Please click here if you wish to skip directly to the Table of Contents below. To learn more about our MedIntelliBase Custom Email Alerts, click here to complete our request form or contact us directly. Please click here to learn how to use this alert.

• Compress*
  • Advanced Circulatory Systems Inc (1)
  • Enerton Engineering Co.
  • Huntleigh Healthcare Inc. (1)
  • Nihon Seimitsu Sokki Co.
  • Pilling Surgical – Teleflex Medical (1)
  • Sims Pneu Pac Ltd.
  • Zoll Circulation (2)
• Resusc*
  • CW Medical Inc
  • Dixie EMS Supply (1)
  • Michigan Instruments, Inc (1)
  • Ambu
  • Armstrong Medical Industries
• Cardiopulmonary Resusc*
• Assist Device (2)
• External Cardiac Compress* (1)
• Adult
• Pediatric (2)
• CPR
  • Assist Device
  • External Cardiac Compress*
  • Adult (2)
  • Pediatric
• Acute
  • Heart Failure (1)
  • Lung Failure
  • Organ Support
• Chest Compression
• Chest Massage
• Circulatory Arrest
• Extracorporeal & Circulation (or Extra corporeal circulation or ECC)
  • Arrested Heart (1)
  • Cardiac Arrest (2)
• Extracorporeal lung assist
  • Arrested Heart
  • Cardiac Arrest
• Extracorporeal heart assist
  • Arrested Heart
  • Cardiac Arrest
• Extracorporeal system
  • Arrested Heart
  • Cardiac Arrest
• Heart Massage (3)
• Rhythmic Compression

(A small sampling of results from a October 1, 2006 to January 22, 2007 MIB Abstract Alert search)

Go to Archive

Vital organ blood flow with the impedance threshold device.

Crit Care Med. 2006 Dec;34(12 Suppl):S466-73.

Aufderheide TP, Lurie KG.

From the Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI (TPA); Advanced Circulatory Systems, Eden Prairie, MN (KGL); and the Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN (KGL).

OBJECTIVE:: The purpose of this study is to review cardiopulmonary resuscitation hemodynamics and vital organ blood flow in animal models with the use of the impedance threshold device (ITD) and to correlate these findings with the results of human clinical trials. RESULTS:: Animal studies have demonstrated near normalization of cerebral blood flow and an increase between 50% and 100% in cardiac blood flow with use of the ITD. Coincident coronary perfusion pressure is significantly increased with the ITD. Results of human clinical trials generally reflect the data seen in animal models, with near normal blood pressure during active compression-decompression cardiopulmonary resuscitation and the ITD, near doubling of blood pressure with standard cardiopulmonary resuscitation plus the ITD, and significantly increased short-term survival rates. CONCLUSIONS:: Improved vital organ perfusion with ITD use during cardiopulmonary resuscitation is an important advance in resuscitation. Incorporation of the ITD into protocols that improve other aspects of the care of patients during cardiac arrest and after successful resuscitation should result in further benefit from the ITD.

PreMedline Identifier: 17114979

***To access this PubMed use the PreMedline Identifier in the PubMed search field

AWARDS; Cardinal Health recognizes outstanding suppliers

Hospital Business Week December 3, 2006

During its recent annual national sales training meeting in San Antonio, Cardinal Health honored 41 leading manufacturers with awards for superior industry performance.

Winners represent organizations that provide products and services for the hospital supply, laboratory and ambulatory care distribution businesses of Cardinal Health.

"We are proud to recognize these exceptional suppliers for their contributions toward teamwork and shared commitment to excellence and passion for the customer," said Howard Jagoda, Cardinal Health's vice president of medical products vendor relations, Supply Chain Services. "These award winners display the qualities that contribute to an outstanding supplier/distributor relationship."

Cardinal Health uses numerous criteria to evaluate its suppliers including industry leadership, sales and marketing excellence, superior customer service, financial and operational standards and innovation in product and service solutions.

"We are focused on creating integrated solutions that improve the delivery and economics of healthcare. These awards recognize suppliers who share that focus, " said Eric Timm, Cardinal Health's vice president of marketing, Hospital Supply Distribution.

This year's award winners include: 3M Healthcare, Aircast, Aplus, B. Braun, Bard Medical Division, Bayer Corporation, Becton-Dickinson, bioMerieux, Colgate-Palmolive, Current Technologies, Dale Medical Products, DiaSorin, DJ Orthopedics, Ethicon Endo-Surgery, Ethicon Inc., Ever Scientific, Gillette Company, Huntleigh Healthcare, J & J ASP, JumpTech, Lagasse, Mabis Healthcare, Mead Johnson, Medex, Medi-Flex Inc., MedTox Laboratories, Midmark Medical, Molnlycke Healthcare, Nerl Diagnostics, Ortho-Clinical Diagnostics, Paperpak Products, Professional Disposables International, Print Media, Procter & Gamble, Roche Diagnostics, Sage Products, Sakura Finetek, Smith & Nephew, Tyco Healthcare - Kendall, Wampole and Welch Allyn.

* To access this Lexis-Nexis article the user must create an account.

