for a 30-min CPR cycle when the team consists of men and women.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar
Pessoal de Saúde
Manequins
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189412



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