Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhyt...Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.展开更多
Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52...Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.展开更多
Acute myocardial infarction(AMI)is characterized by myocardial necrosis resulting from acute coronary circulatory insufficiency.In cases progressing to cardiac arrest,two interventions are important:sustained high-qua...Acute myocardial infarction(AMI)is characterized by myocardial necrosis resulting from acute coronary circulatory insufficiency.In cases progressing to cardiac arrest,two interventions are important:sustained high-quality cardiopulmonary resuscitation(CPR)and prompt coronary reperfusion to minimize irreversible myocardial damage.With advances in emergency medical care,both emergency thrombolysis and extracorporeal cardiopulmonary resuscitation(ECPR)are utilized,even in prehospital treatment,thereby extending the golden window for rescuing such patients.展开更多
The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of...The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.展开更多
BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic thera...BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.展开更多
Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using ...Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using a self-administered questionnaire.Multiple logistic regression was conducted to test the associated factors with the dependent variables.Results:Only 9.3%of participants had a standardized level of knowledge,while 68.9%reported adequate skills for neonatal resuscitation.Factors associated with a standardized level of knowledge were age(p=0.001)and supportive supervision(p=0.007).Factors associated with the standardized practice level were the presence of hospital guidelines(p=0.028),previous training of nurses(p=0.011),and the presence of supportive supervision(p<0.001).Conclusions:The majority of emergency nurses in Hebron hospitals demonstrated a substandard level of knowledge of neonatal resuscitation.However,most of those nurses surprisingly reported a standardized practice level.The presence of hospital guidelines,training programs,or direct supervision for nurses are factors that can be considered to improve both knowledge and practice toward neonatal resuscitation among emergency nurses in Hebron.展开更多
Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online data...Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online databases,including PubMed,Embase,Web of Science,and the Cochrane Library.The articles included in this review were published from inception to July 31,2024.The Iain Crombie assessment tool was used to assess study quality.Meta-analysis was performed using RevMan(version 5.4)software.The review protocol has been registered with PROSPERO(CRD42024570491).Results A total of 1,434 research articles were initially identified,among which 18 were incorporated into this study,and all of the included studies were cross-sectional.Meta-analysis results demonstrated that gender(male;OR=1.37,95%CI:1.28–1.47),profession(healthcare provider;OR=0.17,95%CI:0.06–0.47),knowledge and skill level(OR=1.63,95%CI:1.25–2.11),willingness to undergo training(OR=2.68,95%CI:1.89–3.79),interest in first aid(OR=2.08,95%CI:1.60–2.69),previous training(OR=2.14,95%CI:1.49–3.08),and previous first-aid experience(OR=1.70,95%CI:1.37–2.11)were the principal influencing factors of the public’s willingness to engage in out-of-hospital cardiopulmonary resuscitation.Conclusion Demographic factors,knowledge,belief,and behavior are crucial in influencing public emergency decision-making.Medical personnel could create specialized training programs based on relevant factors to enhance the public's willingness to engage in out-of-hospital CPR.展开更多
Objective:Cardiopulmonary resuscitation(CPR)is one of the most important life-saving procedures in the hospital.Contrary to medical guidelines,family presence during CPR is still not accepted in some countries.Family ...Objective:Cardiopulmonary resuscitation(CPR)is one of the most important life-saving procedures in the hospital.Contrary to medical guidelines,family presence during CPR is still not accepted in some countries.Family presence during CPR depends on the nurses’attitude,which is influenced by various factors.Emotional intelligence(EI)helps nurses make wise decisions and display responsible behavior,which is necessary for proper and good performance in nursing.The study’s purpose was to determine the attitude of acute care nurses toward family presence during CPR and its relationship with EI.Methods:The descriptive-analytical study was conducted among the nurses of acute care units(intensive care unit[ICU],critical care unit,and emergency department)in teaching hospitals of Qazvin University of Medical Sciences,Iran,in 2022-2023.A total of 186 nurses were included in the study using convenience sampling.The data collection tools were a checklist of demographic characteristics,nurses’attitude toward the presence of family scale,and Siberia Schering’s EI questionnaire.The collected data were analyzed using descriptive and analytical statistics and SPSS software.Results:The mean age of the participants was(32.05±6.93)years.Of 186 nurses participating in the study,127(68.3%)were women and the rest were men.The mean score of attitude was 47.41±9.41(the minimum score of the nurses was 19 and the maximum score was 95).The mean score of EI was 99.27±8.86(the minimum score was 69 and the maximum score was 128).The results of Pearson’s correlation coefficient showed no significant relationship between the total score of attitude and EI of the participants(P=0.588).Data analysis showed that only the self-arousal dimension of EI has a significant relationship with the range of family self-control behaviors in attitude(P=0.037).Conclusions:The results showed that the nurses of acute care units have a positive attitude toward the presence of the family during CPR and have high EI.Although no significant relationship was observed between the 2 variables,paying attention to the influencing factors on the attitude of the nurse toward family presence during CPR in different societies needs more research and investigation.展开更多