2007 New Year's Resolution: Sleep better for better overall health

Business Wire. New York: Jan 9, 2007. pg. n/a

Sleep apnea, which is linked to cardiovascular risk factors, diabetes and obesity, can be helped through the Hybrid(TM) Full Face Mask from Teleflex Medical

Teleflex Medical

Christianna Vance, 919-433-4809

cvance@teleflexmedical.com

A variety of surveys show that millions of Americans have welcomed the New Year by resolving to improve their health with exercise and diet. However, medical studies suggest that combating obstructive sleep apnea (OSA) may also contribute to good health. More than an annoyance to a snorer's family, OSA is a suspected link to cardiovascular risk factors. For example, an estimated 50 percent of sleep apnea patients have high blood pressure. OSA is also linked to obesity and diabetes, as well as diminished concentration and daytime performance. The Hybrid Universal Interface from Teleflex Medical is one way to treat obstructive sleep apnea.

The Hybrid is a dual airway mask designed to provide continuous positive airway pressure (CPAP) and help OSA patients breathe more easily at night. According to Dr. Natalio J. Chediak of the Boca Raton Sleep Center, "Both our technologists and patients found fitting the Hybrid to be a simple task. Its nasal inserts and oral cushion sizes make the mask versatile in its application and use at home. The Hybrid's unique fit also gives patients an unobstructed view, so they can read before bedtime to relax. The comfortable design also eliminates the abrasions on the forehead and the nose that we usually see with more traditional full face masks."

For information on how to obtain the Hybrid Universal Interface from Teleflex Medical, click onto www.teleflexmedical.com/prod_sleeptherapy.php, or you may call Christianna Vance at 919-433-4809.

About Teleflex Medical

Teleflex Medical, a division of Teleflex Incorporated, is a leading global supplier of disposable medical products, surgical instruments and medical devices. The division supports health providers along the continuum of care in three main areas:

-- Devices for sleep therapy, respiratory care, anesthesia and urology

-- Medical devices, instruments and specialty sutures used in surgery

-- Design and manufacture of specialty products for medical device manufacturers.

Teleflex Medical markets health care supplies under the Hudson RCI(R) and Rusch(R) brand names and surgical instruments and medical devices under the Beere(R), Deknatel(R), KMedic(R), Pilling(R) and Weck(R) brands.

About Teleflex Incorporated

Teleflex Incorporated is a diversified company that designs, manufactures and distributes quality-engineered products and services for the automotive, medical, aerospace, marine, and industrial markets worldwide. Headquartered in Limerick, Pa., with operations in 24 countries, Teleflex employs more than 20,000 people worldwide who focus on providing innovative solutions for customers. Additional information about Teleflex can be obtained from the company's website at www.teleflex.com.

Hybrid is a trademark of Respcare Inc. Beere, KMedic, Pilling and Weck are registered trademarks of Teleflex Incorporated. Hudson RCI is a registered trademark of Teleflex Medical Incorporated. Deknatel is a registered trademark of Teleflex-CT Devices Incorporated. Rusch is a registered trademark of Willy Rusch GmbH.

Proquest Identifier: 1191745981
* To access this Proquest article the user must create an account.

AHA guidelines say CPR is back in the spotlight ... for ZOLL, it never left.

Emerg Med Serv. 2006 Nov;35(11):suppl 1-4.

[No authors listed]

**No Abstract Available**

PreMedline Identifier: 17131745

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Medical Devices; ZOLL receives marketing clearance for "code-ready" defibrillator from Health Canada

Managed Care Weekly Digest. Atlanta: Jan 22, 2007. pg. 72

2007 JAN 22 - (NewsRx.com) -- ZOLL Medical Corporation (ZOLL), a manufacturer of resuscitation devices and related software solutions, announced that it has received a Medical Device License from Health Canada for the ZOLL R Series, which company believes is the first "code-ready" defibrillator.

The license provides the necessary approval for the marketing and sale of the device in Canada.

According to Richard A. Packer, president and chief executive officer of ZOLL, "We define code-ready as a device that is simple and always ready to use. The R series offers a one step system that simplifies and speeds up deployment of pacing and defibrillation therapy."

The R series also offers See-Thru CPR functionality that helps clinicians reduce interruptions. While clinicians are viewing the ECG on a monitor/defibrillator, artifact (i.e., "noise") from manual chest compressions makes it difficult to discern the presence of an organized heart rhythm unless compressions are halted. See-Thru CPR filters out this artifact so that clinicians can view an underlying rhythm without stopping chest compressions.

The device also has a visual aid known as the CPR Index that allows clinicians to see how well they are performing the rate and depth of chest compressions in real time. All CPR performance data and the entire resuscitation record, including the ECG, can be downloaded into ZOLL CodeNet and reviewed for quality assurance and training purposes.

ZOLL markets and sells its products in more than 140 countries. The company has direct operations, distributor networks, and business partners throughout the U.S., Canada, Latin America, Europe, the Middle East and Africa, Asia, and Australia.

This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2007, Managed Care Weekly Digest via NewsRx.com.

Proquest Identifier: 1195876231
* To access this Proquest article the user must create an account.

