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Query: KEGG:D01401 (CPR)
 1,683 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hospital mortality was examined in all patients successfully resuscitated from a witnessed out-of-hospital cardiac arrest due to ventricular fibrillation over a 1-yr period. Variables independently predictive of hospital mortality were a history of congestive heart failure before cardiac arrest, the time between collapse and initiation of CPR, and the time between collapse and restoration of circulation. The latter time was not related to either patient age or clinical history. Thus, hospital mortality was predetermined by prehospital factors, some of which can be changed.
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PMID:Predictors of hospital mortality after out-of-hospital cardiopulmonary resuscitation. 405 42

The antifibrillatory effects of lidocaine and bretylium in the postcardiopulmonary resuscitation (CPR) setting were examined using ventricular fibrillation threshold (VFT) determinations in anesthetized dogs. The dogs were fibrillated and CPR was carried out with a pneumatic device. Lidocaine and bretylium were administered intravenously at the onset of CPR, and VFT was serially determined after defibrillation following three consecutive 3-minute CPR periods. A dose of 2 mg/kg of lidocaine caused a significant increase in VFT determinations after the first but not subsequent 3-minute CPR periods; a dose of 1 mg/kg of lidocaine was ineffective at any time point. A dose of 5 mg/kg of bretylium elevated the VFT after the second and third but not the first 3-minute period. In dogs who received lidocaine, a significant elevation of VFT determinations were found to be associated with a high blood lidocaine concentration (mean 13.8 +/- 8.3 micrograms/ml). The present study demonstrates that a 2 mg/kg dose of lidocaine administered during CPR rapidly increases VFT determinations after CPR (within 5 minutes), whereas, a 5 mg/kg dose of bretylium significantly elevates VFT determinations but at a later time (within 10 minutes). The observed significant effect of lidocaine appears to be associated with high lidocaine blood concentrations (greater than 6 micrograms/ml).
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PMID:Antifibrillatory effects of lidocaine and bretylium immediately postcardiopulmonary resuscitation. 406 Dec 67

We used retinal fluorescein photoangiography to determine the circulation time (CTv-a) from the inferior vena cava (IVC) to the retinal artery in anesthetized, intubated, paralyzed, and fibrillated dogs. Animals received either standard CPR (SCPR) (n = 11) or modified CPR (MCPR) (n = 11) manually at 60 compressions per minute in both groups. MCPR consisted of simultaneous ventilation-compression with abdominal binding to 40 mm Hg. SCPR or MCPR was begun immediately after inducing ventricular fibrillation and was performed for an average of 4.5 minutes prior to bolus injection of fluorescein dye (0.7 mL, 25% solution). To compare CTv-a in the two groups, dye was injected through a catheter into the IVC (below the diaphragm) and timed, rapid, sequential retinal photoangiography was begun. The time to first appearance of dye in the retinal vasculature initially was determined visually by the camera operator and later was substantiated photographically. The camera simultaneously photographed the retinal vasculature and the built-in timer, thus displaying the elapsed time from injection on each frame. Our results showed a significantly shorter CTv-a in the MCPR group (58.9 seconds +/- 18.6) when compared to the SCPR group (112.6 seconds +/- 47.4; P less than .01). In addition, we have documented retinal blood flow during CPR.
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PMID:Circulation time during standard and modified manual CPR determined by retinal photoangiography. 406 84

The following parameters were monitored simultaneously in 15 dogs, in order to evaluate the efficacy of conventional CPR (C-CPR), new CPR (N-CPR), and open-chest CPR (O-CPR) on cerebral perfusion: arterial blood pressure (BP), central venous pressure (CVP), intrathoracic airway pressure, blood flow in carotid artery, intracranial pressure (ICP), sagittal sinus blood flow (sinus BF) and pressure (sinus P), and blood flow in cerebral cortex (cortical BF). The sinus blood flow was measured by the direct-method and with a cannulating electromagnetic flowmeter. The cortical blood flow was measured with a termocouple tissue flowmeter. Intracranial pressure was obtained by measuring subarachnoid cerebrospinal fluid pressure. Ventricular fibrillation was induced electrically. Chest compression and ventilation were always done manually in all cardiopulmonary resuscitation. The mean blood pressures during C-CPR, N-CPR and O-CPR were 52, 68 and 95 mmHg, respectively, and mean carotid blood flows per stroke were 36, 71 and 131% of the control values, respectively. The intracranial pressures were 30, 42 and 36 mmHg, respectively, giving the calculated cerebral perfusion pressures (BP-ICP) of 22, 27 and 60 mmHg, respectively. This should have been reflected in cerebral blood flow. Sinus blood flows/min were 18, 18 and 42%, and sinus blood flows per stroke were 55, 45 and 127% of control values, respectively; the differences between C-CPR and N-CPR were not significant. This was also true for cortical blood flow. From this we conclude that, firstly, N-CPR is not significantly better than C-CPR in cerebral perfusion because of its accompanying high intracranial pressure, secondly, O-CPR is far superior to the other two methods in respect of cerebral perfusion.
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PMID:Cerebral blood flow during conventional, new and open-chest cardio-pulmonary resuscitation in dogs. 609 Dec 3

