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Sample records for aggressive fluid resuscitation

  1. Aggressive Fluid Resuscitation in Severe Pediatric Hyperglycemic Hyperosmolar Syndrome: A Case Report

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    Srinivas Murthy

    2010-01-01

    Full Text Available Objective. This report describes a severe case of hyperglycemic hyperosmolar syndrome complicated by rhabdomyolysis, acute kidney injury, hyperthermia, and hypovolemic shock, with management centred upon fluid administration. Design. Case report. Setting. Pediatric intensive care unit in university teaching hospital. Patients. 12 years old adolescent female presenting with hyperglycemic hyperosmolar syndrome with a new diagnosis of type 2 diabetes mellitus. Intervention. Aggressive fluid resuscitation and insulin. Main results. The patient had a good outcome, discharged home on hospital day 6. Conclusions. Hyperglycemic hyperosmolar syndrome is associated with a number of complications. Management strategies are undefined, given the rarity of its presentation, and further studies are warranted.

  2. Aggressive Fluid Resuscitation in Severe Pediatric Hyperglycemic Hyperosmolar Syndrome: A Case Report

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    Sharara-Chami Rana

    2010-03-01

    Full Text Available Objective. This report describes a severe case of hyperglycemic hyperosmolar syndrome complicated by rhabdomyolysis, acute kidney injury, hyperthermia, and hypovolemic shock, with management centred upon fluid administration. Design. Case report. Setting. Pediatric intensive care unit in university teaching hospital. Patients. 12 years old adolescent female presenting with hyperglycemic hyperosmolar syndrome with a new diagnosis of type 2 diabetes mellitus. Intervention. Aggressive fluid resuscitation and insulin. Main results. The patient had a good outcome, discharged home on hospital day 6. Conclusions. Hyperglycemic hyperosmolar syndrome is associated with a number of complications. Management strategies are undefined, given the rarity of its presentation, and further studies are warranted.

  3. Fluid resuscitation in trauma

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    Rudra A

    2006-01-01

    Full Text Available Appropriate fluid replacement is an essential component of trauma fluid resuscitation. Once hemorrhage is controlled, restoration of normovolemia is a priority. In the presence of uncontrolled haemorrhage, aggressive fluid management may be harmful. The crystalloid-colloid debate continues but existing clinical practice is more likely to reflect local biases rather than evidence based medicine. Colloids vary substantially in their pharmacology and pharmacokinetics,and the experimental finding based on one colloid cannot be extrapolated reliably to another. In the initial stages of trauma resuscitation the precise fluid used is probably not important as long as an appropriate volume is given. Later, when the microcirculation is ′leaky′, there may be some advantages to high or medium weight colloids such as hydroxyethyl starch. Hypertonic saline solutions may have some benefit in patients with head injuries. A number of hemoglobin solutions are under development, but one of the most promising of these has been withdrawn recently. It is highly likely that at least one of these solutions will eventually become routine therapy for trauma patient resuscitation. In the meantime, contrary to traditional teaching, recent data suggest that restrictive strategy of red cell transfusion may improve outcome in some critically ill patients.

  4. The Physiologic Basis of Burn Shock and the Need for Aggressive Fluid Resuscitation.

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    Rae, Lisa; Fidler, Philip; Gibran, Nicole

    2016-10-01

    Burn trauma in the current age of medical care still portends a 3% to 8% mortality. Of patients who die from their burn injuries, 58% of deaths occur in the first 72 hours after injury, indicating death from the initial burn shock is still a major cause of burn mortality. Significant thermal injury incites an inflammatory response, which distinguishes burns from other trauma. This article focuses on the current understanding of the pathophysiology of burn shock, the inflammatory response, and the direction of research and targeted therapies to improve resuscitation, morbidity, and mortality.

  5. Early Management and Fluid Resuscitation

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    Kaya Yorgancı

    2011-07-01

    Full Text Available Initial management of severely burned patient is similar with a trauma victim. Determination of airway patency, evaluation of respiration and circulation, early recognition of concomitant trauma has vital importance in burn patients. In the early phase, mortality mainly depends on missed or un-treated severe injuries or pathologies, but not burn injury itself.In patients that have TBSA greater than 15 %, fluid resuscitation should be started. In the first 24 hours, crystalloid solutions should be preferred. .Several formulas can guide fluid resuscitation; however the amount of fluid that is given to the patient should be individualized according to the patient’s need. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 7-10

  6. Fluid therapy for septic shock resuscitation: which fluid should be used?

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    Corrêa, Thiago Domingos; Rocha, Leonardo Lima; Pessoa, Camila Menezes Souza; Silva, Eliézer; de Assuncao, Murillo Santucci Cesar

    2015-01-01

    Early resuscitation of septic shock patients reduces the sepsis-related morbidity and mortality. The main goals of septic shock resuscitation include volemic expansion, maintenance of adequate tissue perfusion and oxygen delivery, guided by central venous pressure, mean arterial pressure, mixed or central venous oxygen saturation and arterial lactate levels. An aggressive fluid resuscitation, possibly in association with vasopressors, inotropes and red blood cell concentrate transfusion may be necessary to achieve those hemodynamic goals. Nonetheless, even though fluid administration is one of the most common interventions offered to critically ill patients, the most appropriate type of fluid to be used remains controversial. According to recently published clinical trials, crystalloid solutions seem to be the most appropriate type of fluids for initial resuscitation of septic shock patients. Balanced crystalloids have theoretical advantages over the classic solutions, but there is not enough evidence to indicate it as first-line treatment. Additionally, when large amounts of fluids are necessary to restore the hemodynamic stability, albumin solutions may be a safe and effective alternative. Hydroxyethyl starches solutions must be avoided in septic patients due to the increased risk of acute renal failure, increased need for renal replacement therapy and increased mortality. Our objective was to present a narrative review of the literature regarding the major types of fluids and their main drawbacks in the initial resuscitation of the septic shock patients. PMID:26313437

  7. New tools for optimizing fluid resuscitation in acute pancreatitis

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    Bortolotti, Perrine; Saulnier, Fabienne; Colling, Delphine; Redheuil, Alban; Preau, Sebastien

    2014-01-01

    Acute pancreatitis (AP) is a frequent disease with degrees of increasing severity responsible for high morbidity. Despite continuous improvement in care, mortality remains significant. Because hypovolemia, together with microcirculatory dysfunction lead to poor outcome, fluid therapy remains a cornerstone of the supportive treatment. However, poor clinical evidence actually support the aggressive fluid therapy recommended in recent guidelines since available data are controversial. Fluid management remains unclear and leads to current heterogeneous practice. Different strategies may help to improve fluid resuscitation in AP. On one hand, integration of fluid therapy in a global hemodynamic resuscitation has been demonstrated to improve outcome in surgical or septic patients. Tailored fluid administration after early identification of patients with high-risk of poor outcome presenting inadequate tissue oxygenation is a major part of this strategy. On the other hand, new decision parameters have been developed recently to improve safety and efficiency of fluid therapy in critically ill patients. In this review, we propose a personalized strategy integrating these new concepts in the early fluid management of AP. This new approach paves the way to a wide range of clinical studies in the field of AP. PMID:25473163

  8. The ebb and flow of fluid (as in resuscitation).

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    Mattox, K L

    2015-04-01

    Since the early 1960's "resuscitation" following major trauma involved use of replacement crystalloid fluid/estimated blood loss in volumes of 3/1, in the ambulance, emergency room, operating room and surgical intensive care unit. During the past 20 years, MAJOR paradigm shifts have occurred in this concept. As a result hypotensive resuscitation with a view towards restriction of crystalloid, and prevention of complications has occurred. Improved results in both civilian and military environments have been reported. As a result there is new focus on trauma surgical involvement in all aspects of trauma patient management, focus on early aggressive surgical approaches (which may or may not involve an operation), and movement from crystalloid to blood, plasma, and platelet replacement therapy.

  9. Early difference in apoptosis of intestinal mucosa of rats with severe uncontrolled hemorrhagic shock after three fluid resuscitation methods

    Institute of Scientific and Technical Information of China (English)

    LU Yuan-qiang; CAI Xiu-jun; GU Lin-hui; WANG Qi; HUANG Wei-dong; BAO De-guo

    2006-01-01

    @@ Hemorrhagic shock is a common clinical emergency case. Successful treatment is usually accomplished by surgical control of hemorrhage and restoration of tissue perfusion. The fluid resuscitation method in the presurgical care of the hypotensive trauma patients is controversial.Current guidelines for presurgical treatment of patients with hemorrhagic shock recommend rapid volume resuscitation to normal blood pressure as quickly as possible. The practice is controversial because aggressive restoration of intravascular volume and rapid increase of blood pressure before securing hemostasis may exacerbate hemorrhage and worsen outcome. Controlled fluid resuscitation allows pre-hospital treatment to work with compensatory mechanisms. The concept is to restore some intravascular fluid while respecting hemostatic mechanisms. Such a scheme would balance the mutually exclusive processes of tissue perfusion and hemostasis.

  10. Fluid resuscitation management in patients with burns: update.

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    Guilabert, P; Usúa, G; Martín, N; Abarca, L; Barret, J P; Colomina, M J

    2016-09-01

    Since 1968, when Baxter and Shires developed the Parkland formula, little progress has been made in the field of fluid therapy for burn resuscitation, despite advances in haemodynamic monitoring, establishment of the 'goal-directed therapy' concept, and the development of new colloid and crystalloid solutions. Burn patients receive a larger amount of fluids in the first hours than any other trauma patients. Initial resuscitation is based on crystalloids because of the increased capillary permeability occurring during the first 24 h. After that time, some colloids, but not all, are accepted. Since the emergence of the Pharmacovigilance Risk Assessment Committee alert from the European Medicines Agency concerning hydroxyethyl starches, solutions containing this component are not recommended for burns. But the question is: what do we really know about fluid resuscitation in burns? To provide an answer, we carried out a non-systematic review to clarify how to quantify the amount of fluids needed, what the current evidence says about the available solutions, and which solution is the most appropriate for burn patients based on the available knowledge. PMID:27543523

  11. Hypotensive Resuscitation among Trauma Patients

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    Carrick, Matthew M.; Leonard, Jan; Slone, Denetta S.; Mains, Charles W.

    2016-01-01

    Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109

  12. Initial fluid resuscitation of patients with septic shock in the intensive care unit

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    Carlsen, Sarah; Perner, A

    2011-01-01

    Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome...... associated with fluid volume....

  13. Associations of Hospital and Patient Characteristics with Fluid Resuscitation Volumes in Patients with Severe Sepsis

    DEFF Research Database (Denmark)

    Hjortrup, Peter Buhl; Haase, Nicolai; Wetterslev, Jørn;

    2016-01-01

    and secondary outcome total fluid input administered from 24 hours before randomisation until the end of day 3 post-randomisation. We performed multivariate analyses with hospital and patient baseline characteristics as covariates to assess associations with fluid volumes given. RESULTS: We included 654......, lower respiratory SOFA subscore and surgery were all independently associated with increased fluid resuscitation volumes. CONCLUSIONS: Hospital characteristics adjusted for patient baseline values were associated with differences in fluid resuscitation volumes given in the first 3 days of severe sepsis......PURPOSE: Fluid resuscitation is a key intervention in patients with sepsis and circulatory impairment. The recommendations for continued fluid therapy in sepsis are vague, which may result in differences in clinical practice. We aimed to evaluate associations between hospital and patient...

  14. Causes of death after fluid bolus resuscitation: new insights from FEAST

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    Myburgh, John; Finfer, Simon

    2013-01-01

    The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscitation with albumin or saline compared with no bolus resuscitation at all. In a secondary analysis of the trial, published in BMC Medicine, the authors found that increased mortal...

  15. Future Therapies in Burn Resuscitation.

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    Hodgman, Erica I; Subramanian, Madhu; Arnoldo, Brett D; Phelan, Herb A; Wolf, Steven E

    2016-10-01

    Since the 1940s, the resuscitation of burn patients has evolved with dramatic improvements in mortality. The most significant achievement remains the creation and adoption of formulae to calculate estimated fluid requirements to guide resuscitation. Modalities to attenuate the hypermetabolic phase of injury include pharmacologic agents, early enteral nutrition, and the aggressive approach of early excision of large injuries. Recent investigations into the genomic response to severe burns and the application of computer-based decision support tools will likely guide future resuscitation, with the goal of further reducing mortality and morbidity, and improving functional and quality of life outcomes. PMID:27600132

  16. KBSIM/FLUIDTHERAPY: a system for optimized design of fluid resuscitation in trauma.

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    Groth, T; Hakman, M; Hedlund, A; Zaar, B

    1991-01-01

    An application of the KBSIM (Knowledge-Based SIMulation) system to the improved design of fluid resuscitation is described. The system integrates knowledge from three domains, viz. the pathophysiology of traumatized patients represented in a quantitative biodynamic model, the heuristics of fluid resuscitation of such patients as represented in 'production rules', and some 'metaknowledge' reflected in the design of a multi-window user interface. This technique of combining numerical simulation with symbolic reasoning has obvious advantages during the design process and in training, by giving the user a possibility to evaluate his measures by direct feedback from the system. This feature of the system to assist in evaluation of alternative resuscitation procedures should also be useful as a means for decision support. PMID:2060289

  17. Blood Flow Versus Hematocrit in Optimization of Oxygen Transfer to Tissue During Fluid Resuscitation.

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    Siam, Jamal; Kadan, Marwa; Flaishon, Ron; Barnea, Ofer

    2015-12-01

    The effectiveness of fluid resuscitation regimens in hemorrhagic trauma is assessed based on its ability to increase oxygen concentration in tissue. Fluid resuscitation using both crystalloids and colloids fluids, creates a dilemma due to its opposing effects on oxygen transfer. It increases blood flow thereby augmenting oxygen transport but it also dilutes the blood simultaneously and reduces oxygen concentration thereby reducing oxygen transport. In this work we have studied these two opposing effects of fluid therapy on oxygen delivery to tissue. A mathematical model of oxygen diffusion from capillaries to tissue and its distribution in tissue was developed and integrated into a previously developed hemodynamic model. The capillary-tissue model was based on the Krogh structure. Compared to other models, fewer simplifying assumptions were made leading to different boundary conditions and less constraints, especially regarding capillary oxygen content at its venous end. Results showed that oxygen content in blood is the dominant factor in oxygen transport to tissue and its effect is greater than the effect of flow. The integration of the capillary/tissue model with the hemodynamic model that links administered fluids with flow and blood dilution indicated that fluid resuscitation may reduce oxygen transport to tissue.

  18. Phase II trial of isotonic fluid resuscitation in Kenyan children with severe malnutrition and hypovolaemia

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    Boga Mwanamvua

    2010-10-01

    Full Text Available Abstract Background Children with severe malnutrition who develop shock have a high mortality. Contrary to contemporaneous paediatric practice, current guidelines recommend use of low dose hypotonic fluid resuscitation (half-strength Darrows/5% dextrose (HSD/5D. We evaluated the safety and efficacy of this guideline compared to resuscitation with a standard isotonic solution. Methods A Phase II randomised controlled, safety and efficacy trial in Kenyan children aged over 6 months with severe malnutrition and shock including children with severe dehydration/shock and presumptive septic shock (non-diarrhoeal shock. Eligible children were randomised to HSD/5D or Ringer's Lactate (RL. A maximum of two boluses of 15 ml/kg of HSD/5D were given over two hours (as recommended by guidelines while those randomised to RL received 10 ml/kg aliquots half hourly (maximum 40 ml/kg. Primary endpoint was resolution of shock at 8 and 24 hours. Secondary outcomes included resolution of acidosis, adverse events and mortality. Results 61 children were enrolled: 41 had shock and severe dehydrating diarrhoea, 20 had presumptive septic shock; 69% had decompensated shock. By 8 hours response to volume resuscitation was poor with shock persisting in most children:-HSD/5D 15/22 (68% and RL14/25 (52%, p = 0.39. Oliguria was more prevalent at 8 hours in the HSD/5D group, 9/22 (41%, compared to RL-3/25 (12%, p = 0.02. Mortality was high, HSD/5D-15/26(58% and RL 13/29(45%; p = 0.42. Most deaths occurred within 48 hours of admission. Neither pulmonary oedema nor cardiogenic failure was detected. Conclusions Outcome was universally poor characterised by persistence of shock, oliguria and high case fatality. Isotonic fluid was associated with modest improvement in shock and survival when compared to HSD/5D but inconclusive due to the limitations of design and effectiveness of either resuscitation strategy. Although isotonic fluid resuscitation did not result in cardiogenic heart

  19. Retrospection and recent advances in fluid resuscitation during bum shock stage%烧伤休克期补液

    Institute of Scientific and Technical Information of China (English)

    郭振荣

    2008-01-01

    To retrospect the development of fluid resuscitation for burn shock and to look to the future. The main achievements in burn care in the past fifty years and existing problems are summarized, and the appropriate regime of fluid resuscitation for burn shock is suggested. Numerous achievements in burn care have been made, including the estimation of burn area, fluid replenishment formula, delayed resuscitation, fluid resuscitation for bum shock complicated by inhalation injury, covert compensatory shock and research on mechanism of bum shock etc. We had established and improved fluid resuscitation formula, and we had made clear how to properly resuscitate burn shock. However how to tide over the patient form burn shock smoothly had not yet reached a consensus. Effective treatment to alleviate hypoxic injuries as a result of severe shock had not been properly defined. Although significant achievements in fluid resuscitation for burn shock have been made, there is still a long way to go to attain a perfect regime. Therefore it is still utterly necessary to carry on in-depth research on this problem both in the laboratory and bedside.

  20. Fluid compartments in hemorrhaged rats after hyperosmotic crystalloid and hyperoncotic colloid resuscitation.

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    Moon, P F; Hollyfield-Gilbert, M A; Myers, T L; Uchida, T; Kramer, G C

    1996-01-01

    Postresuscitation organ failure may be associated with detrimental changes in body fluid compartments. We measured how shock and resuscitation acutely alters the interstitial, cellular, and plasma compartments in different organs. Nephrectomized, anesthetized rats were bled to 50 mmHg mean arterial pressure for 1 h, followed by 60 min of resuscitation to restore blood pressure using 0.9% normal saline (NS,n = 10), 7.5% hypertonic saline (HS,n = 8), 10% hyperoncotic albumin (HA, n = 8), or 7.5% hypertonic saline and 10% hyperoncotic albumin (HSA, n = 7). A 2-h 51Cr-EDTA distribution space estimated extracellular fluid volume (ECFV), and a 5-min 125I-labeled albumin distribution space measured plasma volume (PV). Total tissue water (TW) was measured from wet and dry weights; interstitial fluid volume (ISFV) and cell water were calculated. NS resuscitation required 7 times more fluid (50.9 +/- 7.7 vs. 8.6 +/- 0.7 for HA, 5.9 +/- 0.4 for HS, and 3.9 +/- 0.5 ml/kg for HSA), but there were no differences between solutions in whole animal PV, ECFV, or ISFV. Fluid shifts within tissues depended on resuscitation solution and type of tissue. TW was significantly reduced by hypertonic saline groups in heart, muscle, and liver (P skin. In all tissues, mean cell water in groups receiving HS was smaller; this was significant for heart, lung, muscle, and skin. In conclusion, 1) HS solutions mobilize fluid from cells while expanding both PV and ISFV, and 2) TW and cellular water increase with both isotonic crystalloids and hyperoncotic colloids in many tissues. PMID:8769817

  1. Vasopressin Infusion with Small-Volume Fluid Resuscitation during Hemorrhagic Shock Promotes Hemodynamic Stability and Survival in Swine

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    Gazmuri, Raúl J.; Kasen Whitehouse; Karla Whittinghill; Alvin Baetiong; Jeejabai Radhakrishnan

    2015-01-01

    Introduction Current management of hemorrhagic shock (HS) in the battlefield and civilian settings favors small-volume fluid resuscitation before controlling the source of bleeding. We investigated in a swine model of HS the effects of vasopressin infusion along with small-volume fluid resuscitation; with erythropoietin (EPO) and HS severity as additional factors. Methods HS was induced in 24 male domestic pigs (36 to 41 kg) by blood withdrawal (BW) through a right atrial cannula modeling spo...

  2. A noninvasive computational method for fluid resuscitation monitoring in pediatric burns: a preliminary report.

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    Stewart, Camille L; Mulligan, Jane; Grudic, Greg Z; Pyle, Laura; Moulton, Steven L

    2015-01-01

    The fluid resuscitation needs of children with small area burns are difficult to predict. The authors hypothesized that a novel computational algorithm called the compensatory reserve index (CRI), calculated from the photoplethysmogram waveform, would correlate with percent total body surface area (%TBSA) and fluid administration in children presenting with ≤20% TBSA burns. The authors recorded photoplethysmogram waveforms from burn-injured children that were later processed by the CRI algorithm. A CRI of 1 represents supine normovolemia; a CRI of 0 represents the point at which a subject is predicted to experience hemodynamic decompensation. CRI values from the first 10 minutes of monitoring were compared to clinical data. Waveform data were available for 27 children with small to moderate sized burns (4-20 %TBSA). The average age was 6.3 ± 1.1 years, the average %TBSA was 10.4 ± 0.8%, and the average CRI was 0.36 ± 0.03. CRI inversely correlated with the %TBSA (P 0.5 ml/kg/hr) (P < .001). The CRI is decreased in children with small to moderate size burns, and correlates with %TBSA and fluid administration. This suggests that the CRI may be useful for fluid resuscitation guidance, warranting further study. PMID:25383980

  3. Comparing transesophageal Doppler corrected systolic flow time versus central venous pressure as a guide for fluid resuscitation in septic shock

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    Walid Hamimy

    2016-04-01

    Conclusion: Transesophageal aortic Doppler is a simple, non-invasive tool of guiding fluid therapy in patients with severe sepsis and septic shock. FTC change was a better predictor of fluid responsiveness than CVP in septic shock. There was higher significant difference in SV after resuscitation when using FTC as guidance.

