Browsing by Subject "CPR"
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Item Correlation of End-Tidal Carbon Dioxide to Neurological Outcome in Out-of-Hospital Cardiac Arrest(2014-12-01) Phillips, Sabrina D.; Kirchhoff, Claire; Gwirtz, Patricia A.; Mukerjee, AninditaBackground: Previous studies have established that end tidal carbon dioxide (ETCO2) can positively predict a return of spontaneous circulation (ROSC) and survivability in out-of-hospital cardiac arrest (OHCA). Objective: To assess if ETCO2 predicts neurological outcome as measured by cerebral performance category (CPC) score in an independent cohort of patients suffering OHCA. Methods: This was a retrospective chart review conducted at MedStar Mobile Healthcare of patients who suffered non-traumatic OHCA between January 2014 and July 2014. ETCO2 values were continuously recorded while standard advanced cardiac life support (ACLS) protocols were followed. Results: OHCA was confirmed in 689 patients. ACLS was initiated in 421 patients. Of those, 214 patients were transported to the hospital. There was a good neurologic outcome (CPC 1or 2) in 22 patients and a poor neurologic outcome (CPC of 3, 4, or 5) in 183 patients. Initial ETCO2 (p=0.027, OR 1.002, 95% CI 1.000-1.003) and ETCO2 after ROSC (p=0.007, OR 0.997, 95% CI 0.995-0.999) were correlated to neurological outcome when using binary logistic regression. Conclusion: Initial ETCO2 and ETCO2 after ROSC are predictors of neurological outcome in OHCA. After further research this data can be incorporated into criteria on whether to perform cardiopulmonary resuscitation on patients suffering OHCA.Item INTRAVENOUS PYRUVATE FOR CARDIAC ARREST DOES NOT CAUSE PERSISTENT HYPERNATREMIA(2013-04-12) Cherry, BrandonPurpose: Intravenous infusion of sodium pyruvate can protect internal organs from ischemia-reperfusion imposed by cardiac arrest and resuscitation, but may produce hypernatremia due to the sodium load. The purpose of this study was to examine the effects of Na-pyruvate infusion on plasma pyruvate, bicarbonate and sodium concentrations in order to test the hypothesis that pyruvate infusion does not cause persistent hypernatremia. Methods: Swine were subjected to 6 min cardiac arrest, 4 min closed-chest CPR, defibrillation and 4 h recovery. Na-pyruvate (n=7) or NaCl control (n=9) were infused iv (0.1 mmol/kg/min) during CPR and the first 60 min recovery. Results: Pyruvate infusion produced a sustained increase in plasma bicarbonate concentration (44.2 ± 1.2 mM in pyruvate-treated vs. 27.5 ± 2.6 mM in NaCl-treated group at 3 hours post-treatment; P<0.05), which may potentially offset post-arrest acidemia. Although pyruvate and NaCl infusions similarly increased plasma sodium concentrations (146 ± 2 mM and 148 ± l mM, respectively), the hypernatremia resolved to pre-arrest concentrations by 3 h post-pyruvate (140 ± 1 mM), but persisted 3 h post-NaCl (147 ± 2 mM; P<0.05). Conclusions: This study confirms the hypothesis that pyruvate administration after cardiac arrest did not cause persistent hypernatremia.Item North Texas Health & Science - 2011, Issue 2(University of North Texas Health Science Center at Fort Worth, 2011-01-01)