Between January 1979 and December 1982, 84 patients between the ages of 1 and 39 years presented to the emergency department in a state of cardiac arrest. There were 58 male patients (69%) and 26 female patients (31%) in the group. Presenting rhythms were ventricular fibrillation (37%), asystole (37%), idioventricular rhythm (14%), heart block (4%), bradycardia (4%), ventricular tachycardia (3%), and electromechanical dissociation (3%). Thirty-two percent had bystander CPR. Of 21 patients initially resuscitated (25%), only four (5%) survived to discharge from the hospital. All survivors were neurologically intact. Seventy-five of the 80 patients who died (90%) underwent autopsy. Cause of death in the five remaining patients was inferred from clinical history. Etiologies of the cardiac arrests were the following: toxic exposure or ingestion (26%), atherosclerotic heart disease (23%), undetermined (11%), pulmonary embolism (6%), hemorrhage (6%), epilepsy (2%), cardiomyopathy (7%), myocarditis (2%), pneumonia (4%), and one case each of airway obstruction, asthma, peptic disease, and septic shock. Diverse etiologies should lead to a diagnostic search for reversible conditions in young patients. The prognosis for hospital discharge is poorer in the young population than is reported in our overall cardiac arrest population; however, numbers of neurologically intact survivors are similar in the young and the overall cardiac arrest population.
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PMID:Cardiac arrest under age 40: etiology and prognosis. 648 35

The addition of abdominal counterpulsation to standard cardiopulmonary resuscitation (AC-CPR) during ventricular fibrillation has been shown to improve cardiac output, oxygen uptake, and central arterial blood pressure in dogs. The present study was performed to determine the effect of AC-CPR on regional blood flow. Regional blood flow was measured with radioactively labeled microspheres during sinus rhythm and during alternate periods of AC-CPR and standard CPR (STD-CPR) in nine dogs anesthetized with pentobarbital. Blood pressures and oxygen uptake were measured continuously. As in previous studies, diastolic arterial pressure was higher (30.8%) during AC-CPR than during STD-CPR, as were cardiac output (24.5%) and oxygen uptake (37.5%). Whole brain and myocardial blood flow increased 12.0% and 22.7%, respectively, during AC-CPR. Blood flow to abdominal organs was not changed appreciably in response to abdominal compression, and postmortem examination revealed no gross trauma to the abdominal viscera. The AC-CPR technique is simple and is easily added to present basic life support procedures. In light of the improvements observed in myocardial and cerebral blood flow, AC-CPR could significantly improve the outcome of CPR attempts.
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PMID:Regional blood flow during cardiopulmonary resuscitation with abdominal counterpulsation in dogs. 651 91

This study compares CPR with orciprenaline (8 dogs), with epinephrine (11 dogs) and without any drug (8 dogs) in cardiac arrest caused by anoxia. Resuscitation was successful in all animals of the epinephrine group and in 2 of the orciprenaline group. Spontaneous circulation could not be restored in any of the control animals. There was no difference in the occurrence of ventricular fibrillation between the drug groups. No fibrillation occurred in the controls. On the other hand, the incidence of successful defibrillation was significantly higher with epinephrine. The superiority of epinephrine was due to its having effected a significantly higher diastolic pressure during cardiac massage. The diastolic pressure decreased after orciprenaline injection to such an extent that coronary underperfusion resulted with consequent rise of serum CPK. We conclude that the use of orciprenaline is contraindicated in cardiac arrest.
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PMID:[Orciprenaline (Alupent) in resuscitation for circulatory arrest? Experimental comparison between orciprenaline and adrenaline in dogs]. 661 23

Most sudden cardiac deaths in man are associated with events causing myocardial ischemia and only 40-60% of these patients are successfully resuscitated. Further progress in reducing the mortality from such events will depend on a better understanding of the interventions used during CPR. Animal models currently used for the study of CPR do not involve myocardial ischemia. A new model of cardiac arrest (spontaneous ischemic ventricular fibrillation) in closed-chest dogs resembles more closely the events occurring in man. Initial controlled, randomized studies of the model demonstrate that it responds to resuscitation in a manner similar to human resuscitation. Further study of this model during CPR may lead to changes in patient care which will improve survival from episodes of sudden cardiac death.
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PMID:Spontaneous ischemic ventricular fibrillation in dogs: a new model for the study of cardiopulmonary resuscitation. 662 58

A total of 139 patients had transthoracic pacemakers introduced via a subxiphoid approach for asystole during advanced CPR in the emergency department of a large urban teaching hospital over a calendar year. Two groups were examined retrospectively, A) 34 patients who presented asystolic, and B) 99 patients who presented with ventricular fibrillation that became asystole. Age, sex, and etiologies for cardiac arrest were similar in both groups; there were no survivors. The mean duration of asystole before pacemaker insertion was 4 min (group A) to 7 min (group B). Temporary electrical capture was obtained in six patients from group B, but electrical-mechanical association could not be achieved in any of these patients.
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PMID:Transthoracic pacing in cardiac asystole. 668 Jun 29

One hundred eighty-seven cases of cardiac arrest of presumed cardiac etiology were analyzed to determine factors associated with successful out-of-hospital management by paramedic teams. Field and in-hospital records were reviewed to determine the response time of the advanced life support team, the ECG rhythm on arrival, the presence of paramedics on scene at the time of the arrest, whether bystander CPR had been initiated, and the eventual outcome of the resuscitation attempt. A significant difference in survival-to-leave-hospital was seen in patients in whom ventricular fibrillation or ventricular tachycardia (VF/VT) was present on arrival (15.3%) compared to patients with asystole, idioventricular rhythms, blocks, or electromechanical dissociation (3.4%). Survival rates in patients in whom CPR was being performed by a bystander were 24% in the VF/VT group and zero in the "OTHER" rhythms group. When the advanced life support team arrived in less than four minutes, survival rates in the VF/VT group and "OTHER" rhythms group were 23.1% and 7.7%, respectively. When the field team arrived in less than four minutes and a bystander was performing CPR, the survival rates were 42.9% in the VF/VT group and 15.8% in the "OTHER." These data suggest that efforts to improve survival from out-of-hospital cardiac arrest in a community should be directed toward public education, reduction in response times of paramedic units, and lay CPR training.
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PMID:Out-of-hospital cardiac arrest: factors associated with survival. 670 29


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