  4. Effect of two volume responsiveness evaluation methods on fluid resuscitation and prognosis in septic shock patients

    Institute of Scientific and Technical Information of China (English)

    Xu Qianghong; Yan Jing; Cai Guolong; Chen Jin; Li Li; Hu Caibao

    2014-01-01

    Background Few studies have reported the effect of different volume responsiveness evaluation methods on volume therapy results and prognosis.This study was carried out to investigate the effect of two volume responsiveness evaluation methods,stroke volume variation (SW) and stroke volume changes before and after passive leg raising (PLR-ASV),on fluid resuscitation and prognosis in septic shock patients.Methods Septic shock patients admitted to the Department of Critical Care Medicine of Zhejiang Hospital,China,from March 2011 to March 2013,who were under controlled ventilation and without arrhythmia,were studied.Patients were randomly assigned to the SVV group or the PLR-ASV group.The SVV group used the Pulse Indication Continuous Cardiac Output monitoring of SW,and responsiveness was defined as SW->12%.The PLR-ASV group used ASV before and after PLR as the indicator,and responsiveness was defined as ASV >15%.Six hours after fluid resuscitation,changes in tissue perfusion indicators (lactate,lactate clearance rate,central venous oxygen saturation (SCVO2),base excess (BE)),organ function indicators (white blood cell count,neutrophil percentage,platelet count,total protein,albumin,alanine aminotransferase,total and direct bilirubin,blood urea nitrogen,serum creatinine,serum creatine kinase,oxygenation index),fluid balance (6-and 24-hour fluid input) and the use of cardiotonic drugs (dobutamine),prognostic indicators (the time and rate of achieving early goal-directed therapy (EGDT) standards,duration of mechanical ventilation and intensive care unit stay,and 28-day mortality) were observed.Results Six hours after fluid resuscitation,there were no significant differences in temperature,heart rate,blood pressure,SpO2,organ function indicators,or tissue perfusion indicators between the two groups (P >0.06).The 6-and 24-hour fluid input was slightly less in the SW group than in the PLR-ASV group,but the difference was not statistically significant (P >0

  5. Influence of different fluid resuscitation techniques on the number of myeloid-derived suppressor cells in rats.

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    Wang, Z J; Wang, H X; Li, L; Wang, L; Dou, H H

    2016-04-28

    We investigated the influence of different fluid resuscitation techniques on the number of myeloid-derived suppressor cells (MDSCs) in rats. Seventy-two healthy Sprague-Dawley rats were randomly divided into groups that received sham operation (Sham group), hypertonic saline (HRS group), lactated ringer's solution (LRS group), or crystalloid solution (LCRS group). Six rats from each group were sacrificed by cervical dislocation at 12, 24, and 48 h after resuscitation. The spleens were harvested under sterile conditions and spleen cell suspension was prepared. The number of MDSCs was detected using flow cytometry. The number of MDSCs in the Sham group did not differ significantly among the different time points. Compared with the Sham group, the number of MDSCs after the use of the different fluid resuscitation techniques increased to varying extents and the differences among the groups were significant. The number of MDSCs in the HRS group was much lower than that of the LRS and LCRS groups at both 24 and 48 h (P number of MDSCs in the HRS group was significantly lower than that of the LRS group (P < 0.05). The differences between the HRS and LCRS groups were not statistically significant. Shortly after hemorrhagic shock resuscitation, the immune function of rats was suppressed to a varying extent and was gradually restored over time. Resuscitation with HRS alleviated the immunosuppression at the early stage after shock.

  6. A retrospective analysis of the haemodynamic and metabolic effects of fluid resuscitation in Vietnamese adults with severe falciparum malaria.

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    Hoan Phu Nguyen

    Full Text Available BACKGROUND: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP guided, crystalloid based, resuscitation in adults. METHODS: Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation. RESULTS: 43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m(2 (95% Confidence interval (CI: 0.41 to 1.1, but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3. The CVP and PAoP (pulmonary artery occlusion pressure were highly inter-correlated (r(s = 0.7, p<0.0001, but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit or respiratory status (PaO(2/FiO(2 ratio. There was no correlation between the oxygen delivery (DO(2 and base deficit at the 63 time-points where they were assessed simultaneously (r(s = -0.09, p = 0.46. CONCLUSIONS: In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs.

  7. Effects of two fluid resuscitations on the bacterial translocation and inflammatory response of small intestine in rats with hemorrhagic shock

    Institute of Scientific and Technical Information of China (English)

    GAO Xin-yue; REN Cong-cai; ZHOU Qiang; PANG Qing-feng; WU Chang-yi; ZENG Yin-ming

    2007-01-01

    Objective: To investigate the effects of two fluid resuscitations on the bacterial translocation and the inflammatory factors of small intestine in rats with hemorrhagic shock. Methods: Fifty SD healthy male rats were randomly divided into 5 groups (n=10 per group):Group A (Sham group), Group B (Ringer's solution for 1 h), Group C (Ringer's solution for 24 h), Group D (hydroxyethyl starch for 1 h) and Group E ((hydroxyethyl starch for 24 h). A model of rats with hemorrhagic shock was established. The bacterial translocation in liver, content of tumor necrosis factor-α (TNF-α) and changes of myeloperoxidase enzyme (MPO) activities in small intestine were pathologically investigated after these two fluid resuscitations, respectively. Results: The bacterial translocation and the expression of TNF-α in the small intestine were detected at 1 h and 24 h after fluid resuscitation. There were significant increase in the number of translocated bacteria, TNF-α and MPO activities in Group C compared with Group B, significant decrease in Group E compared with Group D and in Group B compared with Group D. The number of translocated bacteria and TNF-α expression significantly decreased in Group E as compared with Group C.Conclusions: The bacterial translocation and the expression of TNF-α in the small intestine exist 24 h after fluid resuscitation. 6% hydroxyethyl starch can improve the intestinal mucosa barrier function better than the Ringer's solution.

  8. [A propose to suspend the use of hydroxyethyl starch for fluid resuscitation in shock phase of severe burns].

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    Luo, Gao-xing; Peng, Yi-zhi; Wu, Jun

    2013-10-01

    Based on the result of randomized controlled trials and meta-analysis recently, the infusion of hydroxyethyl starch (HES) was not shown to over match routine crystalline solution in exerting resuscitation effect against hypovolemia of patients with burn shock, severe systematic infection, or other critical conditions, on the other hand, it may induce renal toxicity and other toxic and side effects. Since the pathological mechanism underlying hypovolemia during shock phase after burn is similar to that of severe systemic infection, we propose to suspend the use of HES for fluid resuscitation during the shock phase of severe burn until further elucidation. PMID:24359998

  9. Effects of carbachol matching oral fluid resuscitation on intestinal mucosa blood flow and absorption rate of dogs suffered hemorrhagic shock

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    Lin LI

    2011-04-01

    Full Text Available Objective To investigate the effects of carbachol matching oral fluid resuscitation on intestinal mucosa blood flow(IMBF and intestinal absorption rate of dogs suffered hemorrhagic shock.Methods Twenty-four hours after a preliminary intubation of carotid artery,jugular vein and jejunum by asepsis,twelve Beagle dogs were subjected to a loss of 40% total blood volume to establish animal model of hemorrhagic shock.Animals were then divided into oral resuscitation group and carbachol group(6 each.Dogs in oral resuscitation group were given by gastric tube the glucose-electrolyte solution(GES,which was 3 times volume of blood loss,within 24h after bleeding;while dogs in carbachol group were given GES added carbachol(0.25μg/kg.The IMBF and intestinal absorption rate of water before hemorrhage(0h and 2,4 and 8h after hemorrhage were measured.All the animals were sacrificed at 8h after hemorrhage to record the intestinal GES volume.Results The intestinal absorption rate of water remarkably decreased after hemorrhage in both groups,while in carbachol,group it was obviously higher than that in oral resuscitation group(P < 0.05.The GES volume absorbed by intestine in carbachol group was high than that in oral resuscitation group 8h after hemorrhage(P < 0.05.The IMBF decreased significantly in the both groups after hemorrhage,and then increased gradually 2h after hemorrhage.The IMBF in carbachol group was obviously higher than that in oral resuscitation group(P < 0.05.Conclusion Carbachol in oral resuscitation with GES can improve intestinal absorption rate of water and GES,and increase IMBF in dogs with 40% blood loss.

  10. Scandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure

    DEFF Research Database (Denmark)

    Perner, A; Junttila, E; Haney, M;

    2015-01-01

    recommendations for general intensive care unit (ICU) patients and those with sepsis, trauma and burn injury. RESULTS: For general ICU patients and those with sepsis, we recommend using crystalloids for resuscitation rather than hydroxyethyl starch and we suggest using crystalloids rather than gelatin and albumin....... For patients with trauma we recommend to use crystalloids for resuscitation rather than colloid solutions. For patients with burn injury we provide no recommendations as there are very limited data from randomised trials on fluid resuscitation in this patient population. CONCLUSIONS: We recommend using......BACKGROUND: The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure...

  11. Early Fluid Resuscitation and High Volume Hemofiltration Decrease Septic Shock Progression in Swine.

    Science.gov (United States)

    Zhao, Ping; Zheng, Ruiqiang; Xue, Lu; Zhang, Min; Wu, Xiaoyan

    2015-01-01

    This study aimed to assess the effects of early fluid resuscitation (EFR) combined with high volume hemofiltration (HVHF) on the cardiopulmonary function and removal of inflammatory mediators in a septic shock swine model. Eighteen swine were randomized into three groups: control (n = 6) (extracorporeal circulating blood only), continuous renal replacement therapy (CRRT) (n = 6; ultrafiltration volume = 25 mL/Kg/h), and HVHF (n = 6; ultrafiltration volume = 85 mL/Kg/h). The septic shock model was established by intravenous infusion of lipopolysaccharides (50 µg/kg/h). Hemodynamic parameters (arterial pressure, heart rate, cardiac output, stroke volume variability, left ventricular contractility, systemic vascular resistance, and central venous pressure), vasoactive drug parameters (dose and time of norepinephrine and hourly fluid intake), pulmonary function (partial oxygen pressure and vascular permeability), and cytokines (interleukin-6 and interleukin-10) were observed. Treatment resulted in significant changes at 4-6 h. HVHF was beneficial, as shown by the dose of vasoactive drugs, fluid intake volume, left ventricular contractility index, and partial oxygen pressure. Both CRRT and HVHF groups showed improved removal of inflammatory mediators compared with controls. In conclusion, EFR combined with HVHF improved septic shock in this swine model. The combination decreased shock progression, reduced the need for vasoactive drugs, and alleviated the damage to cardiopulmonary functions.

  12. A comparative analysis of nasogastric and intravenous fluid resuscitation in patients with malignant obstructive jaundice prior to endoscopic biliary drainage

    Directory of Open Access Journals (Sweden)

    Kavita Baghel

    2013-01-01

    Full Text Available Background: An alternative to intravenous is nasogastric fluid administration through normal functioning gut. Though not common, this practice has significance in mass causalities and elective situations. Aim: The study was designed to compare nasogastric and intravenous fluid resuscitation in malignant obstructive jaundice (OJ and their effect on endotoxemia. Materials and Methods: Sixty patients with malignant OJ undergoing endoscopic biliary drainage were randomized into two groups. A total of 4 l of fluid (Ringer′s lactate was administered to Group A through nasogastric tube and to Group B through intravenous route for 48 h. Vital parameters, serum bilirubin, serum creatinine, creatinine clearance rate, electrolytes, and endotoxemia were monitored. Results: Significant improvement in blood pressure (Group A, P = 0.014; Group B, P = 0.020 and significant decrease in serum bilirubin level (Group A, P = 0.001; Group B, P < 0.0001 was observed in both groups after resuscitation. Significantly decreased (P = 0.036 post hydration endotoxin level was observed in Group A as compared to Group B. Febrile events were significantly higher (P = 0.023 in Group B as compared to Group A (6 vs 0. Electrolyte abnormalities were found more in Group B, however statistically insignificant. Conclusion: In OJ patient undergoing biliary drainage, preoperative fluid resuscitation through nasogastric tube may be helpful in reducing postoperative septic complications and endotoxemia.

  13. Dextrose containing intravenous fluid impairs outcome and increases death after eight minutes of cardiac arrest and resuscitation in dogs.

    Science.gov (United States)

    D'Alecy, L G; Lundy, E F; Barton, K J; Zelenock, G B

    1986-09-01

    Use of dextrose in intravenous resuscitation fluids is common practice; however, this study indicates that 5% dextrose solutions, even if administered in physiologic quantities, greatly worsens the outcome of survivable cardiac arrest. Twelve adult male mongrel dogs were premedicated with morphine, anesthetized with halothane, instrumented, intubated, and ventilated. Each dog was first given 500 ml of either lactated Ringer's (LR) (n = 6) or 5% dextrose in LR (D5LR) (n = 6). Halothane was stopped and fibrillation was induced (60 Hz). Blood glucose just before cardiac arrest was 129 mg/dl in the LR dogs and was increased to 335 mg/dl in the D5LR dogs. After eight minutes of arrest, resuscitation, including internal cardiac massage and standard advanced cardiac life support drug protocols (modified for dogs), was begun. When stable cardiac rhythm was obtained, the chest was closed, and LR or D5LR continued until a total of 1L was given. A neurologic score (0 = normal to 100 = dead) was assigned at 1, 2, 6, and 24 hours. The LR group did not differ statistically from the D5LR group in operative time, number of defibrillatory shocks, time to spontaneous ventilation, time to extubation, or drugs required. Resuscitation was successful in all six LR and five of six D5LR group; however, by 2 hours after resuscitation and thereafter, D5LR group had a significantly greater neurologic deficit (p less than 0.05) than did the LR group. By 9 hours, four of six D5LR dogs displayed convulsive activity and died. At 24 hours the D5LR group had a greater (p less than 0.008) neurologic deficit (82 +/- 11) than did the LR group (21 +/- 7), which walked and ate. We conclude that the addition of 5% dextrose to standard intravenous fluids greatly increases the morbidity and mortality associated with cardiac resuscitation. PMID:3738770

  14. Effect of Hypotensive Resuscitation with a Novel Combination of Fluids in a Rabbit Model of Uncontrolled Hemorrhagic Shock

    OpenAIRE

    Yu-Ming Zhang; Bo Gao; Juan-Juan Wang; Xu-de Sun; Xi-Wen Liu

    2013-01-01

    Objective The aim of this study was to compare the effects of hypotensive and normotensive resuscitation with a novel combination of fluids via lactate Ringer’s solution (LRS), 6% hydroxyethyl starch 130/0.4 solution (HES), and 7.5% hypertonic saline solution (HSS) at early stage of uncontrolled hemorrhagic shock (UHS) before hemostasis. Methods New Zealand white rabbits (n = 32) underwent UHS by transecting the splenic parenchyma, followed by blood withdrawal via the femoral artery to target...

  15. Advances in the research of fluid resuscitation for burn shock%烧伤休克液体复苏研究进展

    Institute of Scientific and Technical Information of China (English)

    郇京宁

    2013-01-01

    The aim of fluid resuscitation is to restore tissue perfusion,ameliorate cellular injury,increase tissue perfusion and oxygenation,and improve end-organ functions.Many researches in the field of fluid resuscitation strategy have been made in the last decade,but vigorous debate on optimal method of resuscitation still exists.The hypotensive resuscitation strategy is particularly applicable in patients with uncontrollable hemorrhage,whereas,it is uncertain whether the theory could be used in burn shock management.Resuscitation using both colloid and crystalloid has a better outcome in treating extensive burns and septic shock.Caution should be exercised when using higher concentrations of artificial colloid and lactated Ringer's solution,of which some adverse effects have been observed.Along with the increasing use of novel hemodynamics monitoring in intensive care,parameters including stroke volume variation (SVV),intrathoracic blood volume index (ITBVI),and cardiac index (CI) have been examined as indexes of resuscitation endpoint.However,further studies should be made when applying SVV,ITBVI,and CI in guiding fluid resuscitation in burns.

  16. Management of acute burns and burn shock resuscitation.

    Science.gov (United States)

    Faldmo, L; Kravitz, M

    1993-05-01

    Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications. PMID:8489882

  17. Vasopressin Infusion with Small-Volume Fluid Resuscitation during Hemorrhagic Shock Promotes Hemodynamic Stability and Survival in Swine.

    Directory of Open Access Journals (Sweden)

    Raúl J Gazmuri

    Full Text Available Current management of hemorrhagic shock (HS in the battlefield and civilian settings favors small-volume fluid resuscitation before controlling the source of bleeding. We investigated in a swine model of HS the effects of vasopressin infusion along with small-volume fluid resuscitation; with erythropoietin (EPO and HS severity as additional factors.HS was induced in 24 male domestic pigs (36 to 41 kg by blood withdrawal (BW through a right atrial cannula modeling spontaneous bleeding by a mono-exponential decay function. The initial 12 pigs received no fluids; the last 12 pigs received normal saline (NS half the BW volume. Pigs were randomized 2:1 to receive intraosseously vasopressin (0.04 U/kg·min-1 or vehicle control from minute 7 to minute 210. Pigs assigned to vasopressin were further randomized 1:1 to receive EPO (1,200 U/kg or vehicle control and 1:1 to have 65% or 75% BW of their blood volume. Shed blood was reinfused at 210 minutes and the pigs recovered from anesthesia.Survival at 72 hours was influenced by vasopressin and NS but not by EPO or % BW. Vasopressin with NS promoted the highest survival (8/8 followed by vasopressin without NS (3/8, NS without vasopressin (1/4, and neither treatment (0/4 with overall statistical significance (log-rank test, p = 0.009 and each subset different from vasopressin with NS by Holm-Sidak test. Vasopressin increased systemic vascular resistance whereas NS increased cardiac output.Vasopressin infusion with small-volume fluid resuscitation during severe HS was highly effective enabling critical hemodynamic stabilization and improved 72 hour survival.

  18. Effects of resuscitation with three kinds of fluid on liver oxygen free radical in rats with severe hemorrhagic shock

    OpenAIRE

    Hua-mei LU; Wei, Li-Juan; Mu-qiang YANG; Zhi-long GENG; Zhao, Feng

    2012-01-01

    Objective  To explore effects of resuscitation with different kinds of fluid on liver oxygen free radical in rats with severe hemorrhagic shock. Methods  Sixty SD Rats were randomly divided into 5 groups (n=12): control group (C), shock alone group (SA), lactated Ringer's solution (LR)-treatment group, hydroxyethyl starch (HES)-treatment group, 7.2% hypertonic saline-6% HES (HSH)-treated group. According to Wigger's method, the rat model of severe hemorrhagic shock was reproduced. The mean ar...

  19. Aggressiveness

    OpenAIRE

    Stepišnik, Urška

    2013-01-01

    There are a lot of aspects of aggressiveness and everybody understands and defines it differently. Professionals define aggressiveness as actually inflicting damage to other organism or object6, the reaction which aims in damaging living organism or object. The objectives of aggressive behaviour are physical and mental damage. The difference between aggressiveness and aggression is that the term aggression relates to a momentary reaction, aggressiveness, however, means permanent characteristi...

  20. Protocolized Resuscitation of Burn Patients.

    Science.gov (United States)

    Cancio, Leopoldo C; Salinas, Jose; Kramer, George C

    2016-10-01

    Fluid resuscitation of burn patients is commonly initiated using modified Brooke or Parkland formula. The fluid infusion rate is titrated up or down hourly to maintain adequate urine output and other endpoints. Over-resuscitation leads to morbid complications. Adherence to paper-based protocols, flow sheets, and clinical practice guidelines is associated with decreased fluid resuscitation volumes and complications. Computerized tools assist providers. Although completely autonomous closed-loop control of resuscitation has been demonstrated in animal models of burn shock, the major advantages of open-loop and decision-support systems are identifying trends, enhancing situational awareness, and encouraging burn team communication. PMID:27600131

  1. 重度烧伤液体复苏的研究进展%Advances in the Research of Fluid Resuscitation Following Severe Burn

    Institute of Scientific and Technical Information of China (English)

    王碧莹(综述); 葛茂星(审校)

    2015-01-01

    Burn shock is the first hurdle in patients with severe burn injury.Fluid resuscitation is an important treatment of burn shock.Reasonable fluid resuscitation can not only avoid burn shock,but also reduce the death risk and complications incidence.Here is to make a review of the research of severe burn fluid infusion volume,infusion method,inhalation injury,wound depth,delayed resuscitation and etc.,for the sake of providing some thoughts for fluid resuscitation of severe burn patients .%烧伤休克是重度烧伤患者伤后面临的第一道难关。液体复苏是休克期救治的重要措施,合理的补液不仅能避免烧伤休克的发生,也将降低后续并发症的发生率及死亡的风险。该文就目前国内外对重度烧伤液体复苏的补液量、补液途径、吸入性损伤、创面深度及延迟复苏等方面的相关研究进行综述,以期为临床重度烧伤的液体复苏提供一个简要的总结和一些思考。

  2. 液体复苏的不良反应及对策%Adverse effects and management of fluid resuscitation

    Institute of Scientific and Technical Information of China (English)

    喻文亮; 葛许华

    2012-01-01

    Adverse effects and management of fluid resuscitation were reviewed in this article,which included pulmonary and peripheral edema,complication in nervous system ( cerebral edema,central pontine myelinalysis,and extrapontine myelinalysis),electrolyte disturbances and metabolic acidosis.%本文介绍了液体复苏时可能出现的不良反应及对策,包括肺水肿及组织水肿、神经系统并发症(如脑水肿、脑桥中央髓鞘溶解症及脑桥外髓鞘溶解症),以及电解质紊乱、酸中毒等.

  3. Effects of fluid resuscitation methods on the pro- and anti-inflammatory cytokines and expression of adhesion molecules after burn injury.

    Science.gov (United States)

    Foldi, Viktor; Lantos, Janos; Bogar, Lajos; Roth, Elizabeth; Weber, Gyorgy; Csontos, Csaba

    2010-01-01

    Fluid resuscitation management can influence inflammatory response after burn injury. The aim of this study was to analyze the effects of two fluid resuscitation methods on the cytokine production and on the expression of the leukocyte surface markers. Thirty patients were included in this prospective randomized study with burn injury affecting more than 20% of the body surface area. Fluid resuscitation was guided by hourly urine output (HUO, n = 15) or by intrathoracic blood volume index (ITBVI, n = 15). Blood samples were taken on admission and on the next five consecutive mornings. Concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha were measured in phorbol myristate acetate-stimulated and -nonstimulated samples. Leukocyte surface marker expressions (CD11a, CD11b, CD14, CD18, CD49d, and CD97) were also determined. In the ITBVI group, IL-6 levels on days 2 to 3 and IL-6/IL-10 ratios on days 2 to 3, and the IL-8/IL-10 ratios on days 3 to 5 were significantly higher than those in HUO group (P burned patients suppresses the shift toward anti-inflammatory imbalance and the expression of leukocyte surface markers more than HUO-guided resuscitation.