Identify the Key & Niche Companies Operating in the World's Medical Oxygen Systems Industry

Business Wire. New York: Sep 11, 2006. pg. 1

Research and Markets Laura Wood, press@researchandmarkets.com fax: +353 1 4100 980

Research and Markets (http://www.researchandmarkets.com/reports/c41884) has announced the addition of Medical Oxygen Systems - Global Strategic Business Report to their offering.

This report analyzes the worldwide markets for Medical Oxygen Systems in Millions of US$. The specific product segments analyzed are Oxygen Concentrators, Liquid Oxygen Systems, Oxygen Cylinders & Regulators, and Oxygen Conserving Devices. The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, and Rest of World. Annual forecasts are provided for each region and product segment for the period of 2000 through 2010. The report profiles 82 companies including many key and niche players worldwide such as AirSep, Chad Therapeutics, Inc., Invacare Corporation, Mallinckrodt, Inc., Respironics, and Sunrise Medical, Inc.

[Table]
Topics Covered
___I. INTRODUCTION, METHODOLOGY & PRODUCT DEFINITIONS
___1. Global Market Outlook & Analysis___
___2. Trends and Issues___
___3. Home Healthcare Market
___4. An Overview of Home Oxygen Therapy Market___
___5. Product Overview___
___6. Product Developments / Introductions___
___7. Recent Industry Activity___
___8. Focus on Select Global Players___
___9. Global Market Perspective___

II. MARKET
___1. United States___
___2. Canada___
___3. Japan___
___4. Europe___
___5. Rest of World___

III. COMPETITION

Companies Mentioned

- Aero All-Gas Co (USA) - Air Products and Chemicals, Inc (USA) - Airgas, Inc (USA) - Airox (France) - AirSep Corporation- Medical Products Div (USA) - Allied Healthcare Products, Inc (USA) - Ambu, Inc (USA) - Americair (USA) - American HomePatient, Inc (USA) - American Medical Equipment Company (USA) - Andonian Cryogenics, Inc (USA) - Apria Healthcare Group, Inc (USA) - BOC Group Plc (The) (UK) - Caire, Inc (USA) - Chad Therapeutics, Inc (USA) - Chart Industries, Inc (USA) - Chest MI, Inc (Japan) - Complete Care, Inc (USA) - Cryofab, Inc (USA) - Daikin Industries Ltd (Japan) - Dalton Medical Corporation (USA) - Dixie EMS Supply USA (USA) - Dyna Med (Canada) - Emergency Medical International, Inc (USA) - Essex Cryogenics Of Missouri, Inc (USA) - Ferno Washington, Inc (USA) - Fukuda Sangyo Co, Ltd (Japan) - GC Industries (USA) - GF Health Products, Inc (USA) - Gulf South Medical Supply, Inc (USA) - HealthFirst Corporation (USA) - Hudson Respiratory Care, Inc (USA) - II-VI, Inc (USA) - Intermed Equipamento Medico Hospitalar LTDA (Brazil) - Invacare Corporation (USA) - Kee Medical Services (USA) - Keeler Instruments, Inc (USA) - Keen Compressed Gas Company (USA) - Kroeber Medizintechnik GmbH (Germany) - L'Air Liquide SA (France) - Lamprecht AG Healthcare Div (Switzerland) - Lewin Medical Supply (USA) - Life Corporation (USA) - Linde Gas AG (Germany) - Mada Medical Products, Inc (USA) - Matheson Tri-Gas, Inc (USA) - Mayo Healthcare Pty, Ltd (Australia) - Medel Italiana SpA (Italy) - Medic Master, Inc (USA) - Medicare Hospital Equipment CC (South Africa) - Medline (USA) - Metro Med, Inc (USA) - Mountain Aire Medical Supply, Inc (USA) - MR Resources, Inc (USA) - MSS Ltd (Canada) - Nidek Medical Products, Inc (USA) - Ocenco, Inc (USA) - Oxlife, Inc (USA) - OxySure Systems, Inc (USA) - Oxytech Co, Ltd (Korea) - Pacific Consolidated Industries LLP (USA) - Pangas Healthcare (Switzerland) - Penox Technologies, Inc (USA) - Pneupac Ltd (UK) - Praxair, Inc (USA) - Radiometer America, Inc (USA) - Red Ball Oxygen Co, Inc (USA) - Respironics, Inc (USA) - Rockford Medical & Safety Co (USA) - Scott Specialty Gases, Inc (USA) - Sequal Technologies, Inc (USA) - SIM Italia Srl (Italy) - Sunrise Medical, Inc (USA) - Taylor Wharton (USA) - The Aftermarket Group (USA) - Three Village Medical Supplies, Inc (USA) - Tyco International Ltd (Bermuda) - U O Equipment Co (USA) - Victor Medical Products (USA) - WT Farley, Inc (USA) - Welders Supply (USA) - Yamato Sanki Co, Ltd (Japan)

For more information visit http://www.researchandmarkets.com/reports/c41884

Proquest Identifier: 1125723541
* To access this Proquest article the user must create an account.

The natural biochemical changes during ventricular fibrillation with cardiopulmonary resuscitation and the onset of postdefibrillation pulseless electrical activity.

Am J Emerg Med. 2006 Sep;24(5):577-81.