BACKGROUND Return of spontaneous circulation(ROSC)following cardiopulmonary resuscitation(CPR)is a critical determinant of survival in patients experiencing cardiac arrest.This study aimed to investigate the relations...BACKGROUND Return of spontaneous circulation(ROSC)following cardiopulmonary resuscitation(CPR)is a critical determinant of survival in patients experiencing cardiac arrest.This study aimed to investigate the relationship between the duration of CPR,the achievement of ROSC,and both short-term[intensive care unit(ICU)and in-hospital]and long-term survival outcomes in patients admitted to the medical intensive care unit(MICU)of Dr.Moopen’s Medical College Hospital,Wayanad,Kerala,India.AIM To assess how cardiopulmonary resuscitation duration impacts short-term and long-term survival in cardiac arrest patients in intensive care.METHODS A retrospective observational cohort study was conducted on adult patients who received CPR in the MICU between March 2023 and March 2024.Data were extracted from electronic medical records,including demographics,duration of CPR,ROSC achievement,and survival outcomes.Short-term survival was defined as survival to ICU discharge and in-hospital mortality,while long-term survival was assessed at six months post-arrest.Statistical analysis was performed using SPSS software,with Kaplan-Meier survival analysis and Cox regression used to identify predictors of mortality.RESULTS A total of 142 patients were included in the study.The median duration of CPR was 15 minutes.ROSC was achieved in 68 patients(47.9%).A significant association was observed between the duration of CPR and ROSC achievement(P<0.001).Patients who achieved ROSC early had significantly higher rates of short-term and longterm survival compared to those who did not(P<0.001).Each additional minute of CPR was associated with a 7%decrease in the odds of achieving ROSC.Longer CPR duration(HR:1.05,95%CI:1.02-1.08),absence of ROSC(HR:4.87,95%CI:2.31-10.28),older age(HR:1.03,95%CI:1.01-1.06)and unwitnessed arrest(HR:1.89,95%CI:1.05-3.41)were independent predictors of mortality.CONCLUSION Timely,effective cardiopulmonary resuscitation improves survival in intensive care.Duration significantly predicts return of circulation and outcomes.Further research should explore factors affecting resuscitation length and optimize treatment strategies.展开更多
BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is ...BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is essential for improving post-resuscitation survival.This study investigated the mechanisms and common targets of myocardial dysfunction and brain injury after resuscitation.METHODS:The male Sprague-Dawley rats(10–12 weeks old,400–500 g) were divided into two groups:the control group(n=6),which received sham surgery,and the CA/CPR group(n=10),which received ventricular fibrillation(VF) followed by CPR.After 24 h,brain and heart tissues were collected for analysis.The sequencing was used to identify differentially expressed genes(DEGs) between control and CA/CPR rats.RESULTS:At 24 h after resuscitation,CA/CPR rats presented 217 DEGs in the hippocampus and 80 DEGs in the left ventricle(LV) compared to the control group.In the hippocampus,the most notable biological process was the positive regulation of tumor necrosis factor production,with key pathways related to inflammation and the immune response.In the LV,the Gene Ontology(GO)enrichment analysis revealed that gene alterations were primarily associated with amyloid-beta clearance,a pathway that was also relevant in the brain.Eleven common targets were identified in the DEGs of both heart and brain tissues.The reverse transcription-polymerase chain reaction(RTPCR) validation revealed significant differences in the mRNA expression of Timp1,Apln,Ccl7,and Lgals3 in both LV and hippocampus.CONCLUSION:This study identified possible key genes and underlying mechanisms involved in PCAS.The differential genes Timp1,Apln,Ccl7,and Lgals3 might serve as common biomarkers for myocardial and neurological injury following resuscitation.展开更多