  4. Effects of different resuscitation fluids on pulmonary expression of aquaporin1 and aquaporin5 in a rat model of uncontrolled hemorrhagic shock and infection.

    Directory of Open Access Journals (Sweden)

    Ju Gao

    Full Text Available BACKGROUND: To investigate the effects of fluids resuscitation on pulmonary expression of aquaporin1 and aquaporin5 in a rat model of uncontrolled hemorrhagic shock and infection. METHODS: Sixty Sprague-Dawley rats were randomly assigned to five groups, sham operation group (Group C and four treated groups: no fluid resuscitation group (Group NF, groups resuscitated with Lactated Ringer's (LR,7.5% NaCl (HTS and Hydroxyl ethyl starch (HES respectively. Three-phased uncontrolled hemorrhagic shock and infection model was used. Phase I: Massive hemorrhage with a mean arterial pressure of 35-40 mmHg for 60 min, and followed by infection of lipopolysaccharide. Then some animals were resuscitated with solutions mentioned above, until 90 min. Phase II: At hemorrhagic shock 90 minutes, phase II of 60 minutes began with hemostasis and returning of all the initial shed blood. Phase III: Observation phase for 3.5 hours. After phase III, arterial blood gas analysis and the survival rates of the rats were recorded, Wet-to-dry lung weight ratio, BALF protein, pulmonary permeability index, and expressions of aquaporin1 and aquaporin5 were tested. RESULTS: The expressions of aquaporin1 and aquaporin5 were decreased in treatment groups comparing with sham operation group. Group HES and Group HTS decreased pulmonary vascular permeability and Wet-to-dry lung weight ratio, improved arterial blood gas analysis and survival rates, and attenuated the decreased pulmonary expression of aquaporin1 and aquaporin5 after the "two-hit", comparing with groups NF and LR,but these beneficial effects were blunted in group HTS. CONCLUSION: The expression of aquaporin1 and aquaporin5 may play important roles in formation of pulmonary edema. Resuscitation with HTS and HES, especially HES can reduce lung injury after hemorrhagic shock, partly by up-regulating the expressions of aquaporin1 and aquaporin5.

  5. Assessment effect of central venous pressure in fluid resuscitation in the patients with shock: a multi-center retrospective research

    Institute of Scientific and Technical Information of China (English)

    HU Bo; XIANG Hu; LIANG Hui; YU Li; XU Tao; YANG Jun-hui; DU Zhao-hui

    2013-01-01

    Background Central venous pressure (CVP) and intrathoracic blood volume index (ITBVI) were used to assess the fluid status.It has previously been shown that CVP is not as accurate as ITBVI for all the shock patients.We therefore hypothesized that the change of CVP has the ability to predict fluid responsiveness in some clinical cases of shock.Methods From September 1st 2009 to September 1st 2011,sixty-three patients with shock from different Intensive Care Unit (ICU) were collected into this retrospective study.All the patients received fluid challenge strategy (infusing 300 ml hydroxyethyl starch in 20 minutes),were monitored with CVP and pulse-indicated continuous cardiac output (PICCO).The correlation between changes in cardiac index (△CI),CVP (△CVP) and ITBVI (△ITBVI) were analyzed.Fluid responsiveness was defined as an increase in CI≥10%.Receiver operating characteristic (ROC) curves were generated for △CVP and △ITBVI.Results For all the patients,there was no correlation between △CI and △CVP (P=0.073),but in the subgroup analysis,the correlation between △CI and △CVP was significant in those younger than 60 years old (P=-0.018) and those with hypovolemic shock (P=0.001).The difference of areas under the ROC curves of △CVP and △ITBVI were not statistically significant in the group younger than 60 years old or hypovolemic shock group (P >0.05,respectively).However,no similar results can be found in the group older than 60 years old and the other two shock type groups from ROC curves of △CVP and △ITBVI.Conclusions △CVP is not suitable for evaluating the volume status of the shock patients with fluid resuscitation regardless of their condition.However,in some ways,△CVP have the ability to predict fluid responsiveness in the younger shock patients or in the hypovolemic shock patients.

  6. Modern trends in fluid therapy for burns.

    Science.gov (United States)

    Tricklebank, Stephen

    2009-09-01

    The majority of burn centres use the crystalloid-based Parkland formula to guide fluid therapy, but patients actually receive far more fluid than the formula predicts. Resuscitation with large volumes of crystalloid has numerous adverse consequences, including worsening of burn oedema, conversion of superficial into deep burns, and compartment syndromes. Resuscitation fluids influence the inflammatory response to burns in different ways and it may be possible, therefore to affect this response using the appropriate fluid, at the appropriate time. Starches are effective volume expanders and early use of newer formulations may limit resuscitation requirements and burn oedema by reducing inflammation and capillary leak. Advanced endpoint monitoring may guide clinicians in when to 'turn off' aggressive fluid therapy and therefore avoid the problems of over-resuscitation.

  7. Burn Resuscitation in the Austere Environment.

    Science.gov (United States)

    Peck, Michael; Jeng, James; Moghazy, Amr

    2016-10-01

    Intravenous (IV) cannulation and sterile IV salt solutions may not be options in resource-limited settings (RLSs). This article presents recipes for fluid resuscitation in the aftermath of burns occurring in RLSs. Burns of 20% total body surface area (TBSA) can be resuscitated, and burns up to 40% TBSA can most likely be resuscitated, using oral resuscitation solutions (ORSs) with salt supplementation. Without IV therapy, fluid resuscitation for larger burns may only be possible with ORSs. Published global experience is limited, and the magnitude of burn injuries that successfully respond to World Health Organization ORSs is not well-described. PMID:27600127

  8. Hydroxyethyl starch for resuscitation

    DEFF Research Database (Denmark)

    Haase, Nicolai; Perner, Anders

    2013-01-01

    PURPOSE OF REVIEW: Resuscitation with hydroxyethyl starch (HES) is controversial. In this review, we will present the current evidence for the use of HES solutions including data from recent high-quality randomized clinical trials. RECENT FINDINGS: Meta-analyses of HES vs. control fluids show clear...

  9. Cardiopulmonary Resuscitation (CPR)

    Science.gov (United States)

    MENU Return to Web version Cardiopulmonary Resuscitation (CPR) Cardiopulmonary Resuscitation (CPR) What is CPR? Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that involves chest compressions and giving ...

  10. [Advanced resuscitation of adults

    DEFF Research Database (Denmark)

    Lippert, F.K.; Lauritsen, T.L.; Torp-Pedersen, C.

    2008-01-01

    International and European Resuscitation Council (ERC) Guidelines for Resuscitation 2005 implicate major changes in resuscitation, including new universal treatment algorithms. This brief summary of Guidelines 2005 for advanced resuscitation of adult cardiac arrest victims is based upon the ERC...

  11. HEARTSMART® SOFTWARE COMPUTER PROGRAM FOR PERFORMING HAEMODYNAMIC STUDIES AT BEDSIDE DURING RESUSCITATIVE FLUID THERAPY: VASOPRESSORS AND INOTROPES

    Directory of Open Access Journals (Sweden)

    Kenneth Warring-Davies

    2013-08-01

    Full Text Available The revolutionary HeartSmart® continuous cardiac dynamic monitoring (CCDM by way of empirical physiological formulae (EPF embedded into an EPROM chip or in any other device with a personal computing platform, permits for haemodynamic monitoring at bedside, see diagram 3. The physiological parameters required to provide the haemodynamic variables are: heart rate, blood pressure, core body temperature degrees Celcius, height (cm weight (kg and mean central venous pressure the only parameter that is not non invasive. Caring for shocked septic – sepsis adult patients is a real challenge. The outcome of any interventional procedure to a great extent relies upon quality, simple, robust haemodynamic monitoring to guide fluid resuscitation with the use of vasopressors and or inotropes. Using the Bland-Altman method for comparing two measurement techniques, there was good agreement between measured and calculated Cardiac Index (Ci, Mean Pulmonary Artery Pressure (MPAP and the Mean Pulmonary Artery Occlusion or Capillary Wedge Pressures (MPAOP / MPWP The measured (PACTD and calculated (HS values of CI are identical agreement mean of differences (CI-0.095 to 0.295 The 95 % limits of agreement -3.662 to 3.861l / min / m2, see Legend 1. The measured (PACTD and calculated (HS values of MPAP agreement the mean of differences PACTD 1.866 mmHg (CI 0.996 to 2.776 and for HS 1.383 mmHg (CI 0.557 to 2.210 The 95 % limits of agreement -15.266 to 19.037 mmHg for PACTD and -13.478 to 16.245 mmHg HS, see Legend 2. The measured (PACTD and calculated (HS values of MPWP agreement the mean of differences PACTD -1.056 mmHg (CI-1.552 to -0.561 and for HS -1.312 (CI -1.764 to -0.860 The 95 % limits of agreement -10.529 to 8.416 mmHg for PACTD and -9.867 to 7.243 mmHg HS, see Legend 3. This indicates that, when estimating CI and MPWP in critically ill septic patients, CCDM-HeartSmart® provides values close to those generated using PACTD.

  12. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  13. The use of cytosolic enzyme increase in cerebrospinal fluid of patients resuscitated after cardiac arrest. Brain Resuscitation Clinical Trial I Study Group.

    Science.gov (United States)

    Vaagenes, P; Mullie, A; Fodstad, D T; Abramson, N; Safar, P

    1994-11-01

    Levels of brain creatine phosphokinase (CPK), glutamic oxalic transaminase, lactate dehydrogenase, and lactate in lumbar cerebrospinal fluid (CSF) were analyzed as an adjunctive study in a randomized clinical trial evaluating the effects of thiopental loading intravenously in comatose survivors of cardiac arrest. Three hospitals participated and a total of 62 cases of enzyme changes were studied. Enzyme levels but not lactate were higher at 48 hours than at 24 hours after restoration of spontaneous circulation. All enzymes were highly correlated with one another at 24 and 48 hours (P < .001). There was a significant negative correlation between cerebral recovery and increased CPK levels at 24 hours (P < .05), and a highly significant correlation with all three enzyme levels at 48 hours (P < .0001). The increase of cytosolic enzyme activity in lumbar CSF reflects permanent brain damage, and there is a relationship between activity levels and cerebral outcome. PMID:7945601

  14. Fluids and Combustion Facility Acoustic Emissions Controlled by Aggressive Low-Noise Design Process

    Science.gov (United States)

    Cooper, Beth A.; Young, Judith A.

    2004-01-01

    The Fluids and Combustion Facility (FCF) is a dual-rack microgravity research facility that is being developed by Northrop Grumman Information Technology (NGIT) for the International Space Station (ISS) at the NASA Glenn Research Center. As an on-orbit test bed, FCF will host a succession of experiments in fluid and combustion physics. The Fluids Integrated Rack (FIR) and the Combustion Integrated Rack (CIR) must meet ISS acoustic emission requirements (ref. 1), which support speech communication and hearing-loss-prevention goals for ISS crew. To meet these requirements, the NGIT acoustics team implemented an aggressive low-noise design effort that incorporated frequent acoustic emission testing for all internal noise sources, larger-scale systems, and fully integrated racks (ref. 2). Glenn's Acoustical Testing Laboratory (ref. 3) provided acoustical testing services (see the following photograph) as well as specialized acoustical engineering support as part of the low-noise design process (ref. 4).

  15. SvO(2)-guided resuscitation for experimental septic shock: effects of fluid infusion and dobutamine on hemodynamics, inflammatory response, and cardiovascular oxidative stress.

    Science.gov (United States)

    Rosário, André Loureiro; Park, Marcelo; Brunialti, Milena Karina; Mendes, Marialice; Rapozo, Marjorie; Fernandes, Denise; Salomão, Reinaldo; Laurindo, Francisco Rafael; Schettino, Guilherme Paula; Azevedo, Luciano Cesar P

    2011-12-01

    The pathogenetic mechanisms associated to the beneficial effects of mixed venous oxygen saturation (SvO(2))-guided resuscitation during sepsis are unclear. Our purpose was to evaluate the effects of an algorithm of SvO(2)-driven resuscitation including fluids, norepinephrine and dobutamine on hemodynamics, inflammatory response, and cardiovascular oxidative stress during a clinically resembling experimental model of septic shock. Eighteen anesthetized and catheterized pigs (35-45 kg) were submitted to peritonitis by fecal inoculation (0.75 g/kg). After hypotension, antibiotics were administered, and the animals were randomized to two groups: control (n = 9), with hemodynamic support aiming central venous pressure 8 to 12 mmHg, urinary output 0.5 mL/kg per hour, and mean arterial pressure greater than 65 mmHg; and SvO(2) (n = 9), with the goals above, plus SvO(2) greater than 65%. The interventions lasted 12 h, and lactated Ringer's and norepinephrine (both groups) and dobutamine (SvO(2) group) were administered. Inflammatory response was evaluated by plasma concentration of cytokines, neutrophil CD14 expression, oxidant generation, and apoptosis. Oxidative stress was evaluated by plasma and myocardial nitrate concentrations, myocardial and vascular NADP(H) oxidase activity, myocardial glutathione content, and nitrotyrosine expression. Mixed venous oxygen saturation-driven resuscitation was associated with improved systolic index, oxygen delivery, and diuresis. Sepsis induced in both groups a significant increase on IL-6 concentrations and plasma nitrate concentrations and a persistent decrease in neutrophil CD14 expression. Apoptosis rate and neutrophil oxidant generation were not different between groups. Treatment strategies did not significantly modify oxidative stress parameters. Thus, an approach aiming SvO(2) during sepsis improves hemodynamics, without any significant effect on inflammatory response and oxidative stress. The beneficial effects associated

  16. Vitamin C in Burn Resuscitation.

    Science.gov (United States)

    Rizzo, Julie A; Rowan, Matthew P; Driscoll, Ian R; Chung, Kevin K; Friedman, Bruce C

    2016-10-01

    The inflammatory state after burn injury is characterized by an increase in capillary permeability that results in protein and fluid leakage into the interstitial space, increasing resuscitative requirements. Although the mechanisms underlying increased capillary permeability are complex, damage from reactive oxygen species plays a major role and has been successfully attenuated with antioxidant therapy in several disease processes. However, the utility of antioxidants in burn treatment remains unclear. Vitamin C is a promising antioxidant candidate that has been examined in burn resuscitation studies and shows efficacy in reducing the fluid requirements in the acute phase after burn injury. PMID:27600125

  17. A propose to suspend the use of hydroxyethyl starch for fluid resuscitation in shock phase of severe burns%建议暂停羟乙基淀粉在严重烧伤休克期中的应用

    Institute of Scientific and Technical Information of China (English)

    罗高兴; 彭毅志; 吴军

    2013-01-01

    Based on the result of randomized controlled trials and meta-analysis recently,the infusion of hydroxyethyl starch(HES)was not shown to overmatch routine crystalline solution in exerting resuscitation effect against hypovolemia of patients with burn shock,severe systematic infection,or other critical conditions,on the other hand,it may induce renal toxicity and other toxic and side effects.Since the pathological mechanism underlying hypovolemia during shock phase after burn is similar to that of severe systemic infection,we propose to suspend the use of HES for fluid resuscitation during the shock phase of severe burn until further elucidation.

  18. Effect of hypotensive fluid resuscitation on microcirculation in an uncontrolled hemorrhagic shock of pregnant rabbits%限制性输液对失血性休克孕兔微循环灌注的影响

    Institute of Scientific and Technical Information of China (English)

    秦薇; 余艳红; 王晨虹

    2010-01-01

    significantly shorter than NH(3.0 ±0.3) days and HHH(3.6 ± 0.3) days group( P < 0.05). FCD at the end of the hospital resuscitation were significantly related with survival time ( r = 0.655, P = 0.000 ). Conclusion Compared with traditional aggressive fluid resuscitation, hypotensive resuscitation reduce constriction of arterial and venule diameter, increase FCD, alleviate metabolic acidosis and improve long-term survival Hypertonic hydroxyl ethyl starch resuscitation ameliorate microcirculation without improving survival rate.%目的 探讨限制性输液对失血性休克孕兔微循环灌注的影响.方法 选择妊娠15~25 d的新西兰孕兔30只分为3组:(1)传统复苏组(NS组):院前复苏期开始接受大量的生理盐水及复方氯化钠液快速输注,以维持平均动脉压在80 mm Hg(1 mm Hg=0.133 kPa)左右;(2)限制性输液复苏组(NH组):院前复苏期开始接受小量生理盐水及复方氯化钠液输注,以维持平均动脉压在60 mm Hg左右;(3)高渗高胶限制性输液复苏组(HHH组):院前复苏期开始输注10%羟乙基淀粉注射液±7.5%氯化钠+生理盐水及复方氯化钠液,以维持平均动脉压在60 mm Hg左右.制作各组孕兔失血性休克模型,实验开始后分为基础期(0 min)、休克期(0~30 min)、院前复苏期(30~90 min)及院内复苏期(90~180 min).监测指标:(1)应用微循环检测仪连续监测耳窗微动脉和微静脉直径;(2)检测各期功能性毛细血管密度(FCD),FCD为开放的毛细血管相对于基础期百分比;(3)应用全自动血气分析仪检测孕兔氧分压(PO2)、二氧化碳分压(PCO2)、pH值、剩余碱(BE)的水平.结果(1)微动脉和微静脉直径:各组孕兔基础期微动脉直径分别比较,差异有统计学意义(P>0.05).NS组、NH组及HHH组休克期微动脉直径分别为(50.8±5.6)、(47.6±3.7)及(51.3±2.4)μm,各组间比较差异无统计学意义(P>0.05),NS组、NH组及HHH组院前复苏期及院内复苏

  19. 限制性液体复苏对颅脑损伤合并多发伤的疗效%Effect of limited fluid resuscitation for craniocerebral injury combined with multiple trauma

    Institute of Scientific and Technical Information of China (English)

    郝继山; 季庆; 孙清; 刘暌

    2015-01-01

    目的 探讨颅脑损伤合并多发伤患者的液体复苏策略. 方法 回顾性分析2007年1月-2013年1月收治的124例颅脑损伤(GCS 3~12分)合并多发伤患者的临床资料,依据液体复苏策略分为积极液体复苏组(AFR组,63例)和限制性液体复苏组(LFR组,61例).补液的量化调控标准:严密监测血流动力学,LFR组将平均动脉压(MAP)控制在70 ~ 80 mmHg,中心静脉压控制在6~8 cmH2O,维持48 h;AFR组MAP控制在患者基础血压水平,中心静脉压控制在8~12 cmH2O,余治疗两组基本相同.比较两组血压水平、休克状况、凝血功能、影像学资料、GCS、伤后6个月GOS等指标. 结果 两组入院时MAP、休克指数、ISS、创伤严重指数(TSI)、GCS差异均无统计学意义(P>0.05),LFR组的血压波动水平(18.5±9.9) mmHg,小于AFR组的(29.4±11.1)mmHg (P<0.01).LFR组颅内出血进展8例,开颅手术3例,少于AFR组颅内出血进展19例及开颅手术10例(P<0.01).LFR组凝血功能指标好于AFR组(P<0.05).入院7 d LFR组GCS为(9.1±3.6)分,AFR组为(7.2±2.3)分(P<0.05).随访6个月时LFR组预后良好34例,不良27例;AFR组预后良好23例,预后不良40例,LFR组好于AFR组(P<0.05). 结论 对于中、重型颅脑损伤合并多发伤患者,LFR可改善凝血功能障碍和休克,降低颅内再出血概率,对改善预后有一定的帮助.%Objective To investigate the fluid resuscitation strategies to craniocerebral injury patients combined with multiple trauma.Methods This retrospective review was made on 124 patients with combined craniocerebal injury (GCS 3-12 points) plus multiple trauma.Based on the fluid resuscitation strategies,63 patients were treated with aggressive fluid resuscitation (AFR),and 61 with limited fluid resuscitation (LFR).A restrictive rehydration principle was performed with intensive hemodynamic monitoring:mean arterial pressure was kept between 70-80 mmHg for 48 hours and central venous pressure between 6-8 cmH2

  20. Damage control resuscitation for abdominal war injury

    Directory of Open Access Journals (Sweden)

    Wei-wei DING

    2014-03-01

    Full Text Available In recent years, the concept of comprehensive treatment for military trauma has been comprehensively updated. The application of damage control surgery has significantly improved the clinical outcome of severe abdominal injury. With appropriate surgical intervention, post-trauma fluid resuscitation plays an increasingly important role in the treatment of abdominal injury. The damage control resuscitation strategy addresses the importance of permissive hypotension and haemostatic resuscitation for patients with severe trauma, under the guidance of damage control surgical principle. DOI: 10.11855/j.issn.0577-7402.2014.03.02

  1. Effect of different fluid resuscitation scheme on the prognosis of patients with septic shock%不同液体复苏策略对脓毒性休克患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    邹外龙; 邓从香

    2014-01-01

    Objective It is to compare the effects of limited fluid resuscitation and open fluid resuscitation on the prognosis of patients with septic shock .Methods 46 cases of patients with septic shock were randomly divided into open group ( n=23 ) which was given open fluid resuscitation and limited group ( n=23 ) which was given limited fluid resuscitation .The changes of hemodynamics indexes , APACHE Ⅱ, SOFA scores, CRP level, the improvements of cardiac function , cardiac muscle damage, and 60 d mortality, the duration of ventilatory support and ICU stay , and duration with no organ failure were com-pared in both groups .Results After resuscitation, there was no significant difference in the improvements of HR , MAP, CVP and blood lactic acid;The improvements of APACHE II scores , SOFA scores , cardiac function indexes , cardiac muscle dam-age indexes and CRP were more significantly in limited group than those in open group (P0.05).The duration of ICU stay and ventilatory support were significantly shorter in limited group than that in open group (P<0.05 or P<0.01).Con-clusion Early limited fluid resuscitation could effectively improve and maintain the stability of hemodynamics in the patients with septic shock , and it had some advantages in decreasing mortality , shortening duration of ICU stay , improving cardiac function and relieving cardiac muscle damage compared with open fluid resuscitation .%目的:比较限制性和开放性液体复苏策略对脓毒性休克患者预后的影响。方法将46例脓毒性休克患者随机分为开放组和限制组各23例,开放组实施开放性液体复苏策略,限制组实施限制性液体复苏策略。比较2组血流动力学指标、APACHEⅡ和SOFA评分、心功能及心肌损伤改善情况,CRP水平的变化,以及60 d病死率、机械通气时间、入住ICU时间和无脏器衰竭时间的差异。结果复苏后2组HR、MAP、CVP及血乳酸水平改善幅度差异无统计学意义;限制

  2. 液体复苏对重症急性胰腺炎早期体液代谢的影响%The effects of fluid resuscitation on body fluid metabolism in severe acute pancreatitis at early Stage

    Institute of Scientific and Technical Information of China (English)

    徐新建; 林筱琦; 王喜艳; 晏冬; 王金宝; 温浩

    2009-01-01

    目的 观察不同剂量和张力液体复苏对重症急性胰腺炎早期体液代谢的影响.方法 取杂种犬60条随机分为4组,每组5条犬,研究设计为2×2析因实验设计,给予不同补液剂量,分别按50ml/kg和100ml/kg,每种补液又分两种补液张力(等张和高张)进行液体复苏,采用自身胆汁逆行主胰管注射法制模.制模后第1~3天每日补液,测定血浆钠离子浓度、血浆醛固酮激素(ALD)水平,记录出量和体液隔离量.结果 低剂量补液血浆钠离子浓度下降程度轻、出量减少和血浆醛固酮激素水平升高,在第3天差异均有统计学意义(P<0.05);高剂量补液可使出量增加,血浆钠离子浓度和血浆醛固酮激素水平也明显下降,但并未减少体液隔离量,反而导致体液在体内储留.高张力补液在补液剂量相同的前提下增加出量,能减少体液隔离量,并能提高晶体渗透压和降低醛固酮的水平,在第3天差异均有统计学意义(P<0.05).结论 补液剂量和补液张力均对SAP体液代谢产生影响,补液量大,能使机体丢失的体液得到及时补充,但易发生血浆晶体渗透压下降和体液隔离量增大;高张力补液不仅增加出量,同时能提高血浆Na离子浓度,避免血浆晶体渗透压降低.%Objective To study the effects of the fluid resuscitation with different fluid volume and fluid tension on the body fluid metabolism in severe acute pancreatitis (SAP) at early stage. Methods Sixty dogs were randomly divided into 4 groups (n=15 per group). Twenty-two factorial experiment designs were done with the fluid volume of 50 and 100 ml/kg,and isotonic contraction and high-tension fluid. SAP model was created by retrograde injection of its own bile into its main pancreatic duct. All the dogs were subjected to infusion therapy at the 1st to 3rd day,and the plasma concentrations of Na~+ ,and the plasma level of aldosterone (ALD) were determined,and the total output fluid and the total

  3. Pediatric Burn Resuscitation.

    Science.gov (United States)

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  4. Complicated Burn Resuscitation.