Geddes LA, Roeder RA, Rundell AE, Otlewski MP, Kemeny AE, Lottes AE.
Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907-2022, USA. geddes@ecn.purdue.edu

OBJECTIVE: The objective of this study was to document the biochemical changes during ventricular fibrillation (VF) with cardiopulmonary resuscitation (CPR), and to identify factors associated with postdefibrillation pulseless electrical activity (PD-PEA). BACKGROUND: It has been reliably estimated that as much as 60% of out-of-hospital sudden cardiac death can be attributed to the onset of PD-PEA (Niemann JT, Cruz B, Garner D et al. Immediate countershock versus CPR before countershock in a 5-minute swine model of ventricular fibrillation arrest. Ann Emerg Med 2000;36:543-6). Previous attempts to treat reversible causes of pulseless electrical activity have not been successful clinically (Niemann JT, Stratton SJ, Cruz B, Lewis RJ. Outcome of out-of-hospital postcountershock asystole and pulseless electrical activity versus primary asystole and pulseless electrical activity. Crit Care Med 2001;29:2366-70). METHODS: This investigation used 22 studies on 14 anesthetized pigs breathing 100% oxygen. Ventricular fibrillation was induced with a right ventricular catheter electrode, and the chest was compressed with a pneumatically driven Chest Thumper (Michigan Instruments) (80-100 lb at 60/min). The electrocardiogram and aortic pressure were recorded continuously. Arterial pH, P(O2), P(CO2), Na+, K+, Ca2+, Cl-, SaO2, glucose, hematocrit, and hemoglobin level were measured at selected times. Ventricular defibrillation was achieved with transchest electrodes. RESULTS: Typically, during VF with CPR, mean aortic pressure was 20 to 25 mm Hg. In all cases aortic P(O2) decreased to about 20% of the initial value in 10 minutes, and aortic blood K+ increased by 50% in 6 minutes. By 5 to 8 minutes, the incidence of PD-PEA was 50%. CONCLUSION: Ventricular fibrillation duration, arterial K+, and arterial P(CO2) were statistically correlated with the onset of PD-PEA in this study. In addition, trends suggest an association of mean arterial blood pressure and arterial P(O2) with the onset of PD-PEA.

PreMedline Identifier: 16938597

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Co-infection with two Chlamydophila species in a case of fulminant myocarditis*

Crit Care Med. 2007 Jan 3; [Epub ahead of print]

Walder G, Gritsch W, Wiedermann CJ, Polzl G, Laufer G, Hotzel H, Berndt A, Pankuweit S, Theegarten D, Anhenn O, Oehme A, Dierich MP, Wurzner R.

From the Department of Hygiene, Microbiology and Social Medicine (GW, MPD, RW), Department of Internal Medicine (WG, CJW, GP), and Department of Cardiac Surgery (GL), Innsbruck Medical University, Innsbruck, Austria; Friedrich Loeffler Institute, Federal Research Institute for Animal Health, Jena, Germany (HH, AB); Clinic of Cardiology, Philipps-University Marburg, Marburg, Germany (SP); Institute of Pathology, Ruhr-University Bochum, Bochum, Germany (DT, OA); Institute of Medical Microbiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany (AO).

OBJECTIVE:: The aim of this study is to describe a case of fulminant myocarditis caused by co-infection with Chlamydophila pneumoniae and Chlamydophila psittaci in order to facilitate diagnosis and clinical management of patients suffering from this rare but life-threatening condition. DESIGN:: Case report. SETTING:: Intensive care unit of Innsbruck Medical University. PATIENT:: A 24-yr-old patient admitted with septicemia and cardiac failure. INTERVENTIONS:: Cardiopulmonary resuscitation, extracorporal membrane oxygenation, implantation of an extracorporal cardiac assist device, and antibiotic treatment with erythromycin. MEASUREMENTS AND MAIN RESULTS:: Cp. pneumoniae and Cp. psittaci were identified by means of polymerase chain reaction and electron microscopy in the patient's myocytes. Successful weaning off the ventricular assist device was performed within 2 wks after commencement of antibiotic therapy. CONCLUSIONS:: This case report demonstrates co-infection with Cp. pneumoniae and Cp. psittaci to be a hitherto unknown cause of fulminant myocarditis. There is a particular risk of misdiagnosis of viral myocarditis, which must be avoided. Patients should be transferred to a center where extracorporal membrane oxygenation therapy and molecular diagnosis of all members of the family Chlamydiaceae are available.

PreMedline Identifier: 17204998

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Aero-medical evacuation with interventional lung assist in lung failure patients.

Resuscitation. 2007 Feb;72(2):280-285. Epub 2006 Nov 28.

Kjaergaard B, Christensen T, Neumann PB, Nurnberg B.

Medical Corps, Royal Danish Air Force, Denmark; Department of Cardiothoracic Surgery, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Skodshoej 2, DK-9530 Stoevring, Denmark; Institute of Clinical Medicine, Aarhus University, Denmark.