BACKGROUNDRectal cancer is a common digestive tract malignancy influenced by genetic,dietary,and environmental factors.While traditional open surgery is effective,itoften leads to significant recovery challenges and c...BACKGROUNDRectal cancer is a common digestive tract malignancy influenced by genetic,dietary,and environmental factors.While traditional open surgery is effective,itoften leads to significant recovery challenges and complications.The da Vincirobotic system provides a minimally invasive option,enhancing precision andreducing recovery time.However,the anesthesia recovery phase is critical foreffective patient outcomes,particularly in older individuals.This study exploresthe impact of enhanced recovery after surgery(ERAS)-based anesthesia resuscitationon awakening quality in patients undergoing da Vinci robotic rectalcancer surgery,aiming to improve recovery protocols.AIMTo analyze the impact of anesthesia resuscitation interventions grounded in theprinciples of ERAS on the awakening quality of patients undergoing da Vincirobotic rectal cancer surgery.METHODSA total of 84 rectal cancer patients admitted from February 2021 to December 2022were selected and randomized into two groups:The control group(n=42)receivedconventional anesthesia recovery nursing care,while the study group(n=42)underwent anesthesia resuscitation interventions based on the ERAS framework.The quality of awakening,pain levels,vital signs,and complications werecompared between the two groups.RESULTSThe study group showed significantly shorter times for eye opening,extubation,orientation recovery,spontaneousrespiration,and anesthesia recovery room stay than the control group(P<0.05).Visual analog scale scores at 1hours,2 hours,4 hours,and 6 hours post-nursing were lower in the study group(P<0.05).In the control group,systolic blood pressure,diastolic blood pressure,heart rate,and respiratory rate at 10 minutes post-anesthesia werehigher than preoperative values(P<0.05),while no significant differences were found in the study group.Theseparameters were also lower in the study group at 10 minutes(P<0.05).The complication rate was significantlylower in the study group(4.76%)than in the control group(28.56%)(P<0.05).CONCLUSIONThe implementation of ERAS-based anesthesia resuscitation interventions in patients undergoing da Vinci roboticrectal cancer surgery enhances awakening quality,reduces complication rates,and helps stabilize vital signs.展开更多
BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT ...BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation(ECPR).METHODS:A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023.All the patients underwent a wholebody CT scan within 1 h of ECPR.Data regarding demographic and clinical characteristics were collected from electronic medical records.The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient.The primary outcome was 28-day survival.Receiver operating characteristic(ROC)curves were used to evaluate the ability of chest CT features(gravitydependent distribution and CT scores)to predict poor outcomes.The cut-off value of the CT score was determined.Kaplan-Meier curves were used to compare 28-day survival between the low-and high-CT score groups,which were classified using the estimated cut-off value.RESULTS:Among the 100 patients included,74 were non-survivors.The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors(P<0.05).Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution(P<0.05).The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually,demonstrating moderate performance(AUC:0.693,95%CI:0.568-0.801).According to the survival analysis,the risk of death increased as the CT score rose,with an estimated cut-off value of≥11(P=0.016).CONCLUSION:Chest CT features were associated with poor outcomes in CA patients following ECPR.展开更多
BACKGROUND:Iron metabolism dyshomeostasis is associated with ferroptosis and ischemiareperfusion injury.We aim to investigate post-cardiac arrest changes in plasma iron metabolism-related parameters and their prognost...BACKGROUND:Iron metabolism dyshomeostasis is associated with ferroptosis and ischemiareperfusion injury.We aim to investigate post-cardiac arrest changes in plasma iron metabolism-related parameters and their prognostic value for 28-day neurological outcomes.METHODS:In this prospective observational cohort study,plasma iron metabolism-related parameters(iron,ferritin,hepcidin,soluble transferrin receptor[sTfR],total iron binding capacity[TIBC],and transferrin saturation),interleukin-6,and neuron-specific enolase(NSE)were assessed in 120 patients after restoration of spontaneous circulation(ROSC)on days 1 and 3 of intensive care unit(ICU)admission and in 40 healthy controls.The primary outcome was poor 28-day neurological prognosis.RESULTS:Compared to controls,post-ROSC patients exhibited significant plasma iron metabolism disturbances,including decreased iron,TIBC,transferrin saturation,with elevated hepcidin,ferritin,sTfR,interleukin-6,and NSE on day 1 after ICU admission(P<0.05 for all).On day 28 post-ROSC,patients with poor neurological outcomes(71/120)presented more pronounced alterations than those with good neurological outcomes.Binary logistic analysis revealed that a plasma iron concentration≤11.2μmol/L(odds ratio[OR]0.607,95% confidence interval[CI]0.455-0.808)and an NSE concentration≥20.5 ng/mL(OR 1.020,95%CI 1.005-1.035)on day 1 of ICU admission were associated with 28-day poor neurological outcomes.The plasma iron-NSE combination showed better predictive performance(area under the curve=0.935,sensitivity 89.8%,specificity 84.5%).CONCLUSION:Early post-ROSC plasma iron metabolism disturbances combined with NSE elevation were associated with the 28-day neurological prognosis,suggesting the therapeutic potential of targeting the iron metabolism pathway.展开更多
The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Maj...The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.展开更多
