Odomacosta0292
We reported the first case of lung herniation after cardiopulmonary resuscitation (CPR) with a mechanical chest compression device and a literature review. Older age, long CPR duration, mechanical ventilation, and rib fracture were risk factors. Subcutaneous emphysema was the most common manifestation and indication for further computed tomography to make a definite diagnosis. Despite its rarity, physicians should keep a high awareness of this possible fetal complication. Further studies comparing mechanical and manual CPR for the risk of lung herniation are warranted.
The gray-white-matter ratio (GWR) measured on brain computed tomography (CT) following return of spontaneous circulation (ROSC) has been reported to be helpful in the prognostication of mortality or comatose status of cardiac arrest victims. However, whether the use of GWR in predicting the outcomes in out-of-hospital cardiac arrest (OHCA) survivors in Taiwan population remains uninvestigated.
This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic OHCA adults (> 18 years old) with sustained ROSC (≥ 20 minutes) during the period from 2006 to 2014. Patients with following exclusion criteria were further excluded no brain CT within 24 hours following ROSC; the presence of intracranial hemorrhage, severe old insult, brain tumor, ventriculoperitoneal shunt, and severe image artifact. Autophagy inhibitor The GWR values were obtained from the density measurement of bilateral putamen, caudate nuclei, posterior limbs of internal capsule, corpus callosum, mediall outcomes.
The use of GWR measured on bran CT within 24 hours following ROSC can help in predicting survival-to-hospital discharge and neurological outcome in OHCA survivors.
The use of GWR measured on bran CT within 24 hours following ROSC can help in predicting survival-to-hospital discharge and neurological outcome in OHCA survivors.
Traumatic brain injuries (TBIs) is a leading cause of death, disability, and resources consumption. Cerebral hemorrhagic contusions are primary brain lesion and often one of the most visible lesions following TBIs. Interleukin-one beta (
) is pro-inflammatory cytokines it is circulatory level and gene have been implicated in secondary brain injury and worse outcome following TBIs. This study is to determine the significance role of
gene polymorphism (-511C/T) and circulatory level for prediction trauma severity and outcome in traumatic cerebral hemorrhagic contusion.
The study population includes 90 Sudanese patients with traumatic cerebral hemorrhagic and 90 apparently healthy individuals as control. IL-1β serum concentration was measured using enzyme-linked immunosorbent assay and
gene was genotyped using restriction fragment length polymorphism-polymerase chain reaction.
Significant elevation of IL-1β level was seen among trauma patients compared to control (
-value < 0.001). Although there was no significant association between IL-1β level with trauma severity or death; IL-1β level was higher in severe brain injures compared with moderate and mild one, and the mean concentration of IL-1β was high (18.75 pg/mL) among patient developed poor outcome compared to survivals (15.17 pg/mL). T recessive allele of
gene was detected in 13.3% of participant. The highest circulatory level of IL-1β (17.8 pg/mL) was observed among patients with TT homozygous alleles.
gene polymorphism was not associated with trauma severity and death.
IL-1β circulatory level was varied according to trauma severity and highly levels were seen among patients developed unfavorable outcome.
511C/T gene was not associated with trauma severity and outcome.
IL-1β circulatory level was varied according to trauma severity and highly levels were seen among patients developed unfavorable outcome. IL-1β-511C/T gene was not associated with trauma severity and outcome.
Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices.
This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices.
We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both
< 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (
< 0.001). VL also improved the glottic view performance during post-course assessments.
VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
To investigate the association of clinical and hematological parameters with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA).
Clinical data of successive non-traumatic adult OHCA patients with available laboratory data of complete blood count and peripheral blood smear at emergency department (ED) arrival were requested. Hematological parameters were collected and calculated, and logistic regression and survival analysis were performed for association of ROSC with the parameters.
From December 2015 to December 2016, a total of 188 OHCA patients transported to our ED were enrolled. In ROSC group, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signifi cantly higher and smudge cell count was signifi cantly lower when compared with non-ROSC group. In the univariate regression, NLR more than 2.0 (odds ratio [OR] 2.40, 95% confi dence interval [CI] 1.31-4.41;
= 0.004) and smudge cell count less than 0.45 °- 109/L (OR 0.33, 95% CI 0.15-0.71;
= 0.