OBJECTIVE: Acute respiratory failure can make long distance transport by air extremely difficult. Despite pressurised cabins, the pressure will fall to about three quarters of one atmosphere, and the oxygen partial pressure will fall proportionally. Interventional lung assist (iLA) is a well documented treatment in the critical care unit, but has not been evaluated scientifically in long range aero-medical evacuation. The present animal study was performed to test the feasibility of treating lung failure with iLA during intercontinental air evacuation in a military setting. METHODS: Eight adult female pigs were cannulated in the right axillary artery and the right jugular vein. An arterio-venous iLA device (Novalung((R))) was connected. The ventilator was adjusted to below half of the needed minute volume before the use of iLA. The animals went through different modalities of transportation in ambulances, helicopters and aircraft. Two of the pigs were tested in a hypobaric chamber, and the remaining two animals underwent a 7.5h intercontinental transportation from Denmark to Greenland in a Hercules C130J transport airplane. RESULTS: It was possible to maintain physiological PaCO(2) and PaO(2) in normal flight altitudes with iLA. Compared to pump-driven ECMO systems iLA is safer and more efficient. The current study demonstrates the feasibility of iLA during military aero-medical evacuation.

PreMedline Identifier: 17126982

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Intralipid outperforms sodium bicarbonate in a rabbit model of clomipramine toxicity.

Ann Emerg Med. 2007 Feb;49(2):178-85, 185.e1-4. Epub 2006 Nov 13.

Harvey M, Cave G.

Department of Emergency Medicine, Waikato Hospital, Hamilton, New Zealand. harveym@waikatodhb.govt.nz

STUDY OBJECTIVE: Previous investigators have demonstrated amelioration of lipid-soluble drug toxidromes with infusion of lipid emulsions. Clomipramine is a lipid-soluble tricyclic antidepressant with significant cardiovascular depressant activity in human overdose. We compare resuscitation with Intralipid versus sodium bicarbonate in a rabbit model of clomipramine toxicity. METHODS: Thirty sedated and mechanically ventilated New Zealand White rabbits were infused with clomipramine at 320 mg/kg per hour. At target mean arterial pressure of 50% initial mean arterial pressure, animals were rescued with 0.9% NaCl 12 mL/kg, 8.4% sodium bicarbonate 3 mL/kg, or 20% Intralipid 12 mL/kg. Pulse rate, mean arterial pressure, and QRS duration were sampled at 2.5-minute intervals to 15 minutes. In the second phase of the experiment, 8 sedated and mechanically ventilated rabbits were infused with clomipramine at 240 mg/kg per hour to a mean arterial pressure of 25 mm Hg. Animals received either 2 mL/kg 8.4% sodium bicarbonate or 8 mL/kg 20% Intralipid as rescue therapy. External cardiac compression and intravenous adrenaline were administered in the event of cardiovascular collapse. RESULTS: Mean difference in mean arterial pressure between Intralipid- and saline solution-treated groups was 21.1 mm Hg (95% confidence interval [CI] 13.5 to 28.7 mm Hg) and 19.5 mm Hg (95% CI 10.5 to 28.9 mm Hg) at 5 and 15 minutes, respectively. Mean difference in mean arterial pressure between Intralipid- and bicarbonate-treated groups was 19.4 mm Hg (95% CI 18.8 to 27.0 mm Hg) and 11.5 mm Hg (95% CI 2.5 to 20.5 mm Hg) at 5 and 15 minutes. The rate of change in mean arterial pressure was greatest in the Intralipid-treated group at 3 minutes (6.2 mm Hg/min [95% CI 3.8 to 8.6 mm Hg/min] Intralipid versus -0.25 mm Hg/min [95% CI -1.9 to 1.4 mm Hg/min] saline solution) and 5 minutes (4.4 mm Hg/min [95% CI 3.0 to 5.9 mm Hg/min] Intralipid versus 0.06 mm Hg/min [95% CI -0.9 to 1.1 mm Hg/min] saline solution). In the second phase of the experiment spontaneous circulation was maintained in all Intralipid-treated rabbits (n=4). All animals in the bicarbonate-treated group developed pulseless electrical activity and proved refractory to resuscitation at 10 minutes (n=4, P=.023). CONCLUSION: In this rabbit model, Intralipid infusion resulted in more rapid and complete reversal of clomipramine-induced hypotension compared with sodium bicarbonate. Additionally, Intralipid infusion prevented cardiovascular collapse in a model of severe clomipramine toxicity.

PreMedline Identifier: 17098328

***To access this PubMed use the PreMedline Identifier in the PubMed search field

[Cardiorespiratory arrest in children with trauma]

An Pediatr (Barc). 2006 Nov;65(5):439-47.

[Article in Spanish]

Lopez-Herce Cid J, Dominguez Sampedro P, Rodriguez Nunez A, Garcia Sanz C, Carrillo Alvarez A, Calvo Macias C, Bellon Cano JM; Grupo Espanol de Estudio de la Parada Cardiorrespiratoria en Ninos.