Comments were made on some thought-provoking articles,which included articles that dealt with cardiac arrest(CA).Two articles on CA elaborate on the role of automated compression devices to provide chest compressions ...Comments were made on some thought-provoking articles,which included articles that dealt with cardiac arrest(CA).Two articles on CA elaborate on the role of automated compression devices to provide chest compressions during cardiopulmonary resuscitation(CPR)in“hostile”environments and on a predictive model in cases of out-of-hospital CA(OHCA).CPR after CA has been practiced for centuries,and the evolution until current modern-day practices are discussed.The delay in adopting efficient techniques of resuscitation by the medical community for decades is also touched upon.Both in-hospital and OHCA are discussed along with guidelines and strategies to improve outcomes.Areas of possible research in the future are mentioned.展开更多
Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly select...Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly selected for the study from September 2022 to September 2023,Class A(52 students,conventional teaching method)and Class B(52 students,virtual reality combined with flipped classroom teaching mode).The assessment scores and independent learning ability scores of the students in the two classes were compared.Results:CPR theory and operation scores,passing rate,and independent learning ability scores of Class B were higher than those of Class A(P<0.05).Conclusion:the use of virtual reality combined with the flipped classroom teaching mode in CPR teaching is conducive to the improvement of students’assessment scores and independent learning ability.展开更多
Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membran...Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membranous nephropathy,who underwent treatment with prednisone and cyclosporine in 2016.In early 2017,the patient was diagnosed with a"fungal infection"and discontinued the use of cyclosporine.After one month of anti-infection therapy,a cranial magnetic resonance imaging scan showed multiple abscesses in the right temporal region.The diagnosis of nocardiosis was confirmed based on the presence of metastatic abscess masses,multiple lung and brain lesions,and a positive culture of Nocardia in the drainage.We changed the anti-infection therapy to a combination of trimethoprim-sulfamethoxazole(TMP-SMX),minocycline,and voriconazole.However,the patient experienced a sudden cardiac arrest and subsequently recovered after cardiopulmonary resuscitation.During the five-month follow-up period following the discharge,the patient displayed an enhanced nutritional status and stable renal function.The focal infection ultimately resolved during the subsequent three years.Neuro-infection caused by Nocardia should be considered in immunocompromised patients,and TMP-SMX is the preferred initial therapy;however,because of the high mortality rate,a long-term combination therapy with imipenem,cefotaxime,amikacin,and TMP-SMX is suggested.展开更多
Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is...Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.展开更多
Spinal surgery is usually performed in the prone position, which is a longer and more difficult procedure and is prone to complications such as circulatory dysfunction and stress injuries. Among them, stress injury is...Spinal surgery is usually performed in the prone position, which is a longer and more difficult procedure and is prone to complications such as circulatory dysfunction and stress injuries. Among them, stress injury is the main complication of prone spine surgery, but the reasons for stress injury in prone spine surgery are not clear, and whether prone cardiopulmonary resuscitation (CPR) can be used needs to be further verified. Supine cardiopulmonary resuscitation is commonly used in posterior spinal surgery, retroperitoneal surgery, and so on, which can effectively improve the patient’s hypoxemia. Such surgeries require a high level of anesthetic management, and cardiopulmonary resuscitation is necessary if a patient in a prone position experiences cardiac arrest. In the process of cardiopulmonary resuscitation, supine cardiopulmonary resuscitation is often used, especially for some obese patients, if they are immediately changed to the supine position, it takes up more time, there may be wound infection, and there is a possibility of missing the optimal rescue and resuscitation time. Based on this, this paper reviews the use of prone-position cardiopulmonary resuscitation for spinal surgery in the prone position.展开更多
Thirty-seven years have passed since the first K-1 resuscitation maneuver implementation next to both basic and advanced CPR failure and Prof.Inchauspe has consistently continued such unique research recovering impend...Thirty-seven years have passed since the first K-1 resuscitation maneuver implementation next to both basic and advanced CPR failure and Prof.Inchauspe has consistently continued such unique research recovering impending death situation victims in the most varied scenarios.After a dozen publications on the issue-mostly in World Journal of Critical Care Medicine and Hainan University Medical Editorial in China,the number of rescues increased to more than 195 cases.Having been contacted by experts in Ayurvedic medicine from India,the authors made a comparative analysis between said K-1 Yongquan and the Talahridaya points,and realized that not only are they located at the very same place for stimulation,but they are also integrated in the Reconciliation Vessel,a new Marvelous meridian discovered by Prof.Inchauspe within the Ancient Chinese classics.The following paper will show a statistical analysis made by Prof.Inchauspe and Dr.Saidman about the possible future impact that would result from the inclusion of the aforementioned maneuver in life support protocols.展开更多
文摘Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.