    Science.gov (United States)

    Harrington, David T

    2016-10-01

    More than 4 decades after the creation of the Brooke and Parkland formulas, burn practitioners still argue about which formula is the best. So it is no surprise that there is no consensus about how to resuscitate a thermally injured patient with a significant comorbidity such as heart failure or cirrhosis or how to resuscitate a patient after an electrical or inhalation injury or a patient whose resuscitation is complicated by renal failure. All of these scenarios share a common theme in that the standard rule book does not apply. All will require highly individualized resuscitations. PMID:27600129

  5. 烧伤休克期有关补液公式的临床应用与评价%Clinical practice and evaluation of relative fluid resuscitation formula at bum shock stage

    Institute of Scientific and Technical Information of China (English)

    罗高兴; 罗奇志; 黄跃生; 彭毅志; 庄颖; 张立辉; 周秘; 程文广; 吴军; 张家平; 袁志强

    2008-01-01

    目的 评价第三军医大学烧伤休克期补液公式(简称三医大公式)在大面积烧伤患者休克防治中的应用.方法 选择2005-2007年笔者单位收治的热力烧伤患者(烧伤总面积大于或等于30%TBSA、伤后8 h内入院且无特殊疾患)共71例,分为成人组(46例)、小儿组(25例).患者入院后即按照三医大公式进行液体复苏治疗,同时监测尿量、心率、血压等指标,根据患者实际情况随时调整补液速度.记录并统计2组患者补液量、实际补液系数、尿量. 结果 71例患者均平稳度过休克期,未发生明显的因液体复苏引起的相关并发症.成人组伤后第1、2个24 h及小儿组伤后第2个24 h的实际补液量超过各自计划补液量的16%~38%.成人组第1、2个24 h的实际补液系数大于公式所要求的补液系数.2组患者第1个24 h尿量为1.1~1.2 mL·kg-1·h-1左右;第2个24 h成人组为(1.2±0.4)mL·kg-1·h-1,小儿组为(1.7±0.5)mL·kg-1·h-1. 结论 三医大公式是大面积烧伤患者休克期治疗的较好选择,在应用此公式时须强调进行个性化液体复苏治疗.%Objective To evaluate the application of the Third Military Medical University (TMMU) formula for fluid resuscitation on the major burn patients during shock stage. Methods Seventy-one ther- mal injury patients (burn area more than 30% TBSA,without especial illness, hospitalization within 8 hour after burn ) admitted from 2005 to 2007 were divided into adult group ( n = 46) ,child group( n = 25 ). Fluid resuscitation was initiated as per the TMMU formula. Results All patients survived the first 48 hours post bum injury and none developed recognized complications associated with fluid resuscitation. The average in- fused fluid was 16% ~ 38% more than the calculated in both adult and child groups. The average urine out- put during the first 24 hours post burn injury was 1.1 ~ 1.2 mL · kg-1 · h-1 in the two groups, but reached 1.2 mL and 1.7 mL · kg

  6. Damage control resuscitation for massive hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Osaree Akaraborworn

    2014-01-01

    Hemorrhage is the second most common cause of death among trauma patients and almost half of the deaths occur within 24 hours after arrival.Damage control resuscitation is a new paradigm for patients with massive bleeding.It consists of permissive hypotension,hemostatic resuscitation and transfusion strategies,and damage control surgery.Permissive hypotension seems to have better results before the bleeding is controlled.The strategy of fluid resuscitation is minimizing crystalloid infusion and increasing early transfusion with a high ratio of fresh frozen plasma to packed red cells.Damage control surgery is done when the patient's condition is unfit for definitive surgery.Hemorrhage and contamination control with temporary abdominal closure is performed before transferring the patients to intensive care unit and the operating room for a permanent laparotomy.

  7. Anti-MUC1 Antibody in Nipple Aspirate Fluids Correlates with Tumor Aggressiveness in Breast Cancer: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Ebru Menekse

    2015-01-01

    Full Text Available Antibodies against MUC1 are found in circulation of breast cancer (BC patients. We hypothesized that anti-MUC1 antibodies might be present in even a higher concentration in nipple aspirate fluid (NAF and could be used to predict aggressiveness of BC. Serum and NAF samples were collected from high risk lesions, BC, and healthy contralateral breasts. ELISA was used to measure the amount of IgG, IgM, and IgA against a tumor-specific MUC1 peptide derived from the extracellular tandem repeat domain of MUC1. Tumor characteristics were recorded prospectively; 120 NAF samples were obtained from a total of 77 women in the study. There was no significant difference of anti-MUC1 antibody levels compared to BC with other lesions. Anti-MUC1 IgG level in NAF was higher in triple negative tumors (P=0.02; serum anti-MUC1 IgG levels were significantly higher in patients with ER (− tumor and recurrent disease (P=0.01; NAF anti-MUC1 IgA levels were significantly higher in patients with LVI and Her2-neu (+ tumors (P<0.05. These results show that NAF could be a reliable biomarker to predict tumor aggressiveness in BC. A larger study will be needed to confirm these data and to investigate the potential of anti-MUC1 antibodies in NAF and serum to predict disease outcome.

  8. Albumin for fluid resuscitation sepsis:is just harmless or beneficial%白蛋白用于脓毒症液体复苏:是仅仅无害还是有益

    Institute of Scientific and Technical Information of China (English)

    郑岩; 马朋林

    2013-01-01

    Without solid evidences from clinical trials, the controversies were existed about the value of fluid resuscitation with albumin in septic patients. One of the focuses, the safety, has been well identified by RCTs with a large number of cases. Meanwhile, it still reminded unclear whether resuscitation with albumin improved outcome, or was beneficial to correcting some of the pathophysiological abnormalities in sepsis, such as serious hypoalbuminemia, hemodynamic instability, and even inflammation - induced cell injury. In this article, the following conclusions were made through a systematic review on albumin resuscitation for septic patients. Administration of albumin in initial resuscitation of sepsis or severe sepsis was safe, valid in correction of hypoalbuminemia, beneficial to maintainance of hemodynamic stability, but lacked sufficient data in reduction of mortality. Thus, it might be more reasonable to suggest adding albumin in the initial fluid resuscitation regimen of severe sepsis and septic shock if the serum albumin is known or anticipated to be low, and the hemodynamics was unstable.%由于缺乏有力的临床研究证据,白蛋白用于脓毒症液体复苏的价值存在争议.焦点之一--安全性问题已得到大样本、随机、对照研究证实,而白蛋白容量复苏是否有利于改善预后或有益于纠正脓毒症病理生理过程中的一些异常变化,如严重低蛋白血症、血流动力学不稳定、甚至炎症反应介导的细胞损伤仍有待阐明.本文通过对现有相关文献的系统回顾分析,得出以下结论:在脓毒症初始液体复苏过程中应用白蛋白是安全的,能迅速、有效改善严重低蛋白血症,有益于维持严重脓毒症患者循环稳定,但尚缺乏降低病死率的充分证据.因此,这样的推荐可能更加合理,即对于存在或可能发生严重低蛋白血症的严重脓毒症患者,出现循环不稳定,在容量复苏初始阶段可考虑应用适量白蛋白实施容量复苏.

  9. ABC of Resuscitation

    CERN Document Server

    Colquhoun, Michael

    2003-01-01

    This guide has concise and practical information on all aspects of resuscitation. New guidelines are just one of the changes to the 5th edition of this book as many of the chapters have been completely rewritten.

  10. Viscoelastic guidance of resuscitation

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse R; Johansson, Pär I

    2014-01-01

    the use of viscoelastic hemostatic assays to guide trauma resuscitation. RECENT FINDINGS: Viscoelastic hemostatic assays such as thrombelastography and rotational thrombelastometry have shown to reduce bleeding, transfusion of fresh frozen plasma and platelets, and possibly mortality in different surgical...

  11. 儿童感染性休克液体复苏相关病理生理学研究进展%Advances in pathophysiology of fluid resuscitation of septic shock in children

    Institute of Scientific and Technical Information of China (English)

    喻文亮; 葛许华

    2016-01-01

    Fluid resuscitation is one of the most important advances in the treatment of septic shock in recent 20 years. Although saving many children's lives,this technique has been challenged by some studies. This article re-viewed systematically hemodynamics characteristic,myocardial depression and capillary leak syndrome in septic shock in children.%液体复苏是近20年感染性休克救治方面最重要的进展之一,近有临床研究对液体复苏的效果提出质疑。现从病理生理学角度阐述儿童感染性休克时血流动力学变化、心脏功能抑制及毛细血管渗漏综合征相关进展。

  12. Rabbit model of uncontrolled hemorrhagic shock and hypotensive resuscitation

    Directory of Open Access Journals (Sweden)

    J.B. Rezende-Neto

    2010-12-01

    Full Text Available Clinically relevant animal models capable of simulating traumatic hemorrhagic shock are needed. We developed a hemorrhagic shock model with male New Zealand rabbits (2200-2800 g, 60-70 days old that simulates the pre-hospital and acute care of a penetrating trauma victim in an urban scenario using current resuscitation strategies. A laparotomy was performed to reproduce tissue trauma and an aortic injury was created using a standardized single puncture to the left side of the infrarenal aorta to induce hemorrhagic shock similar to a penetrating mechanism. A 15-min interval was used to simulate the arrival of pre-hospital care. Fluid resuscitation was then applied using two regimens: normotensive resuscitation to achieve baseline mean arterial blood pressure (MAP, 10 animals and hypotensive resuscitation at 60% of baseline MAP (10 animals. Another 10 animals were sham operated. The total time of the experiment was 85 min, reproducing scene, transport and emergency room times. Intra-abdominal blood loss was significantly greater in animals that underwent normotensive resuscitation compared to hypotensive resuscitation (17.1 ± 2.0 vs 8.0 ± 1.5 mL/kg. Antithrombin levels decreased significantly in normotensive resuscitated animals compared to baseline (102 ± 2.0 vs 59 ± 4.1%, sham (95 ± 2.8 vs 59 ± 4.1%, and hypotensive resuscitated animals (98 ± 7.8 vs 59 ± 4.1%. Evidence of re-bleeding was also noted in the normotensive resuscitation group. A hypotensive resuscitation regimen resulted in decreased blood loss in a clinically relevant small animal model capable of reproducing hemorrhagic shock caused by a penetrating mechanism.

  13. Vitamin D-Binding Protein Levels in Plasma and Gingival Crevicular Fluid of Patients with Generalized Aggressive Periodontitis

    Directory of Open Access Journals (Sweden)

    Xin Zhang

    2014-01-01

    Full Text Available Vitamin D-binding protein (DBP is the main transport protein of vitamin D and plays an important role in the immune system and host defenses. The purpose of this study was to measure DBP levels in plasma and gingival crevicular fluid (GCF of patients with generalized aggressive periodontitis (GAgP, in comparison to healthy controls, with the goal of elucidating the relationship between DBP and GAgP. Fifty-nine GAgP patients and 58 healthy controls were recruited for the study; clinical parameters of probing depths (PD, bleeding index, and attachment loss (AL were recorded. DBP levels were measured by enzyme-linked immunosorbent assay. From the results, GAgP patients had higher plasma DBP concentrations (P<0.001 but lower GCF DBP concentrations (P<0.001 than healthy controls. In GAgP group, after controlling the potential confounders of age, gender, smoking status, and BMI index, GCF DBP concentrations correlated negatively with PD (P<0.001 and AL (P=0.009. Within the limits of the study, we concluded that decreased GCF DBP level and increased plasma DBP level are associated with periodontitis.

  14. [Resuscitation - Adult advanced life support].

    Science.gov (United States)

    Gräsner, Jan-Thorsten; Bein, Berthold

    2016-03-01

    Enhanced measures for resuscitation of adults are based on basic measures of resuscitation. The central elements are highly effective chest compressions and avoidance of disruptions that are associated with poor patient outcomes that occur within seconds. The universal algorithm distinguishes the therapy for ventricular fibrillation from the therapy in asystole or pulseless electrical activity (PEA) by the need of defibrillation, and amiodarone administration in the former. Defibrillation is biphasic. In all other aspects, there are no differences in therapy. In each episode of cardiac arrest, reversible causes should be excluded or treated. For the diagnosis during resuscitation, sonography can be helpful. What is new in the 2015 ERC recommendations is the use of capnography, which can be used for the assessment of ROSC (return of spontaneous circulation), ventilation, resuscitation and intubation quality. Mechanical resuscitation devices can be used in selected situations. Successful primary resuscitation should be directly followed by measures of the post-resuscitation care. PMID:27022698

  15. Witnessed resuscitation: a concept analysis.

    Science.gov (United States)

    Walker, Wendy Marina

    2006-03-01

    The science and practice of resuscitation is recognised and endorsed on an international level, yet for more than a decade it has appeared in the literature alongside words such as witnessing or witnessed to signify the practice of family presence during a resuscitation attempt. This paper explores the meaning of witnessed resuscitation using the process for concept analysis proposed by Rodgers. The term resuscitation is explored, followed by identification of relevant uses of the concept of witnessed resuscitation. The reader is introduced to conceptual variations that challenge the way in which the concept has become associated with family or relatives presence in the resuscitation room of an accident and emergency department. Conceptual clarity is further enhanced through the identification of references, antecedents and consequences of witnessed resuscitation and by providing a model case of the concept that includes its defining attributes. PMID:16043184

  16. Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest.

    Science.gov (United States)

    Rittenberger, Jon C; Friess, Stuart; Polderman, Kees H

    2015-12-01

    Cardiac arrest is the most common cause of death in North America. Neurocritical care interventions, including targeted temperature management (TTM), have significantly improved neurological outcomes in patients successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an emergency neurological life support protocol. Patients remaining comatose following resuscitation from cardiac arrest should be considered for TTM. This protocol will review induction, maintenance, and re-warming phases of TTM, along with management of TTM side effects. Aggressive shivering suppression is necessary with this treatment to ensure the maintenance of a target temperature. Ancillary testing, including electrocardiography, computed tomography and/or magnetic resonance imaging of the brain, continuous electroencephalography monitoring, and correction of electrolyte, blood gas, and hematocrit changes, are also necessary to optimize outcomes. PMID:26438463

  17. The application of pulse indication contour cardiac output to early fluid resuscitation in patients with septic shock%脉搏轮廓法在感染性休克早期液体复苏中的运用

    Institute of Scientific and Technical Information of China (English)

    李家琼; 李茂琴; 许继元; 史载祥; 张舟; 李琳; 卢飞; 莫逊; 许艳军

    2011-01-01

    液体复苏及血管活性药应用,能更精确进行液体管理,减少盲目补液,减少机械通气时间,缩短住ICU时间.%Objective To explore the use of pulse indication contour cardiac output (PiCCO) as a guidance for fluid resuscitation and vasopressors employment in patients with septic shock in order to find out the efficacy of this resuscitation strategy in the respect of outcome of patients. Mtthod A total of 30 patients with septic shock were treated with the EDGT fluid treatment protocol as the conventional treatment group from December 2006 to June 2008; and another 26 patients were given fluid treatment under the guidance of PiCCO as PiCCO group from July 2008 to October 2009. Exclusion criteria included patients with history of heart and lung diseases, and liver and kidney dysfunction. The mean arterial blood pressure was maintained above or equal to 65mmHg in PiCCO group,and fluid resuscitation was concluded when global end-diastolic volume index reached 600~750 mL·-2 with the stroke volume variation in < 10% and without auricular fibrillation. Nor-epinephrine was administrated to adiust the systemic peripheral vascular resistance index during 1300~1500 d·s·cm-5·m-2.Dobutamine was empoyed when global ejection fraction was compromised. The options of liquid and diuretics depend upon the presence d extra-vascular lung water. Central venous oxygen saturation and the level of lactate were observed 6hours after resuscitation. The liquid equilibrium for 3 days and the dosage of vasopressors were also recorded. The rate of survival, the time taken for weaning from mechanical ventilation, the days of ICU stay and rate of intact organ function within 28 days were compared between two groups. Results The demphics of patients of two goups were similar. There were no significant difference between PiCCO and the conventional group in values of central venous oxygen saturation and lactate 6 hours after admission to ICU (P > 0.05). And 6 h and 1d

  18. 卡巴胆碱对大鼠烫伤休克期肠内补液时肠道的影响%Carbachol alleviates intestinal inflammation during enteral fluid resuscitation of rats with burn shock

    Institute of Scientific and Technical Information of China (English)

    车晋伟; 胡森; 耿世佳; 吴静; 王磊; 杜颖; 田易军; 盛志勇

    2008-01-01

    Objective To investigate the effect of carbachol on local gut inflammation during entetal resuscitation of rats with bum shock. Method Thirty-eight Wistar rats were subjected to 35%TBSA full thickness scald injury, and enteral fluid was infused into animal intestines via duodenal stomas 30 minutes post bum. The animals were randomly divided into four groups: no resuscitation (Control, n = 8), enteral resuscitation using either a glucose electrolyte solution (GES, n = 10) or GES plus carbachol (60 μg·kg-1,GES/CAR, n = 10), or carbachol alone (CAR, n = 10) .The volumeof GES infusion was based on the Parkland formula (4 ml· 1% TB-SA-1·Kg-1) - All animals were sacrificed 4 hours post bum, and specimens of jejunal tissue were collected to determine the levels of tumor necrosis factor (TNF)-α, nitric oxide (NO), nitric oxide synthase (NOS) and myeloperoxidase (MPO). Serum assays for plasma diamine oxidase (DAO) activities were also performed. Results There were no statistical differences in the intestinal levels of NOS, NO, TNF-α and MPO, and plasma OAO activities, between the GES group and the control group. Compared to the GES group, the GES/CAR group showed significantly lowered levels of intestinal NOS (1.276 ±0.391 vs. 1.818 ±0.436, P<0.05), NO (0.925 ±0.402 vs. 1.561 ±0.190, P < 0.05, TNF-α (0.87±0.13 vs. 1.94±0.47, P <0.01) and MPO (0.465 ±0.092 vs. 0.832±0.214, P<0.05),and reduction in plasma DAO activites (0.732±0.192 vs. 1.381 ±0.564, P <0.05). The CAR group also showed significantly lowered levels of intestinal NOS, NO, TNF-α and MPO and reduced plasma DAO activites, compared to the GES group. Conclusions Theses results suggest that carbachol significantly inhibits the release of proinflammatory mediator and attenuates local inflammation in gut during enteral fluid resuscitation of rats in rats with bum shock. We postulate that carbachol may exert its and-inflammatory effects via the cholinergic anti-inflammatory pathway.%目的

  19. 早期液体复苏对脓毒性休克患者肾功能的影响%Effect of early fluid resuscitation on the renal function of patients with septic shock

    Institute of Scientific and Technical Information of China (English)

    王澜涛; 刘红娟; 胡振杰

    2012-01-01

    Objective To study the effect of early fluid resuscitation on renal function of the patients with septic shock by determining the neutrophil gelatinase - associated lipocalin ( NGAL) and cystatin C. Methods 48 patients with septic shock were admitted into the ICU of the 4th Affiliated Hospital of the Hebei Medical University during March 1 and November 11, 2010. According to the 2004 international guideline for the treatment of sepsis, fluid resuscitation was conducted through the emplaced deep venous catheter following the early goal directed therapy (EGDT). Blood samples were taken at 0 h before the fluid loading, and at 6, 24, 48 h after the fluid loading. The plasma NGAL and cystatin C were detected by the ELISA method. Meanwhile, the temperature, heart rate, respiration rate, mean arterial pressure, hourly - and 24 - hour urine volume, ScvO2 and the APACHE II score were simultaneously recorded. The subjects were further divided into survival and non - survival groups. The controls were 20 healthy volunteers. Results The plasma NGAL and cystatin C levels before fluid loading were statistically higher than those in the control ( P 0. 05 ) . The correlation between the plasma NGAL, cystatin C levels and Scr was very good, and the plasma NGAL, Cystatin C levels step up earlier than Scr. Conclusion ①The plasma concentration of NGAL and cystatin C are clearly elevated in the patients with septic shock, which indicates the occurrence of acute kidney injury ( AKI). ② Early and complete fluid loading may markedly improve the renal function in the studied patients. ③The correlation between the plasma NGAL, cystatin C and Scr is very good, but the plasma NGAL and cystatin C could reflect the damage of the renal earlier, and the plasma concentration of the NGAL and cystatin C are positive correlation with damage of the renal.%目的 通过检测早期肾损伤监测指标血浆胱抑素C(Cystatin C)、中性粒细胞明胶酶脂质转运蛋白(NGAL),探讨早期液

  20. Resuscitation Prior to Emergency Endotracheal Intubation: Results of a National Survey

    Directory of Open Access Journals (Sweden)

    Robert S. Green

    2016-09-01

    Full Text Available Introduction: Respiratory failure is a common problem in emergency medicine (EM and critical care medicine (CCM. However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI. Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian Critical Care Trials Group. The questionnaire was distributed to all EM and CCM physician members of three national organizations. Using three clinical scenarios (trauma, pneumonia, congestive heart failure, we assessed physician preferences for use and types of fluid and vasopressor medication in pre-EETI resuscitation of critically ill patients. Results: In total, 1,758 physicians were surveyed (response rate 50.2%, 882/1,758. Overall, physicians would perform pre-EETI resuscitation using either fluids or vasopressors in 54% (1,193/2,203 of cases. Most physicians would “always/often” administer intravenous fluid pre-EETI in the three clinical scenarios (81%, 1,484/1,830. Crystalloids were the most common fluid physicians would “always/often” administer in congestive heart failure (EM 43%; CCM 44%, pneumonia (EM 97%; CCM 95% and trauma (EM 96%; CCM 96%. Pre-EETI resuscitation using vasopressors was uncommon (4.9%. Training in CCM was associated with performing pre-EETI resuscitation (odds ratio, 2.20; 95% CI, [1.44-3.36], p<0.001. Conclusion: Pre-EETI resuscitation is common among Canadian EM and CCM physicians. Most physicians use crystalloids pre-EETI as a resuscitation fluid, while few would give vasopressors. Physicians with CCM training were more likely to perform pre-EETI resuscitation.