Seccion de Cuidados Intensivos Pediatricos, Hospital General Universitario Gregorio Maranon, Madrid, Espana. pielvi@ya.com

OBJECTIVE: To analyze the characteristics and outcome of cardiorespiratory arrest secondary to trauma in children. PATIENTS AND METHODS: We performed a secondary analysis of data from a prospective, multicenter study of cardiorespiratory arrest in children. Data were recorded according to the Utstein style. Twenty-eight children (age range: 7 days to 16 years) with cardiorespiratory arrest secondary to trauma were evaluated. The outcome variables were return of spontaneous circulation, sustained (more than 20 minutes) return of spontaneous circulation (initial survival), and survival at hospital discharge (final survival) in relation to the characteristics of the cardiorespiratory arrest and cardiopulmonary resuscitation. Neurological and general performance outcome was assessed by means of the Pediatric Cerebral Performance Category scale and the Pediatric Overall Performance Category scale. RESULTS: Return of spontaneous circulation was obtained in 18 patients (64.2 %), initial survival was achieved in 14 (50 %) and final survival was achieved in three (10.7 %) (two without neurological sequelae and one with vegetative status). Final survival was significantly higher in patients with respiratory arrest (33.3 %) than in those with cardiac arrest (4.5 %), p = 0.04. Final survival was also higher in patients with a duration of cardiopulmonary resuscitation shorter than 20 minutes (27.2 %) than in the remaining patients (0 %), p =0.05. The two survivors without neurologic sequelae had respiratory arrest. CONCLUSIONS: Survival until hospital discharge in children with cardiorespiratory arrest secondary to trauma is lower than that in children with cardiorespiratory arrest. Patients with respiratory arrest when resuscitation is started and those with a duration of cardiopulmonary resuscitation of less than 20 minutes showed better survival than the remaining patients.

PreMedline Identifier: 17184604

***To access this PubMed use the PreMedline Identifier in the PubMed search field

[Pediatric advanced life support]

An Pediatr (Barc). 2006 Oct;65(4):342-63.

[Article in Spanish]

Castellanos Ortega A, Rey Galan C, Alvarez Carrillo A, Lopez-Herce Cid J, Delgado Dominguez MA.

Servicio de Cuidados Intensivos. Residencia Cantabria. Santander. Espana.

Advanced life support (ALS) includes all the procedures and maneuvers used to restore spontaneous circulation and breathing, thus minimizing brain injury. The fundamental steps of ALS are airway control with adjuncts, ventilation with 100% oxygen, vascular access and fluid and drug administration, and monitoring to diagnose and treat arrhythmias. Airway control can be achieved by means of oropharyngeal airway, endotracheal intubation, and alternative methods (laryngeal mask and cricothyroidotomy). Vascular access can be achieved by the peripheral venous, intraosseous, central venous, and tracheal routes. The most frequent rhythms found in children with cardiorespiratory arrest are nonshockable (asystole, severe bradycardia, pulseless electrical activity, and complete atrioventricular block). In these cases, adrenaline continues to be the essential drug. Currently, low adrenaline doses (0.01 mg/kg IV and 0.1 mg/kg intratracheal administration) are recommended throughout the resuscitation period. Amiodarone (5 mg/kg) is the drug of choice in cases of ventricular fibrillation refractory to electric shock. The treatment sequence for shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia) is one 4 J/kg electric shock, followed by cardiopulmonary resuscitation (chest compressions and ventilation) for 2 minutes with subsequent reassessment of the electrocardiographic rhythm. Adrenaline must be administered immediately before the third electric shock and subsequently every 3-5 minutes. Amiodarone must be administered immediately before the fourth shock.

PreMedline Identifier: 17153762

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Evaluation of emergency medical dispatch in out-of-hospital cardiac arrest in Taipei.

Resuscitation. 2007 Jan 19; [Epub ahead of print]

Ma MH, Lu TC, Ng JC, Lin CH, Chiang WC, Ko PC, Shih FY, Huang CH, Hsiung KH, Chen SC, Chen WJ.

Department of Emergency Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.

INTRODUCTION: Emergency medical dispatchers are the entry points to the emergency medical services (EMS). The overall performances of the dispatchers are imperative determinants of the emergency medical services dispatching system. There is little data on the cultural and language impacts on emergency medical dispatch. OBJECTIVE: This study examined the emotional content and cooperation score (ECCS) among Mandarin Chinese speaking callers for cardiac arrests, and evaluated the performances of emergency medical services dispatching system in Taipei. METHODS: This retrospective, observational study examined dispatching audio recordings obtained from the Taipei City Fire Department Dispatching Center between January 2004 to April 2004. The tapes of call relating to adult (age >/=18 years), non-traumatic cases with a presumed or field diagnosis of out-of-hospital cardiac arrest (OHCA) underwent systemic review. The caller's ECCS and the dispatcher's performances, including interview skills, provision of telephone-assisted cardiopulmonary resuscitation (T-CPR), and dispatcher's ability to identify OHCA were examined. Interrater reliability for determining ECCS and interview skills were assessed using kappa statistic. RESULTS: A total of 199 audio recordings were reviewed. A mean ECCS of 1.42+/-0.64 (95% CI: 1.33-1.51) demonstrated that most callers were emotionally stable and cooperative when calling for help, even when facing cardiac arrest patients. There was a good association between ECCS and the sex of the callers (male 1.32 versus female 1.49; p<0.05). In 82% of interviews, the interview skills of the dispatchers was high (4 or 5 points); while in one fifth the interview skills were suboptimal. About one third of the cases were provided with T-CPR by the dispatchers. The sensitivity and positive predictive value (PPV) for predicting OHCA by dispatchers were 96.9% and 97.9%, respectively. A kappa value of 0.65 and 0.68 were obtained for the interrater reliability of ECCS and interview skills. CONCLUSION: Most callers were found to be emotional stable and cooperative with dispatcher's interrogations when calling for cardiac arrest victims in this Mandarin speaking population. The dispatchers have shown satisfactory interview skills in approaching emergency calls and a good ability to identify OHCA. There is a low rate of T-CPR offered to the callers in the investigation. Efforts should be made to address the deficiencies in order to maximise the function of the EMS.