文摘Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.
文摘Acute myocardial infarction(AMI)is characterized by myocardial necrosis resulting from acute coronary circulatory insufficiency.In cases progressing to cardiac arrest,two interventions are important:sustained high-quality cardiopulmonary resuscitation(CPR)and prompt coronary reperfusion to minimize irreversible myocardial damage.With advances in emergency medical care,both emergency thrombolysis and extracorporeal cardiopulmonary resuscitation(ECPR)are utilized,even in prehospital treatment,thereby extending the golden window for rescuing such patients.
文摘The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.
基金Supported by Scientific Research Projects from Wuhan Municipal Health Commission of China,No.WX23B42.
文摘BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.
文摘Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using a self-administered questionnaire.Multiple logistic regression was conducted to test the associated factors with the dependent variables.Results:Only 9.3%of participants had a standardized level of knowledge,while 68.9%reported adequate skills for neonatal resuscitation.Factors associated with a standardized level of knowledge were age(p=0.001)and supportive supervision(p=0.007).Factors associated with the standardized practice level were the presence of hospital guidelines(p=0.028),previous training of nurses(p=0.011),and the presence of supportive supervision(p<0.001).Conclusions:The majority of emergency nurses in Hebron hospitals demonstrated a substandard level of knowledge of neonatal resuscitation.However,most of those nurses surprisingly reported a standardized practice level.The presence of hospital guidelines,training programs,or direct supervision for nurses are factors that can be considered to improve both knowledge and practice toward neonatal resuscitation among emergency nurses in Hebron.
基金supported by Major Scientific Research Special Project for High-level Talents in Health and Wellness,Hunan Province(R2023072)Project of Hunan Provincial Department of Finance(2050205)Hunan Provincial Department of Finance Project(050205).
文摘Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online databases,including PubMed,Embase,Web of Science,and the Cochrane Library.The articles included in this review were published from inception to July 31,2024.The Iain Crombie assessment tool was used to assess study quality.Meta-analysis was performed using RevMan(version 5.4)software.The review protocol has been registered with PROSPERO(CRD42024570491).Results A total of 1,434 research articles were initially identified,among which 18 were incorporated into this study,and all of the included studies were cross-sectional.Meta-analysis results demonstrated that gender(male;OR=1.37,95%CI:1.28–1.47),profession(healthcare provider;OR=0.17,95%CI:0.06–0.47),knowledge and skill level(OR=1.63,95%CI:1.25–2.11),willingness to undergo training(OR=2.68,95%CI:1.89–3.79),interest in first aid(OR=2.08,95%CI:1.60–2.69),previous training(OR=2.14,95%CI:1.49–3.08),and previous first-aid experience(OR=1.70,95%CI:1.37–2.11)were the principal influencing factors of the public’s willingness to engage in out-of-hospital cardiopulmonary resuscitation.Conclusion Demographic factors,knowledge,belief,and behavior are crucial in influencing public emergency decision-making.Medical personnel could create specialized training programs based on relevant factors to enhance the public's willingness to engage in out-of-hospital CPR.
文摘Objective:Cardiopulmonary resuscitation(CPR)is one of the most important life-saving procedures in the hospital.Contrary to medical guidelines,family presence during CPR is still not accepted in some countries.Family presence during CPR depends on the nurses’attitude,which is influenced by various factors.Emotional intelligence(EI)helps nurses make wise decisions and display responsible behavior,which is necessary for proper and good performance in nursing.The study’s purpose was to determine the attitude of acute care nurses toward family presence during CPR and its relationship with EI.Methods:The descriptive-analytical study was conducted among the nurses of acute care units(intensive care unit[ICU],critical care unit,and emergency department)in teaching hospitals of Qazvin University of Medical Sciences,Iran,in 2022-2023.A total of 186 nurses were included in the study using convenience sampling.The data collection tools were a checklist of demographic characteristics,nurses’attitude toward the presence of family scale,and Siberia Schering’s EI questionnaire.The collected data were analyzed using descriptive and analytical statistics and SPSS software.Results:The mean age of the participants was(32.05±6.93)years.Of 186 nurses participating in the study,127(68.3%)were women and the rest were men.The mean score of attitude was 47.41±9.41(the minimum score of the nurses was 19 and the maximum score was 95).The mean score of EI was 99.27±8.86(the minimum score was 69 and the maximum score was 128).The results of Pearson’s correlation coefficient showed no significant relationship between the total score of attitude and EI of the participants(P=0.588).Data analysis showed that only the self-arousal dimension of EI has a significant relationship with the range of family self-control behaviors in attitude(P=0.037).Conclusions:The results showed that the nurses of acute care units have a positive attitude toward the presence of the family during CPR and have high EI.Although no significant relationship was observed between the 2 variables,paying attention to the influencing factors on the attitude of the nurse toward family presence during CPR in different societies needs more research and investigation.