  1. Resuscitation and auto resuscitation by airway reflexes in animals

    OpenAIRE

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Jakus, Jan; Gresova, Sona

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath – sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant – autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasp...

  2. Studies on the application of two methods of fluid resuscitation in trauma patients with hemorrhagic shock%两种液体复苏方法在创伤失血性休克患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    张希国; 李星毓; 宝音; 张永; 庞存海

    2012-01-01

    [目的]比较延迟液体复苏和即刻液体复苏对创伤失血性休克(HTS)患者的救治效果.[方法]回顾性分析2006年5月-2011年10月我院急诊经院前急救收治的63例有HTS患者,根据患者入院前纠正平均动脉压(MAP)水平分为即刻液体复苏组(A组,MAP 90~110 mmHg,32例)和延迟液体复苏组(B组,MAP 70 ~ 89 mmHg,31例),对两组患者复苏前后的3个时间节点检测血红蛋白(Hb)、红细胞压积(Hct)、血小板(Plt)、碱缺失(BE)、动脉血PH(BpH)、谷丙转氨酶(ALT),统计两组患者输入液体量、MAP、并发症发生率及死亡率.[结果]两组在建立静脉通路前(即液体复苏前)Hb、Hct、Plt、BE、BpH、ALT比较无统计学差异(P>0.05).在院前急救期,A组较B组Hb、Hct、Plt、BE、BpH均下降,有统计学意义(P<0.05),在院内救治期,A组较B组Hb、Hct、Plt、BE、BpH均下降,差异有统计学意义(P<0.05).两组MAP在充分液体复苏前各自稳定在90 ~ 110mmHg和70~90 mmHg,A组液体输入量(3 250±457)ml,B组液体输入量(1 080±514)ml,两组在MAP和输液量比较差异有统计学意义(P<0.05),本研究发生并发症20例,死亡5例,两组患者并发症发生率和死亡率比较差异无统计学意义(P>0.05).[结论]对活动性出血的HTS患者院前延迟性液体复苏,维持适当的MAP水平,可在一定程度上改善休克期组织脏器的灌注和氧供.%[Objective] To compare the effect of treating patient with delayed fluid resuscitation and immediate fluid resuscitation in traumatic hemorrhagic shock(HTS). [Methods] A total of 63 patients with HTS admitted to our emergency department form 2006-05 to 2011-10 were reviewed. These cases were divided into two groups according to the levels of the mean arterial pressure(MAP) before hospital ization: which were immediate fluid resuscitation group(Group A, MAP 90 ~ 110 mmHg , 32 cases) and delayed fluid resuscitation group (Group B, MAP 70 ~ 89 mmHg, 31 cases). Hemoglobin

  3. Overcoming resistance to family-witnessed resuscitation.

    Science.gov (United States)

    Jordahl, Erica; Hyde, Yolanda M; Kautz, Donald D

    2015-01-01

    Giving family members the option of being present during resuscitation has been shown to be beneficial for both family and staff. However, only a small percentage of intensive care units have policies promoting family-witnessed resuscitation. This article reviews current research showing the benefits of family-witnessed resuscitation, outlines how to successfully integrate a family facilitator during resuscitation, and includes research that has been effective in changing the prevailing attitudes of staff. The authors also argue for the resuscitation team to practice ethical and cultural humility when involving family members so that all resuscitation efforts are a success, whether the patient lives or dies. PMID:26436295

  4. Stabilized hemoglobins as acellular resuscitative fluids.

    Science.gov (United States)

    Cerny, L C; Green, A; Noga, B; Cerny, E R

    1992-01-01

    This study reports some recent work dealing with the stabilization of the tetramers of hemoglobin. It is shown that by using a variety of diacids, it is possible to increase the P50 above that of stroma free hemoglobin. In order to lengthen the retention times in the circulatory system, the stabilized hemoglobins were complexed with both hydroxyethyl starch polymers and polyol tetronic polymers. The resulting hemoglobin-polymer compounds were then freeze-dried. It was possible to reconstitute the powder by the addition of physiological saline when needed. The methods presented here appear to be appear to be as effective as using pyridoxal phosphate but at a fraction of the cost. PMID:1391448

  5. Effects of resuscitating fluid volume changes on internal organ functions after burn-blast combined injury%不同补液量对重度烧冲复合伤犬脏器功能的影响

    Institute of Scientific and Technical Information of China (English)

    张东海; 柴家科; 李百玲; 张旭龙; 胡泉; 马丽; 郁永辉; 刘玲英

    2015-01-01

    40±0.19)L/min,增量20%组高于增量30%组,差异具有统计学意义(t =3.890,P <0.05)。伤后对照组和增量30%组谷丙转氨酶高于增量20%组,伤后24 h(t =2.745、3.864)、48 h(t =5.080、6.869)和72 h(t =4.195、5.143),差异均有统计学意义(P <0.05)。伤后4 h 和8 h 时,增量20%组、增量30%组血尿素氮低于对照组,伤后4 h(t =4.372、7.429),伤后8 h(t =3.719、6.171),差异均有统计学意义(均 P <0.05),增量20%组、增量30%组低于增量10%组,伤后4 h(t =3.519、6.508)、伤后8 h(t =3.922、6.835),差异均有统计学意义(均 P <0.05)。伤后各组间血肌酐比较差异均无统计学意义(均 P >0.05)。四组伤后较伤前,血管外肺水指数均上升,动脉氧分压下降,组间比较差异均无统计学意义(均 P >0.05)。结论犬Ⅲ度烧伤35%总体表面积并中度冲击伤休克适宜的补液量应按 Parkland 公式补液量增量20%计算,即第一个24 h 内4.8 mL·kg -1·h -1,第二个24 h 内2 mL·kg -1·h -1,与 Parkland 公式补液量及增量10%相比,可在伤后早期显著改善尿输出量和心输出量,且不会引起肺水肿的加重;增量30%与增量20%相比,尿输出量提升过高,早期容量负荷过重。%Objective To figure out an optimal resuscitating fluid volume after burn-blast combined injury by determining effects of gradient volume changes on internal organ functions.Methods Thirty-two healthy male beagle dogs were subjected to a burn-blast combined injury (35% total body surface area full thickness burn combined with middle severity blast injury)and randomLy assigned into 4 groups,namely, the controlled group,volume increasing group 1 0%,20% and 30%,with 8 dogs in each group.The controlled group was resuscitated with the Parkland formula

  6. Resuscitation Using Liposomal Vasopressin in an Animal Model of Uncontrolled Hemorrhagic Shock.

    Directory of Open Access Journals (Sweden)

    Meng-Tse Gabriel Lee

    Full Text Available Current research suggests that administration of vasopressin to patients with uncontrolled hemorrhagic shock (UHS can avoid the detrimental effects associated with aggressive fluid resuscitation. However, vasopressin has a short half-life of 10~35 minutes in in vivo use and precludes its use in the pre-hospital setting. To increase the half-life of vasopressin, we proposed to synthesize liposome-encapsulated vasopressin and test it in a rat model of UHS.The film hydration method was used to prepare liposomal vasopressin consisting of: Dipalmitoylphosphatidylcholine, cholesterol, and dipalmitoyl phosphatidylethanolamine (20:20:1 mole ratio. 42 rats were subjected to UHS and randomly received 5 different treatments (vasopressin, liposomal vasopressin, lactate ringer (LR, liposome only and sham. Outcome of UHS were measured using 4 common prognostic tests: mean arterial pressure (MAP, serum lactate level, inflammatory profile and pulmonary edema.The dynamic light scattering results confirmed that we had prepared a successful liposomal vasopressin complex. Comparing the serum vasopressin concentration of liposomal vasopressin and vasopressin treated animals by ELISA, we found that the concentration of vasopressin for the liposomal vasopressin treated group is higher at 60 minutes. However, there was no significant difference between the MAP profile of rats treated with vasopressin and liposomal vasopressin in UHS. We also observed that animals treated with liposomal vasopressin performed indifferently to vasopressin treated rats in serum lactate level, inflammatory profile and edema profile. For most of our assays, the liposome only control behaves similarly to LR resuscitation in UHS rats.We have synthesized a liposomal vasopressin complex that can prolong the serum concentration of vasopressin in a rat model of UHS. Although UHS rats treated with either liposomal vasopressin or vasopressin showed no statistical differences, it would be worthwhile

  7. Vasopressin decreases neuronal apoptosis during cardiopulmonary resuscitation

    OpenAIRE

    Ma, Chi; Zhu, Zhe; Wang, Xu; Zhao, Gang; Liu, Xiaoliang; Li, Rui

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommended that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopulmonary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, ...

  8. Resuscitation with hydroxyethyl starch 130/0.4 attenuates intestinal injury in a rabbit model of sepsis

    Directory of Open Access Journals (Sweden)

    Wei-Hua Lu

    2015-01-01

    Conclusions: Fluid resuscitation with 6% HES 130/0.4 protects against intestinal mucosal barrier dysfunction in rabbits with sepsis, possibly via mechanisms associated with improving intestinal oxygen metabolism and reducing the release of inflammatory mediators.

  9. 严重延迟复苏烧伤休克患者血浆脑钠肽的变化%Change in plasma brain natriuretic peptide and its clinical significance in burn patients after delayed fluid resuscitation of shock

    Institute of Scientific and Technical Information of China (English)

    黄永新; 詹新华; 郑静伟; 吴祖煌; 陈建崇; 朱剑仙; 谢包根; 刘世康

    2010-01-01

    Objective To observe the early change in plasma brain natriuretic peptide (BNP) level in burn patients with long delayed fluid resuscitation of burn shock and its clinical significance.Methods Thirty-six burn patients with second and third degree of burn covering 32%- 92% total body surface area were enrolled for the study, among them 10 patients were complicated with serious heart failure (heart failure group), and 26 patients rallied from shock after delayed fluid resuscitation without heart failure (stable group).The level of plasma BNP, lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), and left ventricle ejection fraction (LVEF) were determined at admission and 3 hours after hospitalization, and 24, 48, 72, 168 hours after the injury in both groups with electrochemiluminescence (ECL).Results Compared with stable group, the plasma BNP level (ng/L) of heart failure group at 3 hours after hospitalization, and 24, 48, 72 hours after the burn injury increased significantly (3 hours after hospitalization: 1 521.38±121.11 vs.391.36±63.27, 24 hours after burn: 2 516.86±193.25 vs.360.79±146.56, 48 hours after burn: 1 587.76±169.23 vs.398.92±77.46, 72 hours after burn: 974.45±166.33vs.283.43 ± 68.15, all P< 0.01), the level of LVEF lowered significantly (3 hours after hospitalization;0.33±0.03 vs.0.58±0.09, 24 hours after burn: 0.36±0.09 vs.0.60±0.10, 48 hours after burn: 0.35±0.08 vs.0.62±0.11, 72 hours after burn: 0.39±0.10 vs.0.64±0.10, all P<0.05).The levels of LDH (μmol·s-1·L-1)in stable group were 2.87±0.50 at admission,3.02±0.43 3hours after hospitalization,4.02±0.87 24 hours after burn, 6.90±0.87 48 hours after burn, 3.64±0.75 72 hours after burn, 2.670.45 168 hours after burn while in heart failure group, they were 2.97±1.40, 3.84±0.37, 4.29±0.45,8.50±0.38, 3.84±0.62, 2.30±0.38, respectively;and CK-MB (U/L) in stable group were 59.12±13.75at admission, 70.39 ±10.72 3 hours after hospitalization, 79.29 ±17

  10. 感染性休克复苏中血管活性药撤离对预后的影响%Effect of vasopressin withdrawal during early fluid resuscitation on prognosis in patients with septic ;shock

    Institute of Scientific and Technical Information of China (English)

    李家琼; 史载祥; 许继元; 张舟; 李琳; 卢飞; 莫逊; 李茂琴

    2014-01-01

    887)ml vs.(2326±568)ml;(4554±738)ml vs.(3847±454)ml],但第2天与第3天的液体复苏量比A组[(2289±376)ml vs.(2597±428)ml;(989±302)ml vs.(1438±313)ml]减少,3 d总液体复苏[(7648±815)ml vs.(7965±678)ml]明显减少(P<0.05)。(5)B组28 d生存率和无脏器衰竭时间有改善趋势但差异无统计学意义,28 d内脱离呼吸机时间[(16.3±9.2)d vs.(19.5±8.5)d]增加,住ICU时间缩短[(9.6±3.2)d vs.(8.4±3.1)d](P<0.05)。结论感染性休克复苏过程中严密监测下进行血管活性药撤离,能尽早充分复苏稳定循环,改善脏器灌注,并减少液体过负荷的风险,减少机械通气时间,缩短住ICU时间。%Objective To explore the effect of vasopressin withdrawal during early fluid resuscitation on tissue perfusion and prognosis in patients with septic shock. Methods Inclusion criteria:septic shock patients with APACHEII from 18 to 28 and GCS more than 7 when admitted to ICU. Exclusion criteria: patients with chronic history of heart, lung, liver and kidney dysfunction. 32 patients were given the EDGT protocol as group A from 2006 October to 2009 June; 30 patients were given vasopressin withdrawal during fluid resuscitation as group B from 2009 July to 2009 December. Norepinephrine (NE) and/or dobutamine were administrated to maintain mean arterial pressure (MAP)≥65 mmHg during EDGT progress in group A. Dose of vasopressors was adjusted according to experience of doctors. To maintain the MAP≥75 mmHg in group B, norepinephrine was administrated to adjust the systemic circulation peripheral vascular resistance index during 900 to 1 500 d·s·cm-5·(m2)-1;After MAP maintained stability for 1 h, dose of NE was dropped at 0.4 µg·kg-1·h-1 per 10 min. The dose of the last NE was injected when MAP was lower than 65 mmHg. Central venous oxygen saturation and lactate values were observed after 6 h. 3 d liquid balance and

  11. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  12. Closed-loop and decision-assist resuscitation of burn patients.

    Science.gov (United States)

    Salinas, Jose; Drew, Guy; Gallagher, James; Cancio, Leopoldo C; Wolf, Steven E; Wade, Charles E; Holcomb, John B; Herndon, David N; Kramer, George C

    2008-04-01

    Effective resuscitation is critical in reducing mortality and morbidity rates of patients with acute burns. To this end, guidelines and formulas have been developed to define infusion rates and volume requirements during the first 48 hours postburn. Even with these standardized resuscitation guidelines, however, over- and under-resuscitation are not uncommon. Two approaches to adjust infusion rate are decision-assist and closed-loop algorithms based on levels of urinary output. Specific decision assist guidelines or a closed-loop system using computer-controlled feedback technology that supplies automatic control of infusion rates can potentially achieve better control of urinary output. In a properly designed system, closed-loop control has the potential to provide more accurate titration rates, while lowering the incidence of over- and under-resuscitation. Because the system can self-adjust based on monitoring inputs, the technology can be pushed to environments such as combat zones where burn resuscitation expertise is limited. A closed-loop system can also assist in the management of mass casualties, another scenario in which medical expertise is often in short supply. This article reviews the record of fluid balance of contemporary burn resuscitation and approaches, as well as the engineering efforts, animal studies, and algorithm development of our most recent autonomous systems for burn resuscitation. PMID:18385584

  13. Aggressive Behavior

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Aggressive Behavior Page Content Article Body My child is sometimes ... type of behavior? The best way to prevent aggressive behavior is to give your child a stable, secure ...

  14. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

    Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

  15. Statins for post resuscitation syndrome.

    Science.gov (United States)

    Kämäräinen, Antti; Virkkunen, Ilkka; Silfvast, Tom; Tenhunen, Jyrki

    2009-07-01

    After sudden cardiac arrest, successful resuscitation and return of spontaneous circulation, a multi-faceted ischaemia/reperfusion related disorder develops. This condition now known as post resuscitation syndrome is characterised by marked increases in the inflammatory response and changes in coagulation profile and vascular reactivity. Additionally, the production of reactive oxygen species and activation of cytotoxic cascades of metabolism add to these injury mechanisms resulting in multiorgan perfusion deficits and dysfunction. Especially in the cerebrum these injuries may be the cause of significant morbidity and mortality. Recent evidence has shown that statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) exert numerous beneficial effects in cardiovascular diseases irrespective of the lipid status. Remarkably, these pleiotropic effects seem to extended beyond cardiovascular diseases such as immunomodulative and antioxidative properties. We hypothesised that administration of statins early in the post resuscitation phase would prove beneficial in the resuscitated patient via several pleiotropic effects. These include inhibition of excessive coagulation and inflammatory response, suppression of oxygen radical production and improved vascular reactivity. The discussed effects are mediated via multiple pathways activated in the cardiac arrest victim, to which statins have been shown to have a beneficial modulating effect in experimental settings and non-cardiac arrest patients. To test this hypothesis in clinical practice, a randomized, controlled trial with sufficient power and standardised post resuscitation treatment would be necessary. The generally good tolerance of statin therapy with minimal adverse effects would support this experiment, although a parenteral form of the drug to ensure adequate dosage might be a prerequisite. PMID:19254829

  16. The impact of in-house surgeons and operating room resuscitation on outcome of traumatic injuries.

    Science.gov (United States)

    Hoyt, D B; Shackford, S R; McGill, T; Mackersie, R; Davis, J; Hansbrough, J

    1989-08-01

    As trauma systems develop, more patients can potentially benefit from immediate surgery. With in-house surgeons available, enthusiasm for direct transfer from the scene to the operating room (OR) has developed in many institutions. The purpose of this study was to define precisely which patients should be taken to the OR for resuscitation. Three hundred twenty-three patients were taken to the OR directly from the field during a 4-year period (6.9% of trauma activations). Indications included the following: (1) cardiac arrest--one vital sign present, (2) persistent hypotension despite field intravenous fluid, and (3) uncontrolled external hemorrhage. A board-certified surgeon and resuscitation team met the field transport team in the OR in all cases. Cardiopulmonary resuscitation for patients with blunt trauma was not accompanied by survival even with immediate surgery by a trained surgeon and it wastes valuable OR resources. Patients with prehospital hypotension unresponsive to fluid resuscitation indicate the need for rapid surgery. Patients with blunt injuries even with hypotension infrequently undergo operations in less than 20 minutes and can be resuscitated in traditional areas where better roentgenograms are obtained. Penetrating injuries to the chest and abdomen with hypotension are the primary indications for OR resuscitation. It can be anticipated with field communication and accompanied by enhanced survival. PMID:2757502

  17. The effects of fluid resuscitation with different crystalloid-colloid ratio on extravascular lung water index in severe acute pancreatitis%不同晶胶比液体复苏对重症急性胰腺炎患者血管外肺水指数的影响

    Institute of Scientific and Technical Information of China (English)