PreMedline Identifier: 17241736

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Gas concentrations in expired air during basic life support using different ratios of compression to ventilation.

Resuscitation. 2007 Jan 20; [Epub ahead of print]

Eisenburger P, Funk GC, Burda G, Sterz FR, Laggner AN, Herkner H.

Department of Emergency Medicine, Medical University Vienna, Waehringer Guertel 18-20/6D, A-1090 Vienna, Austria.

AIM: In cardiopulmonary resuscitation, different ratios of compression to ventilation with regard to optimal oxygen transport are considered. We hypothesised that the end tidal fraction of oxygen might increase from levels found in the conventional compression-ventilation ratio of 15:2 if more consecutive ventilations are given because the rescuer would hyperventilate. The second hypothesis was that the air blown into an infant with mouth to mouth ventilation consists of rescuer's dead space air only, meaning that the fraction of oxygen should increase. METHODS: In a basic life support simulation, we measured the expired air of rescuers using a VmaxST((R)) (Sensormedics, USA) respiratory gas analyser connected to an adult and to an infant resuscitation manikin. Fourteen participants performed five different compression-ventilation ratios (30:2, 30:5, 50:5, 100:10 and 5:1). These were compared to a ratio of 15:2 (control group). RESULTS: We found a significant increase in end tidal oxygen in 30:2 (16.3%), 30:5 (16.8%), 50:5 (16.8%), 100:10 (17.0%) compared to 15:2 (15.9%), p</=0.004 for all groups versus control; p for trend: 0.014. In the infant CPR observation (ratio 5:1), the difference with the adult control group (15:2) also reached statistical significance (17.9% versus 15.9%, p=0.0005). CONCLUSION: Increasing consecutive compressions and ventilations above 15:2 leads to a statistically significant increase in expired fraction of oxygen. In infant ventilation, the air exhaled into a victim contains some dead space air with a higher end tidal oxygen fraction than in adults.

PreMedline Identifier: 17241731

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers.

Can J Cardiol. 2007 Jan;23(1):21-45.

Arnold JM, Howlett JG, Dorian P, Ducharme A, Giannetti N, Haddad H, Heckman GA, Ignaszewski A, Isaac D, Jong P, Liu P, Mann E, McKelvie RS, Moe GW, Parker JD, Svendsen AM, Tsuyuki RT, O'halloran K, Ross HJ, Rao V, Sequeira EJ, White M.

University of Western Ontario, London, Canada.

Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada.

PreMedline Identifier: 17245481

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Hemodynamic energy generated by a combined centrifugal pump with an intra-aortic balloon pump.

ASAIO J. 2006 Sep-Oct;52(5):592-4.

Lim CH, Son HS, Fang YH, Lee JJ, Baik KJ, Kim KH, Kim BS, Lee HW, Sun K.
Anesthesiology and Pain Medicine, Korea University, Seoul, Korea.

We examined the pulsatility generated by an intra-aortic balloon pump/centrifugal pump (IABP/CP) combination in terms of energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE). In five cardiac-arrested pigs, the outflow cannula of the CP was inserted into the ascending aorta, the inflow cannula in the right atrium. A 30-ml IABP was subsequently placed in the descending aorta. Extracorporeal circulation was maintained for 30 minutes using a pump flow of 75 ml/kg per minute by CP alone or by IABP/CP with pressure and flow measured in the right internal carotid artery. The IABP/CP combination converted the flow to pulsatile and increased pulse pressure significantly from 9.1 +/- 1.3 mm Hg to 54.9 +/- 6.1 mm Hg (p = 0.012). It also significantly increased the percent change from mean arterial pressure to EEP from 0.2 +/- 0.3% to 23.3 +/- 6.1% (p = 0.012) and SHE from 133.2 +/- 234.5 erg/cm to 20,219.8 +/- 5842.7 erg/cm3 (p = 0.012). However, no statistical difference was observed between CP and IABP/CP in terms of mean carotid artery pressure (p = NS). In a cardiac-arrested animal model, pulsatility generated by a IABP/CP combination may be effective in terms of energy equivalent pressure and surplus hemodynamic energy.

PreMedline Identifier: 16966865

***To access this PubMed use the PreMedline Identifier in the PubMed search field

[Severe accidental hypothermia with cardiac arrest and extracorporeal rewarming : A case report of a 2-year-old child.]

Anaesthesist. 2006 Nov 10; [Epub ahead of print]

[Article in German]

Maisch S, Ntalakoura K, Boettcher H, Helmke K, Friederich P, Goetz AE.

Klinik fur Anasthesiologie, Universitatsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Deutschland, maisch@uke.uni-hamburg.de.