文摘BACKGROUND Return of spontaneous circulation(ROSC)following cardiopulmonary resuscitation(CPR)is a critical determinant of survival in patients experiencing cardiac arrest.This study aimed to investigate the relationship between the duration of CPR,the achievement of ROSC,and both short-term[intensive care unit(ICU)and in-hospital]and long-term survival outcomes in patients admitted to the medical intensive care unit(MICU)of Dr.Moopen’s Medical College Hospital,Wayanad,Kerala,India.AIM To assess how cardiopulmonary resuscitation duration impacts short-term and long-term survival in cardiac arrest patients in intensive care.METHODS A retrospective observational cohort study was conducted on adult patients who received CPR in the MICU between March 2023 and March 2024.Data were extracted from electronic medical records,including demographics,duration of CPR,ROSC achievement,and survival outcomes.Short-term survival was defined as survival to ICU discharge and in-hospital mortality,while long-term survival was assessed at six months post-arrest.Statistical analysis was performed using SPSS software,with Kaplan-Meier survival analysis and Cox regression used to identify predictors of mortality.RESULTS A total of 142 patients were included in the study.The median duration of CPR was 15 minutes.ROSC was achieved in 68 patients(47.9%).A significant association was observed between the duration of CPR and ROSC achievement(P<0.001).Patients who achieved ROSC early had significantly higher rates of short-term and longterm survival compared to those who did not(P<0.001).Each additional minute of CPR was associated with a 7%decrease in the odds of achieving ROSC.Longer CPR duration(HR:1.05,95%CI:1.02-1.08),absence of ROSC(HR:4.87,95%CI:2.31-10.28),older age(HR:1.03,95%CI:1.01-1.06)and unwitnessed arrest(HR:1.89,95%CI:1.05-3.41)were independent predictors of mortality.CONCLUSION Timely,effective cardiopulmonary resuscitation improves survival in intensive care.Duration significantly predicts return of circulation and outcomes.Further research should explore factors affecting resuscitation length and optimize treatment strategies.
基金supported by the National High Level Hospital Clinical Research Funding (2022-NHLHCRF-YS-03)the National Natural Science Foundation of China (82272196)。
文摘BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is essential for improving post-resuscitation survival.This study investigated the mechanisms and common targets of myocardial dysfunction and brain injury after resuscitation.METHODS:The male Sprague-Dawley rats(10–12 weeks old,400–500 g) were divided into two groups:the control group(n=6),which received sham surgery,and the CA/CPR group(n=10),which received ventricular fibrillation(VF) followed by CPR.After 24 h,brain and heart tissues were collected for analysis.The sequencing was used to identify differentially expressed genes(DEGs) between control and CA/CPR rats.RESULTS:At 24 h after resuscitation,CA/CPR rats presented 217 DEGs in the hippocampus and 80 DEGs in the left ventricle(LV) compared to the control group.In the hippocampus,the most notable biological process was the positive regulation of tumor necrosis factor production,with key pathways related to inflammation and the immune response.In the LV,the Gene Ontology(GO)enrichment analysis revealed that gene alterations were primarily associated with amyloid-beta clearance,a pathway that was also relevant in the brain.Eleven common targets were identified in the DEGs of both heart and brain tissues.The reverse transcription-polymerase chain reaction(RTPCR) validation revealed significant differences in the mRNA expression of Timp1,Apln,Ccl7,and Lgals3 in both LV and hippocampus.CONCLUSION:This study identified possible key genes and underlying mechanisms involved in PCAS.The differential genes Timp1,Apln,Ccl7,and Lgals3 might serve as common biomarkers for myocardial and neurological injury following resuscitation.