    冯永文; 吴明; 曾晶晶; 李颖; 李明利; 崔曼丽

    2011-01-01

    Objective To investigate the effects of fluid resuscitation with different crystalloid-colloid ratio on extravascular lung water (EVLW) in patients with severe acute pancreatitis (SAP). Methods Clinical data of 24 SAP patients ,who had undergone intrathoracic blood volume index (ITBVI <750 ml/m2),were analyzed retrospectively, in Department of Critical Care Medicine in the First Affiliated Hospital of Shenzhen University, during January of 2009 to December of 2010. ITBVI 850 - 1 000 ml/m2 was confirmed the end criterion of the end point of resuscitation. Low crystalloid-colloid ratio group (n = 13) and high crystalloid-colloid ratio group (n = 11) were divided according to crystalloid-colloid ratio (3∶1) as the borderline. Hemodynamic parameters, extravascular lung water index (EVLWI), oxygenation index (PaO2/FiO2), bladder pressure (ICP) and B-type natriuretic peptide (BNP) were observed at the time point of before fluid resuscitation, and 0, 24 ,48, 72 hours after resuscitation, EVLWI was measured with thermal dilution pulse index continuous cardiac output (PiCCO), and BNP with radioimmunoasaay. Results ① Hemodynamic parameters can be improved at early fluid resuscitation stage in both groups. ② The total amount of fluid[(16 438±1 758) ml], amount of crystalloid fluid[(13 459±425) ml]and crystalloid-colloid ratio (4. 50± 0. 23) of the high crystalloid-colloid ratio group was significantly higher than that of the low crystalloid-colloid ratio group[(13 895±1 783) ml, (6 945± 454) ml, 2. 32± 0. 18, respectively, P<0. 05or P<0. 01]at the time point of 72 hours after resuscitation. ③ Compared with low crystalloid-colloid ratio group, PaO2/FiO2 (mm Hg, 1 mm Hg=0. 133 kPa) in high crystalloid-colloid ratio group was lowered significantly at 48 hours and 72 hours after resuscitation (48 hours: 186.51 ±42. 26 vs. 268. 35± 34. 18,72 hours: 172.85 ± 21.50 vs. 263. 95 ± 24.20); but EVLWI, ICP and BNP were increased significantly [EVLWI (ml/kg) 48

  18. Impact of hemoglobin nitrite to nitric oxide reductase on blood transfusion for resuscitation from hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Chad Brouse

    2015-01-01

    Full Text Available Background: Transfusion of blood remains the gold standard for fluid resuscitation from hemorrhagic shock. Hemoglobin (Hb within the red blood cell transports oxygen and modulates nitric oxide (NO through NO scavenging and nitrite reductase. Aims: This study was designed to examine the effects of incorporating a novel NO modulator, RRx-001, on systemic and microvascular hemodynamic response after blood transfusion for resuscitation from hemorrhagic shock in a hamster window chamber model. In addition, to RRx-001 the role of low dose of nitrite (1 × 10−9 moles per animal supplementation after resuscitation was studied. Materials and Methods: Severe hemorrhage was induced by arterial controlled bleeding of 50% of the blood volume (BV and the hypovolemic state was maintained for 1 h. The animals received volume resuscitation by an infusion of 25% of BV using fresh blood alone or with added nitrite, or fresh blood treated with RRx-001 (140 mg/kg or RRx-001 (140 mg/kg with added nitrite. Systemic and microvascular hemodynamics were followed at baseline and at different time points during the entire study. Tissue apoptosis and necrosis were measured 8 h after resuscitation to correlate hemodynamic changes with tissue viability. Results: Compared to resuscitation with blood alone, blood treated with RRx-001 decreased vascular resistance, increased blood flow and functional capillary density immediately after resuscitation and preserved tissue viability. Furthermore, in RRx-001 treated animals, both mean arterial pressure (MAP and met Hb were maintained within normal levels after resuscitation (MAP >90 mmHg and metHb <2%. The addition of nitrite to RRx-001 did not significantly improve the effects of RRx-001, as it increased methemoglobinemia and lower MAP. Conclusion: RRx-001 alone enhanced perfusion and reduced tissue damage as compared to blood; it may serve as an adjunct therapy to the current gold standard treatment for resuscitation from

  19. 早期液体复苏前后血流动力学参数对脓毒性休克患者短期预后的预测价值研究%Predictive Value of Hemodynamic Parameters Before and After Early Fluid Resuscitation on the Short-term Prognosis of Patients With Septic Shock

    Institute of Scientific and Technical Information of China (English)

    古旭云; 陈炜; 赵磊; 牛素平; 臧学峰

    2015-01-01

    Objective To assess the early predictive value of hemodynamic parameters before and after early fluid resuscitation on short-term prognosis of patients With septic shock. Methods We made a retrospective analysis on the data of 47 patients With septic shock Who Were admitted into Beijing Shijitan Hospital from January to December in 2013. General data and hemodynamic parameters of monitored by PICCO Were collected,including CI,GEDI,SVRI,ELWI,PVPI before and six hours after early fluid resuscitation. According to survival or death on day 7,the patients Were divided into survival group and death group. The tWo groups Were compared by hemodynamic parameters,and ROC curves Were plotted. The early predictive value of hemodynamic parameters in prognosis Was analyzed. Results ( 1 )Within 7 days after early fluid resuscitation,21 patients died With a mortality rate of 44. 7%. Apart from SVV,the tWo groups Were not significantly different(P >0. 05)in the rest hemodynamic parameters before early fluid resuscitation;the tWo groups Were significantly different(P0.05);而液体复苏后6 h每搏量指数( SVI)、平均动脉压( MAP)、全心射血分数( GEF)、ELWI、PVPI和心功能指数( CFI)比较差异有统计学意义(P<0.05)。(2)血流动力学各指标预测预后的ROC曲线图显示,早期液体复苏后6 h的ELWI预测患者预后结局的AUC最大为0.898,切点值为9.5 ml/kg,在此截点值下灵敏度为76.2%,特异度为92.3%。早期液体复苏后6 h的PVPI预测患者预后结局的 AUC 为0.842,切点值为1.75,在此截点值下灵敏度为66.7%,特异度为96.2%。(3)多因素Logistic回归分析结果显示,早期液体复苏后6 h的ELWI水平对预后判断有统计学意义( P<0.05)。结论 PICCO监测的血流动力学参数PVPI、ELWI、MAP与脓毒性休克患者的预后相关,早期液体复苏后6 h的ELWI水平是评估脓毒性休克患者短期预后的早期独立预测因素。

  20. Evolução de variáveis hemodinâmicas e perfusionais durante o choque séptico experimental tratado com ressuscitação volêmica guiada por metas Hemodynamic and perfusion variables during experimental septic shock treated with goal-directed fluid resuscitation

    Directory of Open Access Journals (Sweden)

    Marcelo Park

    2011-09-01

    Full Text Available OBJETIVOS: Apesar da ressuscitação volêmica guiada por saturação venosa central de oxigênio (SvcO2 ser considerada atualmente padrão ouro no tratamento da sepse, poucos estudos caracterizaram o perfil evolutivo de variáveis hemodinâmicas e perfusionais durante esta abordagem terapêutica. Este estudo teve por objetivo descrever evolutivamente estes parâmetros durante o choque séptico experimental sem ressuscitação e após 12 horas de ressuscitação guiada por metas. MÉTODOS: Treze porcos (35-45 kg anestesiados foram submetidos a peritonite por inoculação fecal (0,75g/kg. Após desenvolverem hipotensão persistente, ambos os grupos receberam antibióticos e foram randomizados em dois grupos: controle (n=7, com suporte hemodinâmico otimizado para pressão venosa central entre 8-12mmHg, diurese acima de 0,5ml/kg/h e pressão arterial média maior que 65mmHg; e SvO2 (n=6, com os objetivos acima e SvO2 acima de 65%. As intervenções incluíram ringer lactato e noradrenalina nos 2 grupos e dobutamina no grupo SvO2. Os animais foram tratados durante doze horas ou óbito. RESULTADOS: A sepse não tratada associou-se a uma significante redução da SvO2, PvO2, débito cardíaco e pressão venosa central e aumento da diferença arterio-venosa da saturação de oxigênio e veno-arterial de CO2. Após ressuscitação, esses parâmetros foram corrigidos em ambos os grupos. A ressuscitação guiada por metas associou-se a um melhor perfil hemodinâmico caracterizado por maiores SvO2, débito cardíaco e pressão venosa central. CONCLUSÕES: A sepse não ressuscitada apresenta um perfil hemodinâmico sugestivo de hipovolemia, com piora perfusional e hemodinâmica revertida após ressuscitação volêmica. A ressuscitação guiada por metas associa-se a uma significante melhora dos parâmetros hemodinâmicos e perfusionaisOBJECTIVES: Although fluid resuscitation guided by central venous oxygen saturation (SvcO2 is currently considered the

  1. Resuscitating the Baby after Shoulder Dystocia

    Directory of Open Access Journals (Sweden)

    Savas Menticoglou

    2016-01-01

    Full Text Available Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1 the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2 the neonatal resuscitators give volume much sooner.

  2. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  3. Neonatal Resuscitation in Low-Resource Settings.

    Science.gov (United States)

    Berkelhamer, Sara K; Kamath-Rayne, Beena D; Niermeyer, Susan

    2016-09-01

    Almost one quarter of newborn deaths are attributed to birth asphyxia. Systematic implementation of newborn resuscitation programs has the potential to avert many of these deaths as basic resuscitative measures alone can reduce neonatal mortality. Simplified resuscitation training provided through Helping Babies Breathe decreases early neonatal mortality and stillbirth. However, challenges remain in providing every newborn the needed care at birth. Barriers include ineffective educational systems and programming; inadequate equipment, personnel and data monitoring; and limited political and social support to improve care. Further progress calls for renewed commitments to closing gaps in the quality of newborn resuscitative care. PMID:27524455

  4. Influence of small volume resuscitation with different fluids on cardiac function and hemodynamics of abdominal aorta in septic shock rats%超声多普勒评估小容量复苏时感染性休克大鼠心功能及腹主动脉血流的变化

    Institute of Scientific and Technical Information of China (English)

    罗晨芳; 刘德昭; 陈景晖; 庞红宇; 黑子清

    2012-01-01

    Objective To investigate Influence of different fluids small -volume resuscitation on cardiac function and hemodynamics of abdominal aorta in septic shock rats. Methods 30 SD rats weighting 180 ~ 250 g were divided randomly into 5 groups ( n = 6 ) : Group N ( LPS negative control group) , Group E(LPS + 4 mL/kg physiologic saline) , Group HSS(LPS + 4 mL/kg Hypertonic saline solution) , Group HES ( LPS + 4 ml/kg Hydroxyethyl Starch) , Group HSH ( LPS + 4 mL/kg Hypertonic Sodium Chloride Hydroxyethyl Starch). Resuscitation were administrated 30 min after LPS injected. Doppler ultrasound examination of heart and abdominal aorta were measured at five time points: pre - injection of LPS, 30min post - injection of LPS, l0min post resuscitation, 30min post resuscitation , 60min post resuscitation. Then rats were executed and hearts were taken out. Heart pathological examination was observed under light microscope. Results ①On the early stage of sepsis, septic septic shock rats'heart systolic function increased first and then decreased obviously (P <0. 01) , LVDd decreased significantly, heart rate increased and blood pressure dereased. while these indexes were obviously recovered in resuscitation group, especially Group HSH; ② septic shock rats'abdominal aorta blood flow rate( BFR) became slower in systolic and diastolic phase, resistent index( RI) increased significantly(P < 0. 01) . While BFR rised and RI descended in resuscitation group, especially Group HSH; ③ There were no significant pathological change between these five group. Conclusion Septic shock rats cardiac function depressed, blood volume decreased, the abdominal aorta BFR descended, RI increased. Small - volume resuscitation could improve cardiac function, increased blood volume and BFR, lowered RI. The use of HSH succeed to ameliorate the deleterious hemodynamic responses associated with endotoxemia in rat.%目的 探讨不同液体早期小容量复苏对大鼠感染性休克引起的心功能和

  5. Aggressive Angiomyxoma

    OpenAIRE

    Padmavathy, L.; L Lakshmana Rao; M Dhana Lakshmi; N Sylvester

    2014-01-01

    Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid) matrix. [1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence. [2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity.

  6. Aggressive behavior

    NARCIS (Netherlands)

    Didden, H.C.M.; Lindsay, W.R.; Lang, R.; Sigafoos, J.; Deb, S.; Wiersma, J.; Peters-Scheffer, N.C.; Marschik, P.B.; O’Reilly, M.F.; Lancioni, G.E.

    2016-01-01

    Aggressive behavior is common in individuals with intellectual and developmental disabilities (IDDs), and it is most often targeted for intervention. Psychological, contextual, and biological risk factors may contribute to the risk of aggressive behavior. Risk factors are gender (males), level of ID

  7. 液体复苏对创伤致严重脓毒症和脓毒性休克患者心肌损伤的影响%Effects of fluid resuscitation on myocardial injury in patients with severe sepsis and septic shock

    Institute of Scientific and Technical Information of China (English)

    张新亮; 秦延军; 卞晓华; 董士民

    2012-01-01

    Objective To observe the influence of fluid resuscitation on patients suffered from myocardial injury with severe sepsis and septic shock,and to evaluate the markers of myocardial injury during fluid resuscitation.Methods Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score of 78 patients with severe sepsis and septic shock induced by combined injuries was 18-35.Serum cardiac troponin Ⅰ (cTnI),N-terminal-ventricular natriuretic peptide precursor (NT-proBNP) and the hemodynamic parameters were recorded before,3 days,and 5 days after treatment,and correlative analysis was conducted.Results Serum cTnI was increased in 62.8% (49/78) patients with severe sepsis and septic shock,and in 73.5% of patients (36/49) the increase was greater than 2-fold of the borderline value,and in 30.6% of patients (15/49) was greater than 4-fold of the borderline value.The patients with elevated serum NT-proBNP at admission accounted for 46.2% (36/78),and after fluid resuscitation treatment,patients with continuously rising value accounted for 74.4% (58/78).The serum cTnI,NT-proBNp,pulmonary arterial wedge pressure (PAWP) and cardiac index (CI) after treatment in survival group (55 cases) were obviously improved,and changes in them in non-survival group (23 cases) was not obvious.The serum cTnI (μg/L) and NT-proBNP (ng/L) levels in the non-survival group were distinctly higher than those of the survival group (cTnl 3 days:2.09 ± 1.00 vs.1.57 ± 0.93,5 days:1.78 ± 0.67 vs.0.72 ± 0.51; NT-proBNP 3 days:3.52 ± 0.73 vs.3.16 ± 0.65,5 days:3.21 ± 0.66 vs.2.66 ± 0.58 ),and CI (ml·s-1· m-2) was obviously lower than that of the survival group (3 days:57.6 ± 6.2 vs.68.3 ±5.6,5 days:40.5 ±4.7 vs.80.7 ±6.8,all P<0.05).The cTnI level (μg/L) of 46 patients whose fluid resuscitation achieved the target was lower than that of the 32 cases without achieving the target ( 1.16 ± 0.62 vs.1.97 ± 0.76,P<0.05 ),and the CI (ml· s-1· m-2) was obviously increased

  8. The Beneficial Effect of Direct Peritoneal Resuscitation on Septic Shock in Rats

    Directory of Open Access Journals (Sweden)

    Xingjun Luo

    2011-01-01

    Full Text Available The high mortality associated with conventionally resuscitated septic shock and the subsequent multiple-organ failure remain a very significant and costly clinical problem. Conventional simple intravenous resuscitation (CR from septic shock often fails to restore the progressive splanchnic vasoconstriction and hypoperfusion, and fails to reverse gut-derived systemic inflammatory response and fluid sequestration. Numerous interventions have been used to protect organ systems and cellular viability from the lethal injury accompanying hypoperfusion and ischemia but none of these efforts have been sufficient to halt or reverse the main course of the pathophysiology noted with conventional resuscitated shock. Recently, some studies have found that in hemorrhagic shock, direct peritoneal resuscitation (DPR not only produces sustained hyperperfusion in viscera but also has immunomodulatory and anti-fluid sequestration effects. Although the etiology and pathogenesis of septic shock and hemorrhagic shock differ, both kinds of shock result in hypoperfusion of the intestines and other internal organs. In this paper, we seek to determine whether DPR has a similar therapeutic effect on septic shock/resuscitation.

  9. Effect of Shengmai injection on extravascular lung water and related factors at early fluid resuscitation stage of septic shock%生脉注射液对脓毒性休克早期液体复苏血管外肺水及相关因素的影响

    Institute of Scientific and Technical Information of China (English)

    赵滋苗; 陆军; 丁月平; 马丹女

    2013-01-01

    Objective To investigate the effect of Shengmai injection on extravacular lung water and related factors at the early fluid resuscitation stage of septic shock. Methods Thirty-eight patients with septic shock were randomly assigned to the treatment group(n=20) and the control group(n=18). Patients received basic treatment combined with fluid resuscitation until the central venous pressure (CVP) reached ≥8mmHg. Patients in treatment group additional y received Shengmai injection. The hemodynamic indices, including extra-vascular lung water index(EVLWI), CVP, cardiac index(CI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), intrathoracic blood volume index (ITBVI) and oxygenation index (PaO2/FiO2) were monitored at baseline(T0), 6(T6), 12(T12) and 24h(T24) after ending fluid resuscitation, and the 28d mortality was also observed. Results Compared with the control group, CI, GEDVI and PaO2/FiO2 increased significantly at T6,T12 and T24, while EVLWI and 28d mortality was decreased in the treatment group ( P0.05). Conclusion On the basis of the fluid resuscitation and basic treatment Shengmai injection can further improve CI, GEDVI, ITBVI and PaO2/FiO2, decrease EVLWI and 28-d mortality, but showed no effect on CVP or SVRI at the early fluid resuscitation stage of septic shock.%  目的探讨生脉注射液对脓毒性休克早期液体复苏患者血管外肺水及相关因素的影响。方法选取38例感染性休克患者(生脉组20例,对照组18例),两组患者均以液体复苏至患者中心静脉压(CVP)≥8mmHg作为复苏终点,并施以内科基础治疗。生脉组同时加用生脉注射液80ml,用5%葡萄糖注射液250ml稀释,1次/d。通过脉搏轮廓曲线连续心排血量监测技术监测两组患者液体复苏结束后即刻(T0)、6h(T6)、12h(T12)、24h(T24)的血管外肺水指数(EVLWI)、CVP、心排血指数(CI)、外周血管阻力指数(SVRI)、

  10. Time matters – Realism in resuscitation training

    DEFF Research Database (Denmark)

    Krogh, Kristian; Høyer, Christian Bjerre; Østergaard, Doris;

    2014-01-01

    Background: The advanced life support guidelines recommend 2 min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation...... significantly better to the recommended 2-min CPR cycles (time- 120 s) (mean 13; standard derivation (SD) 8) than the shortened CPR cycle group (mean 45; SD 19) when tested (p time is an important part of fidelity. Variables critical for performance, like......-based resuscitation training, the recommended 2-min CPR cycles are often deliberately decreased in order to increase the number of scenarios. The aim of this study was to test if keeping 2-min CPR cycles during resuscitation training ensures better adherence to time during resuscitation in a simulated setting...

  11. Time matters--realism in resuscitation training

    DEFF Research Database (Denmark)

    Krogh, Kristian; Høyer, Christian; Ostergaard, Doris;

    2014-01-01

    BACKGROUND: The advanced life support guidelines recommend 2min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation...... better to the recommended 2-min CPR cycles (time-120s) (mean 13; standard derivation (SD) 8) than the shortened CPR cycle group (mean 45; SD 19) when tested (ptime is an important part of fidelity. Variables critical for performance, like adherence to time......-based resuscitation training, the recommended 2-min CPR cycles are often deliberately decreased in order to increase the number of scenarios. The aim of this study was to test if keeping 2-min CPR cycles during resuscitation training ensures better adherence to time during resuscitation in a simulated setting...

  12. Fluid resuscitation strategy in septic shock following urinary infection with severe pulmonary capillary leakage%肾源性脓毒性休克合并严重肺毛细血管渗漏的液体复苏策略

    Institute of Scientific and Technical Information of China (English)

    常平; 彭升; 周健; 谢海庭; 刘占国; 王华

    2013-01-01

    evaluate the fluid therapy on treatment of hypovolemic shock and the role of transpulmonary thermodilution technique with pulse induced continuous cardiac output (PiCCO) monitoring.Methods A retrospective study was conducted.Eight patients surviving septic shock following urinary infection with severe pulmonary capillary leakage were enrolled,and all of them underwent PiCCO monitoring in the intensive care unit (ICU) when the diagnosis was established.The monitoring started at admission,and ended when shock was corrected or transferred from ICU.The clinical data including general end diastolic volume index (GEDVI),extravascular lung water index (EVLWI),input and output volume of fluid,net fluid balance,oxygenation index (PaO2/FiO2),the level of arterial blood lactic acid,and chest X ray were collected and analyzed retrospectively the characteristics of septic shock following urinary infection,and the role of PiCCO monitoring in fluid resuscitation.Results Septic shock following urinary infection occurred in a median of 4.5 days in 8 patients after renal and ureteric calculi lithotripsy,accompanied with severe pulmonary vessel effusion and hypoxemia in different degrees.The mean value of EVLWI was (22 ± 7) ml/kg,and the PaO2/FiO2 (164 ± 82) mm Hg (1 mm Hg=0.133 kPa) at the time of admission to ICU.Conservative fluid resuscitation strategy was adopted in management of septic shock with severe pulmonary capillary leakage,the mean fluid input in 8 patients was (2412 ± 1121) ml/d,and the net fluid balance-553 ml/d,and the central venous pressure (CVP) and GEDVI were maintained at levels of (9 ± 3) mm Hg and (749 ± 236) ml/m2 respectively.Diuretics were administered to 6 patients and the mean dosage of fursemide was (264± 133)mg.Norepinephrine and dobutamine infusion were given to 7 patients to maintain blood pressure at normal range for (4 ± 1) days.Seven patients were mechanically ventilated,and the mean length of ventilation was (8 ± 6) days.All of the 8 patients

  13. The Initial Application of Invasive blood Pressure Monitoring in Fluid Resuscitation of Severe hand, Foot and Mouth Disease with Mechanical Ventilation%有创血压监测在重症手足口病机械通气下液体复苏中的初步应用

    Institute of Scientific and Technical Information of China (English)

    魏琛; 徐庆荣; 杨玉霞

    2016-01-01

    Objective:To evaluate the feasibility and clinical value of invasive blood pressure monitoring in fluid resuscitation of severe hand , foot and mouth disease with mechanical ventilation .Methods:From May 2014 to Aug 2014 in the third affiliated hospital of Zheng-zhou University , 35 cases of severe hand , foot and mouth disease children with mechanical ventilation , who already had right radial pe-ripheral arterial catheters,had simultaneous measurements of blood pressure via invasive blood pressure ( IBP)and noninvasive blood pressure ( NBP) methods.IBP and NBP were recorded every 30 minutes in the 24 hours after mechanical ventilation , which were recor-ded the measured value of the two methods respectively .The two values and changes were compared after fluid resuscitation .Results:The blood pressure values measured invasively were lower than those non -invasively(P﹤0.05).There were no statistically significant be-tween the rangeability of IBP and NBP in fluid resuscitation (P﹥0.05).Conclusion:Invasive blood pressure monitoring can be used for severe hand , foot and mouth disease monitoring under mechanical ventilation .Compared to NBP , IBP can be more convenient and sus-tainable.%目的:评价有创血压监测在重症手足口病液体复苏中的可行性及监测效果。方法:采用自身对照的方法,对2014年5月~2014年8月郑州大学第三附属医院35例重症手足口病患儿机械通气后,进行24小时有创血压和无创血压的监测比较。选择桡动脉穿刺行直接动脉血压连续监测,每30分钟记录1次,同时同侧肱动脉每30分钟进行无创血压测定1次,分别记录2种方法的测量值,比较两者的数值以及早期液体复苏后变化的情况。结果:有创血压较无创血压平均值低(P<0.05)。液体复苏时,有创血压的变化幅度与无创血压相比没有统计学差异(P﹥0.05),但有创血压变化较无创血压稍早。结论:有创血压

  14. Role of oxygen in resuscitation

    Energy Technology Data Exchange (ETDEWEB)

    Bokeriya, L.A.; Sokolova, N.A.; Konikova, A.S.