In patients with severe hypothermia and cardiac arrest, active rewarming is recommended by extracorporeal circulation with cardiopulmonary bypass. The current guidelines for resuscitation of the European Resuscitation Council now include the recommendation regarding patients with hypothermia remaining comatose after initial resuscitation to accomplish an active rewarming only up to a temperature of 32-34 degrees C and to maintain a mild hypothermia for 12-24 h. We report the case of a 2-year-old boy who suffered from severe hypothermia after falling into ice-cold water. On discovery cardiac arrest with asystole was present and the first measured temperature was 23.8 degrees C. Resuscitation led to restoration of spontaneous circulation. The patient was rewarmed by extracorporeal circulation with cardiopulmonary bypass to 33 degrees C then mild hypothermia was maintained for a further 12 h. On the third day after the accident the patient was extubated and after a further 9 days was discharged without any sequelae.

PreMedline Identifier: 17096105

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia.

Minerva Anestesiol. 2006 Sep;72(9):763-6.

Arnaoutoglou H, Petrou A, Tefa L, Drossos G, Matsagas M, Papadopoulos G.

Department of Anesthesia and Postoperative Intensive Care, University of Ioannina Medical School, Ioannina, Greece. keme42002@yahoo.gr

Extracorporeal circulation could be effective for cardiac resuscitation in patients who do not respond to ''Advanced cardiac life support'' (ACLS), but cannot guarantee brain survival. A case of successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia, in a 48 year-old man with cardiac arrest due to cardiac tamponade, is reported. The good long term neurologic outcome of the patient is also described.

PreMedline Identifier: 16871157

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Post-mortem administration of urokinase in canine lung transplantation from non-heart-beating donors.

J Heart Lung Transplant. 2006 Sep;25(9):1148-53.

Sugimoto R, Date H, Sugimoto S, Okazaki M, Aokage K, Inokawa H, Aoe M, Sano Y.

Department of Cancer and Thoracic Surgery, Surgery II, Okayama University Graduate School, Okayama, Japan.

BACKGROUND: We previously reported that post-mortem heparinization by closed-chest cardiac massage within 30 minutes after cardiac arrest is beneficial in lung transplantation (LTx) from non-heart-beating donors (NHBDs) by preventing formation of microthrombi. In this study, we evaluated the effects of post-mortem administration of urokinase 60 minutes after cardiac arrest. METHODS: Left LTx was performed in 12 pairs of mongrel dogs. Donors were sacrificed and left at room temperature for 2 hours. In Group 1 (n = 6), heparin sodium (1,000 U/kg) was administered intravenously 60 minutes after cardiac arrest, then closed-chest cardiac massage was performed for 1 minute to distribute the heparin. In Group 2 (n = 6), the donors were treated as in Group 1, except, in addition to heparin sodium, urokinase (120,000 U) was administered intravenously before and at the end of cardiac massage. After 2 hours of cardiac arrest, donor lungs were flushed with low-potassium dextran glucose solution. After left LTx, the right pulmonary artery was ligated, and recipients were followed up for 3 hours. Uni- and multivariate repeat analyses were performed to obtain statistical data. RESULTS: Group 2 had significantly better arterial oxygen tension, lower pulmonary vascular resistance and lower wet/dry weight ratio of the transplanted lung than Group 1. d-dimer level during the warm ischemia was significantly lower in Group 2 than in Group 1. CONCLUSIONS: Post-mortem administration of urokinase along with heparin is beneficial in LTx from NHBDs by fibrinolytic action on already formed pulmonary microthrombi in the cadaver donor lungs.

PreMedline Identifier: 16962479

***To access this PubMed use the PreMedline Identifier in the PubMed search field

The need for head rotation and abdominal compressions during bystander cardiopulmonary resuscitation.

Am J Emerg Med. 2006 Sep;24(5):573-6.

Rottenberg EM.

Department of Perioperative Services, The Ohio State University Medical Center, Columbus, OH 43210-1228, USA. rottenberg.1@osu.edu

The current AHA-ECC guidelines for basic life support focus on the provision of good chest compressions with minimal interruptions for patients with presumed out-of-hospital cardiac arrest. Moreover, international consensus guidelines now support the use of chest compression-only cardiopulmonary resuscitation (CPR) instructions for dispatcher-assisted CPR given over the phone to untrained bystanders. However, evidence that strongly challenge these recommendations have been overlooked. A review of this evidence argues for the need for head rotation (a hands-free method of airway control) and abdominal compressions during bystander CPR.

PreMedline Identifier: 16938596

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Bumpversion vs. thumpversion.

Int J Cardiol. 2006 Nov 10;113(2):247. Epub 2005 Nov 21.

Cheng TO.

**No Abstract Available**

PreMedline Identifier: 16303192

***To access this PubMed use the PreMedline Identifier in the PubMed search field

Please click here if you wish to return to the Table of Contents listing the most recent abstract database additions.

If you wish to know more about our MedIntelliBase Custom Email Alert service, please complete our request form or contact us directly for assistance. Our contact information is noted below.

Thank you for your interest in learning what our services can do to empower you -

The Next Phase® Inc. - Medical Technology Consultancy & Publishing
Redmond, WA, USA
Website - www.MedIntelliBase.com