Archive for the 'Cardiac Arrest' Category

26 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Conclusion

The fact that there was return of neurologic function in 8 of the 10 patients and strong evidence of potential neurologic viability in 4 of the 10 patients is promising. Neurologic function did not return after the short-acting paralytic and sedative drug effects had worn off despite the maintenance of adequate oxygenation, BP, and cardiac […]

24 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Discussion

Our study is consistent with the results of Hartz et al and Tisherman et al and fails to show marked improvement in survival in cardiac arrest patients treated with CPB. Our study does, however, indicate that CPB initiated by ED physicians is feasible. Since previous studies have indicated the importance of proper patient selection and […]

22 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Summary of Previous CPB Studies

Four of the six ED survivors developed multiorgan system failure. In two of these patients, this was the direct cause of death. The other two patients were declared clinically brain dead and therapy, including mechanical ventilation, was withdrawn. One patient died of sepsis secondary to a perforated viscus after the decision was made to forgo […]

20 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Oxygen Transport Variables

It is of note that 8 of the 10 patients began to show signs of neurologic recovery soon after initiating CPB. This ranged from spontaneous respiratory efforts to purposeful movements. Four of the patients had sustained purposeful movements within 1 h of instituting CPB and required sedation and paralysis. Although low doses of a short-acting […]

18 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Summary of all patients’ characteristics

A brief summary of all patients’ characteristics and histories are presented in Table 1. The actual time of arrest was unknown in cases 7 and 10. Case 7 was a patient with a hypothermic arrest found by EMS. In case 10, the original history was that the arrest was witnessed. On further questioning of the […]

14 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Study

Once the patient was on CPB, CPR was discontinued and the ventilatory rate was decreased to 5 breaths/min with tidal volume of 12 to 15 mL/kg to maintain functional residual capacity. Patients were defibrillated as needed. Radial or femoral arterial lines were placed in all patients for monitoring BP. Vasopressors (norepinephrine or epinephrine) were used […]

12 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest: Materials and Methods

This study was approved by the Human Rights Committee (Institutional Review Board) of Henry Ford Hospital, Detroit. Patients with either out-of-hospital cardiac arrest or emergency department (ED) cardiac arrest that was unresponsive to ACLS therapy were considered for entry into the study. Patients were eligible for enrollment if they met the following criteria: age older […]

10 Apr

Emergency Department Cardiopulmonary Bypass in the Treatment of Human Cardiac Arrest

Since the introduction of cardiopulmonary resus citation (CPR) over 20 years ago, it has become apparent that CPR alone is not as effective in saving lives as initially hoped. If CPR and advanced cardiac life support (ACLS) techniques do not quickly restore spontaneous circulation, the chances for survival decline rapidly. A maximum resuscitation time of […]

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