    At the present time, improvement of the system of medical care of cosmonauts is an important problem. For this reason, there are plans for development of a set of resuscitation measures that would be necessary in the case of onset of acute hypoxic and anoxic states, which may occur in sudden emergency situations. The purpose of the experiment was to examine the mechanism of transition from life to death on the molecular level. Renewal of proteins and nucleic acids, and change in their conformation (spatial arrangement) were used as the main indicators of changes in metabolic processes in case of death due to anoxic anoxia (exsanguination). With this procedure it was possible to reflect some patterns of biopolymer conversions related to processes of dying and resuscitation. Processes examined were the intensity of synthesis and dissociation of proteins and nucleic acids in the basic organs and tissues of experimental animals: different parts of the brain, myocardium and skeletal muscles, liver, kidneys, lung, spleen, adrenals, thyroid and pancreas, blood, bile and urine.

  15. 'Resuscitation' of extremely preterm and/or low-birth-weight infants - time to 'call it'?

    Science.gov (United States)

    O'Donnell, Colm P F

    2008-01-01

    Since ancient times, various methods have been used to revive apparently stillborn infants; many were of dubious efficacy and had the potential to cause harm. Based largely on studies of acutely asphyxiated term animal models, clinical assessment and positive pressure ventilation have become the cornerstones of neonatal resuscitation over the last 40 years. Over the last 25 years, care of extremely preterm infants in the delivery room has evolved from a policy of indifference to one of increasingly aggressive support. The survival of these infants has improved considerably in recent years; this has not, however, necessarily been due to more aggressive resuscitation. Urban myths have evolved that all extremely preterm infants died before they were intubated, and that all such infants need to immediately intubated or they will quickly die. This has never been true. Clinical assessment of infants at birth is subjective. Also, many techniques used to support preterm infants at birth have not been well studied and there is evidence that they may be harmful. It may thus be argued that many of our well-intentioned resuscitation interventions are of dubious efficacy and have the potential to cause harm. 'Resuscitation' is an emotive term which means 'restoration of life'. Death, thankfully, is a rare presentation in the delivery room. Therefore, concerning neonatal 'resuscitation', it is time to 'call it' something else. This will allow us to dispassionately distinguish preterm infants who are dead, or nearly dead, from those who are merely at high risk of parenchymal lung disease. We may then be able to refine our interventions and determine what methods of support benefit these infants most.

  16. Resuscitation, prolonged cardiac arrest, and an automated chest compression device

    DEFF Research Database (Denmark)

    Risom, Martin; Jørgensen, Henrik; Rasmussen, Lars S;

    2010-01-01

    The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest.......The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest....

  17. Do-not-resuscitate order: a view throughout the world.

    Science.gov (United States)

    Santonocito, Cristina; Ristagno, Giuseppe; Gullo, Antonino; Weil, Max Harry

    2013-02-01

    Resuscitation has the ability to reverse premature death. It can also prolong terminal illness, increase discomfort, and consume resources. The do-not-resuscitate (DNR) order and advance directives are still a debated issue in critical care. This review will focus on several aspects, regarding withholding and/or withdrawing therapies and advance directives in different continents. It is widely known that there is a great diversity of cultural and religious beliefs in society, and therefore, some critical ethical and legal issues have still to be solved. To achieve a consensus, we believe in the priority of continuing education and training programs for health care professionals. It is our opinion that a serious reflection on ethical values and principles would be useful to understand the definition of medical professionalism to make it possible to undertake the best way to avoid futile and aggressive care. There is evidence of the lack of DNR order policy worldwide. Therefore, it appears clear that there is a need for standardization. To improve the attitude about the DNR order, it is necessary to achieve several goals such as: increased communication, consensus on law, increased trust among patients and health care systems, and improved standards and quality of care to respect the patient's will and the family's role.

  18. Teamwork and leadership in cardiopulmonary resuscitation.

    Science.gov (United States)

    Hunziker, Sabina; Johansson, Anna C; Tschan, Franziska; Semmer, Norbert K; Rock, Laura; Howell, Michael D; Marsch, Stephan

    2011-06-14

    Despite substantial efforts to make cardiopulmonary resuscitation (CPR) algorithms known to healthcare workers, the outcome of CPR has remained poor during the past decades. Resuscitation teams often deviate from algorithms of CPR. Emerging evidence suggests that in addition to technical skills of individual rescuers, human factors such as teamwork and leadership affect adherence to algorithms and hence the outcome of CPR. This review describes the state of the science linking team interactions to the performance of CPR. Because logistical barriers make controlled measurement of team interaction in the earliest moments of real-life resuscitations challenging, our review focuses mainly on high-fidelity human simulator studies. This technique allows in-depth investigation of complex human interactions using precise and reproducible methods. It also removes variability in the clinical parameters of resuscitation, thus letting researchers study human factors and team interactions without confounding by clinical variability from resuscitation to resuscitation. Research has shown that a prolonged process of team building and poor leadership behavior are associated with significant shortcomings in CPR. Teamwork and leadership training have been shown to improve subsequent team performance during resuscitation and have recently been included in guidelines for advanced life support courses. We propose that further studies on the effects of team interactions on performance of complex medical emergency interventions such as resuscitation are needed. Future efforts to better understand the influence of team factors (e.g., team member status, team hierarchy, handling of human errors), individual factors (e.g., sex differences, perceived stress), and external factors (e.g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients.

  19. Minocycline and Doxycycline, but not Tetracycline, Mitigate Liver and Kidney Injury after Hemorrhagic Shock/Resuscitation*

    Science.gov (United States)

    Kholmukhamedov, Andaleb; Czerny, Christoph; Hu, Jiangting; Schwartz, Justin; Zhong, Zhi; Lemasters, John J.

    2014-01-01

    Background Despite recovery of hemodynamics by fluid resuscitation after hemorrhage, development of the systemic inflammatory response and multiple organ dysfunction syndromes can nonetheless lead to death. Minocycline and doxycycline are tetracycline derivatives that are protective in models of hypoxic, ischemic and oxidative stress. Our Aim was to determine whether minocycline and doxycycline protect liver and kidney and improve survival in a mouse model of hemorrhagic shock and resuscitation. Methods Mice were hemorrhaged to 30 mm Hg for 3 h and then resuscitated with shed blood followed by half the shed volume of lactated Ringer's solution containing tetracycline (10 mg/kg), minocycline (10 mg/kg), doxycycline (5 mg/kg) or vehicle. For pre-plus post-treatment, drugs were administered intraperitoneally prior to hemorrhage followed by second equal dose in Ringer's solution after blood resuscitation. Blood and tissue were harvested after 6 h. Results Serum alanine aminotransferase (ALT) increased to 1988 and 1878 U/L after post-treatment with vehicle and tetracycline, respectively, whereas minocycline and doxycycline post-treatment decreased ALT to 857 and 863 U/L. Pre-plus post-treatment with minocycline and doxycycline also decreased ALT to 849 and 834 U/L. After vehicle, blood creatinine increased to 279 μM, which minocycline and doxycycline post-treatment decreased to 118 and 112 μM. Minocycline and doxycycline pre- plus post-treatment decreased creatinine similarly. Minocycline and doxycycline also decreased necrosis and apoptosis in liver and apoptosis in both liver and kidney, the latter assessed by TUNEL and caspase-3 activation. Lastly after 4.5 h of hemorrhage followed by resuscitation, minocycline and doxycycline (but not tetracycline) post-treatment improved 1-week survival from 38%(vehicle) to 69% and 67%, respectively. Conclusion Minocycline and doxycycline were similarly protective when given before as after blood resuscitation and might therefore

  20. 进一步液体复苏时胸腔内血容量与血管外肺水的相关性研究%Association of intrathoracic blood volume index(ITBVI) and extravascular lung water index(EVLWI) in elderly septic shock patients with further fluid resuscitation

    Institute of Scientific and Technical Information of China (English)

    贾圣伟; 龚仕金; 周娟娣; 刘秉宇; 李莉; 戴海文; 虞意华; 王敏佳

    2015-01-01

    Objective To investigate the association of intrathoracic blood volume index(ITBVI) and extravascular lung water index(EVLWI) in elderly septic shock patients with further fluid resuscitation therapy. Methods Twenty five elderly septic shock patients with hemodynamic instability after 6h fluid resuscitation were monitored by pulse indicators continuous cardiac output (PiCCO) in intensive care unit. The cardiac output volume index (CI), ITBVI and EVLWI were recorded at 0, 6, 12, 24 and 48h by PiCCO monitoring, 125 groups of data were col ected in total. The association between ITBVI and EVLWI was analyzed. The patients were further divided into CI>2.5L/(min·m2) and CI2.5L/(min·m2) group was higher than that in CI0.05);however, ITBVI was positively correlated with EVLWI in CI>2.5L/(min·m2) group(n=75, r=0.597;P<0.05). Conclusion For the elderly septic shock patients with instable hemodynamics after fluid resuscitation,the monitoring of cardiac function, ITBVI and EVLWI values by PiCCO is necessary for guidance of further fluid resuscitation.%目的:探讨老年感染性休克患者进一步液体复苏时胸腔内血容量指数(ITBVI)与血管外肺水指数(EVLWI)的相关性。方法对已行液体复苏6h而血流动力学仍不稳定的25例老年感染性休克患者进行脉搏轮廓分析心排出量测定(PiC-CO)连续动态监测,记录监测开始后0、6、12、24、48h相关参数如心排出量指数(CI)、ITBVI、EVLWI,共监测125例次,并分析IT-BVI与EVLWI的相关性;以CI为2.5L/(min·m2)为界分为CI>2.5L/(min·m2)组75例次和CI<2.5L/(min·m2)组50例次,比较两组间ITBVI、EVLWI的差异及相关性。结果未对心功能分组时,ITBVI与EVLWI有相关性(r=0.195,P<0.05);进一步以CI为2.5L/(min·m2)为界分组后对125组数据进行分析,CI>2.5L/(min·m2)组ITBVI[(1107±156)ml/m2]高于CI<2.5L/(min·m2)组[(1017±115)ml/m2](P<0.05

  1. Electronic Aggression

    Centers for Disease Control (CDC) Podcasts

    2007-11-20

    Aggression is no longer limited to the school yard. New forms of electronic media, such as blogs, instant messaging, chat rooms, email, text messaging, and the internet are providing new arenas for youth violence to occur.  Created: 11/20/2007 by National Center for Injury Prevention and Control, Division of Violence Prevention.   Date Released: 11/28/2007.

  2. Clinician performed resuscitative ultrasonography for the initial evaluation and resuscitation of trauma

    Directory of Open Access Journals (Sweden)

    Gillman Lawrence M

    2009-08-01

    Full Text Available Abstract Background Traumatic injury is a leading cause of morbidity and mortality in developed countries worldwide. Recent studies suggest that many deaths are preventable if injuries are recognized and treated in an expeditious manner – the so called 'golden hour' of trauma. Ultrasound revolutionized the care of the trauma patient with the introduction of the FAST (Focused Assessment with Sonography for Trauma examination; a rapid assessment of the hemodynamically unstable patient to identify the presence of peritoneal and/or pericardial fluid. Since that time the use of ultrasound has expanded to include a rapid assessment of almost every facet of the trauma patient. As a result, ultrasound is not only viewed as a diagnostic test, but actually as an extension of the physical exam. Methods A review of the medical literature was performed and articles pertaining to ultrasound-assisted assessment of the trauma patient were obtained. The literature selected was based on the preference and clinical expertise of authors. Discussion In this review we explore the benefits and pitfalls of applying resuscitative ultrasound to every aspect of the initial assessment of the critically injured trauma patient.

  3. 高原烧伤大鼠脑损伤与丙二醛、超氧化物歧化酶含量变化%Early changes of injured brain tissues and superoxide dismutase and malondialdehyde in severely burned rats after delayed fluid resuscitation at high altitude

    Institute of Scientific and Technical Information of China (English)

    蔡黔; 刘毅; 张斌; 张鲜英; 郑荣梁

    2008-01-01

    Objective To explore the early changes of the superoxide dismutase (SOD) and malondialdehyde (MDA) in rata' brain in earlier period after severe burn with delayed fluid resuscitation at high altitude and the relation with cerebral injury. Methods At 3800 m, the experimental bum animal model ( TBSA 30% , Ⅲ° ) of high altitude was designed. One hundred and thirty male Wistar rats were randomly divided into 4 groups:group A (immediate fluid resuscitation group), group B (delayed fluid resuscitation group) ,group C (normal control group at high altitude) and group D (normal control group at Lanzhou region,1517 m). At different time points (post-burn 1,6,12,24,72 h and 7 day) after bum,the levels of SOD and MDA in rats' brain were measured by spectrophotography, brain water was determined by drying eleetrothermostat and the apoptosis ceils in pallium were detected by terminal deoxynucleotidyl transferase[ TdT] -mediated deoxyuridinetriphate [ dUTP] nick end-labeling (TUNEL) staining. Results The activity of SOD in rats' brain in group A was obviously decreased at 24 h post burn. Apart from at 12 h post bum,the aetivity of SOD in group B was reduced as compared with group A at above time points (P<0.05). The contents of MDA in rats' brain in group A were increased obviously, and reached the peak at 12 h post burn. The change tendency of contents of MDA in group B was same as that in group A, but the contents of MDA at 7 day post bum in group B were higher than in group C and group D. Brain water and the apoptosis cells in pallium were increased. Condusion After severe burn with delayed fluid resuseitation at high altitude,contents of MDA were increased and SOD exhausted in rata' brain,indicating that these may be involved in the mechanisms of pathophysiology of brain injury.%目的 观察高原严重烧伤延迟复苏后早期大鼠脑组织中丙二醛及超氧化物歧化酶含量变化及其与脑损伤的关系.方法 130只

  4. [Aggressive fibromatoses].

    Science.gov (United States)

    Döhler, J R; Hamelmann, H; Lasson, U

    1984-03-01

    Benign by nature, aggressive fibromatoses (desmoid fibromas) may represent as difficult therapeutic problems as malignant tumours. When subtotally resected they tend to recur. But spontaneous regression is possible. Expense and limits of their surgical treatment are discussed with reference to seven patients. In five cases primary affliction of bone was evident. There are three reports given in detail: In the first, malignant transformation may be due to radiation therapy and hemipelvectomy could not prevent recurrence. In the second, spontaneous regression of untreated pelvic affection may have occurred. In the third, several resections and amputation of the leg failed to cure congenital infantile fibromatosis.

  5. Drugs during delivery room resuscitation--what, when and why?

    Science.gov (United States)

    Kapadia, Vishal S; Wyckoff, Myra H

    2013-12-01

    Although seldom needed, the short list of medications used for delivery room resuscitation of the newborn includes epinephrine and volume expanders. Naloxone, sodium bicarbonate and the use of other vasopressors are no longer considered helpful during acute resuscitation and are more often administered in the post-resuscitative period under special circumstances. This review examines the existing literature for the two commonly used medications in neonatal resuscitation and identifies the many knowledge gaps requiring further research.

  6. Decision to resuscitate or not in patients with chronic diseases

    DEFF Research Database (Denmark)

    Saltbæk, Lena; Tvedegaard, Erling

    2012-01-01

    Do-not-resuscitate (DNR) decisions are frequently made without informing the patients. We attempt to determine whether patients and physicians wish to discuss the DNR decision, who they think, should be the final decision maker and whether they agree on the indication for cardiopulmonary resuscit...... resuscitation (CPR) in case of cardiac arrest....

  7. Release of endogenous vasopressors during and after cardiopulmonary resuscitation.

    OpenAIRE

    Lindner, K. H.; Haak, T; Keller, A; Bothner, U.; Lurie, K. G.

    1996-01-01

    OBJECTIVE: To assess whether plasma endothelin, adrenaline, noradrenaline, arginine vasopressin, adrenocorticotropin, and cortisol concentrations were higher during cardiopulmonary resuscitation in patients in whom resuscitation was successful than in those in whom it failed, and to measure the concentrations of these hormones in the immediate post-resuscitation phase. DESIGN: Prospective, descriptive study. SETTING: Emergency medical service at a university hospital. PATIENTS: 60 patients wi...

  8. Effect of different does of fluid resuscitation on mortality and renal function on early hemorrhagic shock%不同剂量液体复苏对重度失血性休克兔死亡率及肾功能的影响

    Institute of Scientific and Technical Information of China (English)

    杜鹏飞; 胡敏红; 赵会民

    2014-01-01

    目的:研究不同剂理液体复苏对进行性出血性休克兔死亡率及肾功能的影响。方法采用控制性颈动脉放血法建立进行性出血性休克兔模型,随机分为3组(无补液(对照)组、小剂量组和大剂量组),输注0.9%氯化钠溶液与羟乙基淀粉40氯化钠溶液混合复苏液(体积比2:1)。无补液组不输液,小剂量复苏组按失血量1倍输液,速度参照平均动脉压目标值50~60 mmHg调整,大剂量复苏组按失血量2倍输液,速度参照平均动脉压目标值70~80 mmHg调整,于休克0、1、2、3、4 h分别检测血清肌酐水平、平均动脉压(MAP)并比较4 h死亡率及比较肾脏病理切片等情况。结果小剂量组死亡率显著低于无补液组, P<0.01,与大剂量复苏组相比死亡率差异无统计学意义,P>0.05,大剂量组死亡率与对照组相比无统计学意义,P>0.05;小剂量组肌酐(Cr)与对照组、大剂量液体复苏组比较有明显改善,P<0.05;休克模型形成后个时间段MAP各不相同,P<0.05;各组肾脏组织损伤程度各异,差别较明显。结论对进行性出血性休克进行限制性液体复苏有利于降低休克早期死亡率;早期进行小剂量液体复苏可以改善肾功能,更有效的保护脏器功能。%Objective To investigate the effect of limited fluid resuscitation on mortality and renal function in rabbits’uncontrolled hemorrhagic shock. Methods The rabbits’progressive hemorrhagic model were created by adopting the controlling carotid artery bloodletting method before randomly divided them into 3 groups, non-infusion group (control group), limited-infusion group and massive-infusion group. The infusion liquid was formulated of 0.9% sodium chloride solution and hydroxyethyl starch mixture 40 sodium chloride solution (volume than 2:1). Non-infusion group was given no infusion, while the limited-infusion group was given a small doses of

  9. Usefulness of the bispectral index during cardiopulmonary resuscitation -A case report-

    OpenAIRE

    Jung, Jin Yong; Kim, Yeonbaek; Kim, Jung-Eun

    2013-01-01

    The usefulness of using the bispectral index (BIS) for monitoring during cardiopulmonary resuscitation (CPR) is not clearly understood. However, BIS has been a popular anesthetic monitoring device used during operations. The case presented is of a pregnant woman going into cardiac arrest due to an amniotic fluid embolism during a Cesarean section. CPR was performed, but neither the return of spontaneous circulation (ROSC) nor the return of consciousness was achieved, despite 50 min of effecti...

  10. [ILCOR's new resuscitation guidelines in preterm and term infants: critical discussion and suggestions for implementation].

    Science.gov (United States)

    Hansmann, G; Humpl, T; Zimmermann, A; Bührer, C; Wauer, R; Stannigel, H; Hoehn, T

    2007-01-01

    Recommendations of the International Liaison Committee on Resuscitation (ILCOR) become updated every five years with changing evidence resulting in revised recommendations for clinical practice. New data exist concerning the adequate oxygen concentration to be used in the delivery room, the management of imminent meconium aspiration, ventilation strategies and the role of body temperature during and after resuscitation of preterm and term newborn infants. Only in some cases new evidence has led to clear-cut recommendations for or against specific interventions. Therefore the present publication cites the original ILCOR-recommendations and discusses these with regard to their practical implementation. The authors of the present work suggest to commence resuscitation independendly of gestational age with room air and adjust the inspiratory oxygen concentration thereafter on clinical grounds. The authors also advocate the retention of the presently performed intranatal suction procedure in cases of meconium-stained amniotic fluid and the use of therapeutic hypothermia following perinatal asphyxia in term newborns according to the protocol of one of the published randomized, controlled trials. Standard equipment for neonatal resuscitation should include pressure gauge for monitoring of inspiratory pressures, oxygen blender, and pulse oxymeter. The predominant majority of ILCOR-recommendations have only been cited and have been commented with respect to their practical implementation within the clinical context.