文摘BACKGROUNDRectal cancer is a common digestive tract malignancy influenced by genetic,dietary,and environmental factors.While traditional open surgery is effective,itoften leads to significant recovery challenges and complications.The da Vincirobotic system provides a minimally invasive option,enhancing precision andreducing recovery time.However,the anesthesia recovery phase is critical foreffective patient outcomes,particularly in older individuals.This study exploresthe impact of enhanced recovery after surgery(ERAS)-based anesthesia resuscitationon awakening quality in patients undergoing da Vinci robotic rectalcancer surgery,aiming to improve recovery protocols.AIMTo analyze the impact of anesthesia resuscitation interventions grounded in theprinciples of ERAS on the awakening quality of patients undergoing da Vincirobotic rectal cancer surgery.METHODSA total of 84 rectal cancer patients admitted from February 2021 to December 2022were selected and randomized into two groups:The control group(n=42)receivedconventional anesthesia recovery nursing care,while the study group(n=42)underwent anesthesia resuscitation interventions based on the ERAS framework.The quality of awakening,pain levels,vital signs,and complications werecompared between the two groups.RESULTSThe study group showed significantly shorter times for eye opening,extubation,orientation recovery,spontaneousrespiration,and anesthesia recovery room stay than the control group(P<0.05).Visual analog scale scores at 1hours,2 hours,4 hours,and 6 hours post-nursing were lower in the study group(P<0.05).In the control group,systolic blood pressure,diastolic blood pressure,heart rate,and respiratory rate at 10 minutes post-anesthesia werehigher than preoperative values(P<0.05),while no significant differences were found in the study group.Theseparameters were also lower in the study group at 10 minutes(P<0.05).The complication rate was significantlylower in the study group(4.76%)than in the control group(28.56%)(P<0.05).CONCLUSIONThe implementation of ERAS-based anesthesia resuscitation interventions in patients undergoing da Vinci roboticrectal cancer surgery enhances awakening quality,reduces complication rates,and helps stabilize vital signs.
基金approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(2020-SR-226).
文摘BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation(ECPR).METHODS:A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023.All the patients underwent a wholebody CT scan within 1 h of ECPR.Data regarding demographic and clinical characteristics were collected from electronic medical records.The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient.The primary outcome was 28-day survival.Receiver operating characteristic(ROC)curves were used to evaluate the ability of chest CT features(gravitydependent distribution and CT scores)to predict poor outcomes.The cut-off value of the CT score was determined.Kaplan-Meier curves were used to compare 28-day survival between the low-and high-CT score groups,which were classified using the estimated cut-off value.RESULTS:Among the 100 patients included,74 were non-survivors.The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors(P<0.05).Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution(P<0.05).The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually,demonstrating moderate performance(AUC:0.693,95%CI:0.568-0.801).According to the survival analysis,the risk of death increased as the CT score rose,with an estimated cut-off value of≥11(P=0.016).CONCLUSION:Chest CT features were associated with poor outcomes in CA patients following ECPR.
基金funded by the Shenzhen Key Medical Discipline Construction Fund(SZXK046)the Shenzhen Science and Technology Program(JCYJ20230807112007014).
文摘BACKGROUND:Iron metabolism dyshomeostasis is associated with ferroptosis and ischemiareperfusion injury.We aim to investigate post-cardiac arrest changes in plasma iron metabolism-related parameters and their prognostic value for 28-day neurological outcomes.METHODS:In this prospective observational cohort study,plasma iron metabolism-related parameters(iron,ferritin,hepcidin,soluble transferrin receptor[sTfR],total iron binding capacity[TIBC],and transferrin saturation),interleukin-6,and neuron-specific enolase(NSE)were assessed in 120 patients after restoration of spontaneous circulation(ROSC)on days 1 and 3 of intensive care unit(ICU)admission and in 40 healthy controls.The primary outcome was poor 28-day neurological prognosis.RESULTS:Compared to controls,post-ROSC patients exhibited significant plasma iron metabolism disturbances,including decreased iron,TIBC,transferrin saturation,with elevated hepcidin,ferritin,sTfR,interleukin-6,and NSE on day 1 after ICU admission(P<0.05 for all).On day 28 post-ROSC,patients with poor neurological outcomes(71/120)presented more pronounced alterations than those with good neurological outcomes.Binary logistic analysis revealed that a plasma iron concentration≤11.2μmol/L(odds ratio[OR]0.607,95% confidence interval[CI]0.455-0.808)and an NSE concentration≥20.5 ng/mL(OR 1.020,95%CI 1.005-1.035)on day 1 of ICU admission were associated with 28-day poor neurological outcomes.The plasma iron-NSE combination showed better predictive performance(area under the curve=0.935,sensitivity 89.8%,specificity 84.5%).CONCLUSION:Early post-ROSC plasma iron metabolism disturbances combined with NSE elevation were associated with the 28-day neurological prognosis,suggesting the therapeutic potential of targeting the iron metabolism pathway.
文摘The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.
文摘Comments were made on some thought-provoking articles,which included articles that dealt with cardiac arrest(CA).Two articles on CA elaborate on the role of automated compression devices to provide chest compressions during cardiopulmonary resuscitation(CPR)in“hostile”environments and on a predictive model in cases of out-of-hospital CA(OHCA).CPR after CA has been practiced for centuries,and the evolution until current modern-day practices are discussed.The delay in adopting efficient techniques of resuscitation by the medical community for decades is also touched upon.Both in-hospital and OHCA are discussed along with guidelines and strategies to improve outcomes.Areas of possible research in the future are mentioned.
文摘Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly selected for the study from September 2022 to September 2023,Class A(52 students,conventional teaching method)and Class B(52 students,virtual reality combined with flipped classroom teaching mode).The assessment scores and independent learning ability scores of the students in the two classes were compared.Results:CPR theory and operation scores,passing rate,and independent learning ability scores of Class B were higher than those of Class A(P<0.05).Conclusion:the use of virtual reality combined with the flipped classroom teaching mode in CPR teaching is conducive to the improvement of students’assessment scores and independent learning ability.
基金funded by grants from the National Natural Science Foundation of China(Grant No.81570666)International Society of Nephrology Clinical Research Program(Grant No.18-01-0247)+3 种基金Program of Jiangsu Clinical Research Center(Grant No.BL2014084)Jiangsu Province Key Medical Personnel Project(Grant No.ZDRCA2016002)CKD Anemia Research Foundation from China International Medical Foundation(Grant No.Z-2017-24-2037)Outstanding Young and Middle-aged Talents Support Program of the First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital).
文摘Nocardiosis manifests as an opportunistic infection,primarily affecting individuals who are immunocompromised and susceptible to the infection.We present a case study of one patient with nephrotic syndrome and membranous nephropathy,who underwent treatment with prednisone and cyclosporine in 2016.In early 2017,the patient was diagnosed with a"fungal infection"and discontinued the use of cyclosporine.After one month of anti-infection therapy,a cranial magnetic resonance imaging scan showed multiple abscesses in the right temporal region.The diagnosis of nocardiosis was confirmed based on the presence of metastatic abscess masses,multiple lung and brain lesions,and a positive culture of Nocardia in the drainage.We changed the anti-infection therapy to a combination of trimethoprim-sulfamethoxazole(TMP-SMX),minocycline,and voriconazole.However,the patient experienced a sudden cardiac arrest and subsequently recovered after cardiopulmonary resuscitation.During the five-month follow-up period following the discharge,the patient displayed an enhanced nutritional status and stable renal function.The focal infection ultimately resolved during the subsequent three years.Neuro-infection caused by Nocardia should be considered in immunocompromised patients,and TMP-SMX is the preferred initial therapy;however,because of the high mortality rate,a long-term combination therapy with imipenem,cefotaxime,amikacin,and TMP-SMX is suggested.
文摘Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.
文摘Spinal surgery is usually performed in the prone position, which is a longer and more difficult procedure and is prone to complications such as circulatory dysfunction and stress injuries. Among them, stress injury is the main complication of prone spine surgery, but the reasons for stress injury in prone spine surgery are not clear, and whether prone cardiopulmonary resuscitation (CPR) can be used needs to be further verified. Supine cardiopulmonary resuscitation is commonly used in posterior spinal surgery, retroperitoneal surgery, and so on, which can effectively improve the patient’s hypoxemia. Such surgeries require a high level of anesthetic management, and cardiopulmonary resuscitation is necessary if a patient in a prone position experiences cardiac arrest. In the process of cardiopulmonary resuscitation, supine cardiopulmonary resuscitation is often used, especially for some obese patients, if they are immediately changed to the supine position, it takes up more time, there may be wound infection, and there is a possibility of missing the optimal rescue and resuscitation time. Based on this, this paper reviews the use of prone-position cardiopulmonary resuscitation for spinal surgery in the prone position.
文摘Thirty-seven years have passed since the first K-1 resuscitation maneuver implementation next to both basic and advanced CPR failure and Prof.Inchauspe has consistently continued such unique research recovering impending death situation victims in the most varied scenarios.After a dozen publications on the issue-mostly in World Journal of Critical Care Medicine and Hainan University Medical Editorial in China,the number of rescues increased to more than 195 cases.Having been contacted by experts in Ayurvedic medicine from India,the authors made a comparative analysis between said K-1 Yongquan and the Talahridaya points,and realized that not only are they located at the very same place for stimulation,but they are also integrated in the Reconciliation Vessel,a new Marvelous meridian discovered by Prof.Inchauspe within the Ancient Chinese classics.The following paper will show a statistical analysis made by Prof.Inchauspe and Dr.Saidman about the possible future impact that would result from the inclusion of the aforementioned maneuver in life support protocols.