  11. Quality and outcome of cardiopulmonary resuscitation

    NARCIS (Netherlands)

    S.G. Beesems

    2015-01-01

    Important factors in a successful resuscitation are optimal chest compression rate of 100/min, a compression depth of 5 cm and minimization of pauses in chest compressions. This constitutes ‘high quality’ CPR. The first part of this thesis focuses on assessing this quality and how feedback devices m

  12. Persisting effect of community approaches to resuscitation

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Isbye, Dan Lou; Lippert, Freddy Knudsen;

    2014-01-01

    BACKGROUND: On the Danish island of Bornholm an intervention was carried out during 2008-2010 aiming at increasing out-of-hospital cardiac arrest (OHCA) survival. The intervention included mass media focus on resuscitation and widespread educational activities. The aim of this study was to compar...

  13. Computed tomography scanning during a traumatic resuscitation

    NARCIS (Netherlands)

    L.F.M. Beenen; R. Adams; R.W. Koster; T. Otto

    2011-01-01

    In cardiopulmonary resuscitation, computed tomography (CT) imaging could be of decisive importance to therapeutic strategy making but is yet unavailable because of incompatibility of CT scanning and manual chest compressions. In this report, we describe a case in which CT scanning was performed on a

  14. [Basic and advanced resuscitation of children

    DEFF Research Database (Denmark)

    Lauritsen, T.L.; Jensen, Tim; Greisen, G.

    2008-01-01

    The ERC Guidelines 2005 regarding the resuscitation of children and neonates recommend changes in treatment algorithms. Cardiac arrest in children is most often caused or worsened by hypoxic conditions. On confirmation of cardiac arrest in a child, treatment is initiated with 5 ventilations and c...

  15. Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants.

    Science.gov (United States)

    Cho, Su Jin; Shin, Jeonghee; Namgung, Ran

    2015-10-01

    Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI. PMID:26566357

  16. 钠钾镁钙葡萄糖注射液应用于烧伤休克液体复苏的临床疗效评估——前瞻性、随机、单盲、阳性药物对照、多中心临床试验%Clinical evaluation of sodium potassium magnesium calcium and glucose injection during fluid resuscitation of burn shock: a prospective, randomized, single-blinded, positive drug controlled, multicentre clinical trial

    Institute of Scientific and Technical Information of China (English)

    柴家科; 李利根; 罗高兴; 沈光裕; 张庆富; 王玉莲; 霍然; 牛希华; 孙海宁

    2013-01-01

    Objective To evaluate the efficacy and safety of sodium potassium magnesium calcium and glucose injection(Le Jia (R)) comparing with sodium lactated ringer's solution for burn resuscitation.Methods 198 burned patients who met the criterion were performed fluid resuscitation during the first 6 h after injury.All patients who were enrolled in this study had been assigned assigned either the sodium potassium magnesium calcium and glucose injection group (test group) or the sodium lactated ringer's group (control group) according to random number table.Before the fluid resuscitation according to 1970 National Conference of Burn Injuries formula,the clinical index such as routine blood count,liver and kidney functions,blood biochemistry and coagulation function were detected.The hemodynamic index,arterial blood gas and serum glucose levels were monitored during fluid infusion,and all blood lab indexes were detected at the end of the first and second 24 h after resuscitation beginning.The efficacy index is the changes of serum electrolyte,arterial blood lactate,blood gas and serum glucose levels after resuscitation of two different electrolyte solution.And the safety index is the incidence and specific situation of adverse drug reaction.Results Comprehensive analysis was performed from the aspects of maintaining of serum electrolyte,acid-base equilibrium,changes of blood lactate and glucose levels.No statistically significant difference was found between the two groups.In safety evaluation,safe cases in test group were 99(100%) as well as in control group.No statistically significant difference was found in safety evaluation.Conclusions Sodium potassium magnesium calcium and glucose injection (Le Jia (R)) has the comparative efficacy and safety to sodium lactated ringer's solution,the most commonly used in clinic for burn resuscitation.%目的 以乳酸钠林格注射液为对照,验证钠钾镁钙葡萄糖注射液(乐加(R))用于烧伤休克液体复苏方面

  17. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

    Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references

  18. Automated cardiopulmonary resuscitation: a case study.

    Science.gov (United States)

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar

    2014-02-01

    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices.

  19. Survival after in-hospital Cardiopulmonary Resuscitation

    OpenAIRE

    M Adib Hajbaghery; H. Akbari; GA. Mousavi

    2005-01-01

    Background: During recent years, cardiopulmonary resuscitation (CPR) in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and unt...

  20. A user-designed resuscitation unit.

    OpenAIRE

    MacVicar, S M; Watts, M P; Watt, C S

    1986-01-01

    Prior to the commissioning of the Phase I redevelopment of Glasgow Royal Infirmary, the need for the development of a new type of resuscitation trolley had been identified by a liaison group consisting of medical, nursing and scientific staff which had been set up to collaborate on the selection and specification of clinical equipment. A design study involving the liaison group and the Product Design Section of the Glasgow School of Art was, therefore, undertaken. This resulted in a basic des...

  1. Cardiopulmonary resuscitation: update, controversies and new advances

    Directory of Open Access Journals (Sweden)

    Zago Alexandre C.

    1999-01-01

    Full Text Available Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

  2. Survival after in-hospital Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    M Adib Hajbaghery

    2005-05-01

    Full Text Available Background: During recent years, cardiopulmonary resuscitation (CPR in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran

  3. CONCEPT ANALYSIS: AGGRESSION

    OpenAIRE

    Liu, Jianghong

    2004-01-01

    The concept of aggression is important to nursing because further knowledge of aggression can help generate a better theoretical model to drive more effective intervention and prevention approaches. This paper outlines a conceptual analysis of aggression. First, the different forms of aggression are reviewed, including the clinical classification and the stimulus-based classification. Then the manifestations and measurement of aggression are described. Finally, the causes and consequences of ...

  4. Estimation of cerebral blood flow during cardiopulmonary resuscitation in humans

    DEFF Research Database (Denmark)

    Christensen, S F; Stadeager, Carsten Preben; Siemkowicz, E

    1990-01-01

    Cerebral blood flow (CBF) and cardiac output (CO) were measured during cardiopulmonary resuscitation in patients who were unsuccessfully resuscitated by use of C14-iodoantipyrine injected into the left ventricle. CO varied between 1.3 and 2.2 l/min with mean 1.8 +/- 0.6 l/min (+/- SD) (28 ml...... resuscitation showed signs of maldistribution suggestive of a patchy and incomplete perfusion....

  5. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    OpenAIRE

    Porter, Evelyn; Barcega, Besh; Kim, Tommy Y.

    2014-01-01

    Introduction: The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods: The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error r...

  6. Resuscitation and post resuscitation care of the very old after out-of-hospital cardiac arrest is worthwhile

    DEFF Research Database (Denmark)

    Winther-Jensen, Matilde; Kjaergaard, Jesper; Hassager, Christian;

    2015-01-01

    BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with a poor prognosis. As comorbidity and frailty increase with age; ethical dilemmas may arise when OHCA occur in the very old. OBJECTIVES: We aimed to investigate mortality, neurological outcome and post resuscitation care...... in octogenarians (≥80) to assess whether resuscitation and post resuscitation care should be avoided. METHODS: During 2007-2011 consecutive OHCA-patients were attended by the physician-based Emergency Medical Services-system in Copenhagen. Pre-hospital data based on Utstein-criteria, and data on post resuscitation...... care were collected. Primary outcome was successful resuscitation; secondary endpoints were 30-day mortality and neurological outcome (Cerebral Performance Category (CPC)). RESULTS: 2509 OHCA-patients with attempted resuscitation were recorded, 22% (n=558) were octogenarians/nonagenarians. 166 (30...

  7. 重度肺毛细血管渗漏并发严重低血容量性休克的液体复苏:附1例报告%Fluid resuscitation in a patient with severe hypovolemic shock and severe pulmonary capil-lary leak

    Institute of Scientific and Technical Information of China (English)

    谢海庭; 李忠丽; 吴多斌; 常平; 刘占国

    2014-01-01

    对1例体外超声碎石时出现“呼吸困难、血压低,伴心悸、胸闷、全身大汗”临床考虑为重度肺毛细血管渗漏、低血容量性休克的患者行脉搏波指示连续心排血量(PiCCO)技术监测,动态观察各血流动力学指标,根据血管外肺水指数(EVLWI)及全心舒张末容积指数(GEDI)控制性补液,纠正休克治疗过程中该患者心排量(CO)和GEDI一直偏低,EVLWI最高达到了32 ml/kg,持续可吸出大量淡红色稀薄血性痰,高呼吸机支持参数下氧饱和度仍然非常低。为纠正休克同时减轻肺水肿选择了控制性补液,即当GEDI低于500 ml/m2时选择补充胶体液,当GEDI高于500 ml/m2时减少补液量并减慢补液速度,保持轻度容量不足并及时调整呼吸机参数,经治疗后患者胸片肺水肿逐渐好转,乳酸,肝肾功能,逐渐好转,6 d后停用升压药,10 d后脱呼吸机并拔除经口气管插管,25 d后顺利出院。在治疗过程中PiCCO监测有重要的指导意义。%A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m2, and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m2. Pulmonary edema was gradually reduced after the

  8. Review article: Updated resuscitation guidelines for 2016: A summary of the Australian and New Zealand Committee on Resuscitation recommendations.

    Science.gov (United States)

    Leman, Peter; Morley, Peter

    2016-08-01

    This review paper summarises the key changes made to the resuscitation guidelines used in Australia and New Zealand. They were released by the Australian and New Zealand Committee on Resuscitation in January 2016. These are local adaptations of the evidence previously published in October 2015 by the International Liaison Committee on Resuscitation (ILCOR). They are presented across the main working groups in ILCOR: ALS, BLS, paediatrics, neonates, acute coronary syndromes, first aid and 'Education, Implementation and Teams'. PMID:27357213

  9. 高海拔地区大鼠严重烫伤延迟复苏后肝脏低氧诱导因子-1α和p53的表达与肝脏损伤的关系%Influence of hypoxia inducible factor-1α and p53 expression on liver injury after severe scald with delayed fluid resuscitation in rats in high altitude

    Institute of Scientific and Technical Information of China (English)

    刘毅; 张诚; 刘长海

    2011-01-01

    Objective To explore the influence of hypoxia-inducible factor-1α (HIF-1α) and p53 expression on liver injury after severe scald with delayed resuscitation in high altitude in rats. Methods 240 Wistar rats were employed as the experimental models (TBSA 30%, Ⅲ degree), and they were randomly divided into 3 groups in different altitudes (1 517 m and 3848 m): delayed fluid resuscitation (DFR) group, immediate fluid resuscitation (IFR) group and sham scald (SS) group. The livers of rats were harvested at 1, 6, 12, 24, 72 hours and 168 hours after severe scald respectively. The levels of HIF-1α, p53 and the apoptosis percentage in liver were detected by pathological technique, tissue microarray technique, terminal deoxynucleotidy transferasemediated deoxy-uridine triphosphate nick end labeling, immunohistochemistry and image analysis technique. Results The expression levels of HIF-1α and p53 were much higher in DFR group and IFR group than those in SS group, in 3 848 m altitude and in 1 517 m altitude, and higher in DFR group than those in IFR group (P <0.05). The apoptosis percentage in liver was higher in DFR group than in IFR group, and higher in 3848 m altitude than in 1 517 m altitude (P <0.05). Conclusion HIF-1α expression and activation of p53 apoptotic pathways may play an important role in the hypoxic injury of the liver.%目的 探讨高海拔地区大鼠严重烫伤延迟复苏后肝脏低氧诱导因子-1α(HIF-1α)和p53的表达与肝脏损伤的关系.方法 Wistar大鼠240只,在1 517和3848m两个海拔高度随机分为即时复苏(IFR)组、延迟复苏(DFR)组和假烫伤(SS)组,建立总体表面积30%的Ⅲ°烫伤模型,于伤后1、6、12、24、72和168 h取材.采用组织病理学、组织芯片技术、脱氧核糖核苷酸末端转移酶介导的缺口末端标记(原位末端缺口标记)法、免疫组织化学染色与图像分析技术,观察肝组织病理学改变与细胞凋亡、HIF-1α和p53的表达.结果

  10. Aggressive angiomyxoma of the thigh

    International Nuclear Information System (INIS)

    Aggressive angiomyxoma is a rare tumour that typically occurs in the perineum in women of reproductive age. A small number of cases occurring in men have been reported, all of which were located in the low pelvis, perineum or scrotum. While benign, the tumour is locally infiltrative and consequently has a high rate of local recurrence following surgery; therefore, accurate pre-operative diagnosis is important. The characteristic location of these tumours in the low pelvis or perineum has led to speculation that aggressive angiomyxomas arise from a mesenchymal cell that is unique to the perineum. We describe a case of aggressive angiomyxoma arising in the thigh of a 54-year-old man, which we believe is the first reported instance of this rare neoplasm occurring remote from the pelvis or perineum in a male patient. Cross-sectional imaging demonstrated a well-defined mass that had low density on CT and high intensity on fluid-sensitive MR sequences. Biopsy was non-diagnostic and excision was performed. At histological analysis, the tumour exhibited the characteristic features of aggressive angiomyxoma, with bland spindle cells and large, hyalinised blood vessels in a hypocellular myxoid matrix. Extensive immunohistochemical staining further supported the diagnosis. While the imaging features of these tumours are non-specific and suggestive of myxoid neoplasms, the diagnosis should be considered whenever biopsy of a myxoid-appearing mass yields hypocellular, non-diagnostic material, despite adequate sampling. (orig.)

  11. Aggressive angiomyxoma of the thigh

    Energy Technology Data Exchange (ETDEWEB)

    Heffernan, E.J.; Alkubaidan, F.O.; Munk, P.L. [Vancouver General Hospital, Department of Radiology, Vancouver, BC (Canada); University of British Columbia, Vancouver, BC (Canada); Hayes, M.M. [BC Cancer Agency, Department of Pathology, Vancouver, BC (Canada); Clarkson, P.W. [BC Cancer Agency, Department of Surgery, Radiation Oncology and Developmental Radiotherapeutics, Vancouver, BC (Canada)

    2008-07-15

    Aggressive angiomyxoma is a rare tumour that typically occurs in the perineum in women of reproductive age. A small number of cases occurring in men have been reported, all of which were located in the low pelvis, perineum or scrotum. While benign, the tumour is locally infiltrative and consequently has a high rate of local recurrence following surgery; therefore, accurate pre-operative diagnosis is important. The characteristic location of these tumours in the low pelvis or perineum has led to speculation that aggressive angiomyxomas arise from a mesenchymal cell that is unique to the perineum. We describe a case of aggressive angiomyxoma arising in the thigh of a 54-year-old man, which we believe is the first reported instance of this rare neoplasm occurring remote from the pelvis or perineum in a male patient. Cross-sectional imaging demonstrated a well-defined mass that had low density on CT and high intensity on fluid-sensitive MR sequences. Biopsy was non-diagnostic and excision was performed. At histological analysis, the tumour exhibited the characteristic features of aggressive angiomyxoma, with bland spindle cells and large, hyalinised blood vessels in a hypocellular myxoid matrix. Extensive immunohistochemical staining further supported the diagnosis. While the imaging features of these tumours are non-specific and suggestive of myxoid neoplasms, the diagnosis should be considered whenever biopsy of a myxoid-appearing mass yields hypocellular, non-diagnostic material, despite adequate sampling. (orig.)

  12. Protocol compliance and time management in blunt trauma resuscitation.

    NARCIS (Netherlands)

    Spanjersberg, W.R.; Bergs, E.A.; Mushkudiani, N.; Klimek, M.; Schipper, I.B.

    2009-01-01

    OBJECTIVES: To study advanced trauma life support (ATLS) protocol adherence prospectively in trauma resuscitation and to analyse time management of daily multidisciplinary trauma resuscitation at a level 1 trauma centre, for both moderately and severely injured patients. PATIENTS AND METHODS: All vi

  13. What Is Aggressive Violence?

    Science.gov (United States)

    Singer, Dorothy G.; Luca, Wendy

    1985-01-01

    Responses to a questionnaire dealing with what constitutes aggressive violence on television indicate that health care providers tend to rate items describing acts on television as more aggressive than television writers, producers, and executives do. (MBR)

  14. Applied Research on the Fluid Resuscitation in Geriatric Patients Undergoing Major Chest Trauma Operation by Monitoring ITBVI,EVLWI%ITBVI、EVLWI在老年重大胸部外伤手术中液体复苏的应用研究

    Institute of Scientific and Technical Information of China (English)

    王智钧; 韩全国; 刘永宏; 杜秀珍

    2015-01-01

    目的:观察以胸腔内血容量指数(intrathoracic blood volume index,ITBVI)/血管外肺水指数(extravascular lung water index,EVLWI)在老年重大胸部外伤手术中液体复苏的应用研究。方法:急诊行重大胸部外伤手术的老年患者48例,随机分为以ITBVI/EVLWI为导向的研究组(Study group S组)和对照组(Routine group,R组),每组各24例患者。对照组监测CVP指导补液,研究组应用PICCO监测血流动力学指标,测定ITBVI、EVLWI等指标,准确评估患者容量状况。比较术中患者心率(HR)、平均动脉压(MAP)、中心静脉血氧饱和度(ScvO2)、乳酸等指标。观察术后休克改善情况及氧合指数,术后呼吸机通气时间,以及急性肺水肿发生率、死亡率变化。结果:研究组患者组织灌注改善,休克改善明显好转,氧合指数明显增加,中心静脉血氧饱和度明显增加,血乳酸浓度明显降低,急性肺水肿、死亡率明显低于对照组,两组比较差异均有统计学意义(P<0.05)。结论:对比CVP,以ITBVI、EVLWI指导液体复苏,能更精确评估和指导老年重大胸部外伤手术患者术中液体管理,减少急性肺水肿发生率,减少呼吸机辅助时间,缩短ICU住院时间,降低死亡率。%Objective:To research the valve of ITBVI and EVLWI in fluid resuscitation of geriatric patients undergoing major chest trauma operation.Method:48 cases undergoing major chest trauma operation were included and randomly divided into two groups,24 cases in each group.The study group received pulse indicator continous output(PICCO) monitoring and ITBVI+EVLWI were used as indicator for fluid management.The control group was used central venous pressure (CVP) as indicator for fluid management.Heart rate (HR),mean arterial pressure (MAP),central venous oxygen saturation (ScvO2) and lactic acid were compared.Postoperative shock improvement and oxygenation

  15. Aggression on Roadways

    OpenAIRE

    Novaco, Raymond W.

    1989-01-01

    Aggression and the automobile have had a long standing association, yet research on aggressive behavior has neglected the roadway context. This chapter reviews existing work which has included archival analysis, field interview studies, personality research, and field experiments. Among the recurrent themes have been the relationship between aggressivity in driving to accident liability and to violence in the larger social context. Validity issues in road aggression research are discussed, an...

  16. Aggressive Fibromatosis in Neck.

    OpenAIRE

    Namita Kabdwal; Sanjeev Bhagat; Saurabh Varshney; Sampan Singh Bist; Sarita Mishra; Bhavna Singh

    2013-01-01

    Aggressive fibromatosis (AF) is a locally aggressive infiltrative low-grade benign tumor that accounts for approximately less than 3% of all soft tissue tumors. In the head and neck region this tumor tends to be more aggressive and associated with significant morbidity. Aggressive surgery is a viable management option and may be successfully used as a single modality treatment, or in combination with radiotherapy. We report a rare case of AF in a 38 year old female, who presented with a painl...

  17. Aggressive commercial practicies

    OpenAIRE

    Tomanová, Magdaléna

    2008-01-01

    Diploma thesis evaluates the effectiveness of legal instruments to prevent the use of aggressive commercial practices. Thesis is divided into two main chapters, the first is the protection against aggressive commercial practices in business to consumer market and the second part is dedicated to the protection against aggressive practices in the business to business market. Each section compares the European protection of aggressive commercial practices (and also through European legislation i...

  18. Hypertonic saline solution resuscitation in hemorrhagic shock dogs

    Institute of Scientific and Technical Information of China (English)

    蔡秀军; 黄迪宇; 牟一平; 彭淑牖

    2002-01-01

    To find out the optimal concentration, infusion rate and dosage of saline for resuscitation. Methods: Forty-five dogs were used to establish hypovolemic shock models. The dogs were resuscitated with saline of different concentrations and different dosages under different infusion rates, and the resuscitation results were compared. Results: The best concentration was 7.5%, the best rate of infusion 20 ml/min (a volume equivalent to 15% of the shed blood) and the best dosage 5.71 ml/kg. The method was effective for resuscitation, the mean arterial pressure (MAP) could be elevated to 89% of the baseline, and this MAP could be kept for more than one hour. Conclusions: Using 7.5% sodium chloride solution equivalent to 15% of the shed blood at an infusion rate of 20 ml/min can achieve a best resuscitation result.

  19. Research Paradigm of Displaced Aggression

    OpenAIRE

    Tanno, Syota

    2013-01-01

    A review of research paradigm of displaced aggression is presented. The author arranged the Japanese wording of displaced aggression, summarized the historical transition of research on displaced aggression, and reviewed research paradigm of displaced aggression.

  20. Fluid management in major burn injuries

    Directory of Open Access Journals (Sweden)

    Haberal Mehmet

    2010-10-01

    Full Text Available It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

  1. Resuscitation at the limits of viability--an Irish perspective.

    LENUS (Irish Health Repository)

    Khan, R A

    2012-02-01

    BACKGROUND: Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process. OBJECTIVE: To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28-week preterm newborn. DESIGN\\/METHODS: An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long-term outcome. RESULTS: The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22-25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics. CONCLUSION: Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability.

  2. Continuation of cardiopulmonary resuscitation in a Chinese hospital after unsuccessful EMS resuscitation

    Institute of Scientific and Technical Information of China (English)

    Xiao-Bo Yang; Yan Zhao; Fei Wang

    2009-01-01

    Objective To evaluate the efficacy of the continuation of cardiopulmonary resuscitation (CPR) following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services (EMS) CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients (15%) accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluatad in the future when prehospital information can be combined with in-hospital information.

  3. Resuscitation of the trauma patient:tell me a trigger for early haemostatic resuscitation please!

    OpenAIRE

    Reed, Matthew J; Lone, Nazir; Walsh, Timothy S

    2011-01-01

    The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We ...

  4. Leadership and Teamwork in Trauma and Resuscitation

    Directory of Open Access Journals (Sweden)

    Michael Menchine

    2016-09-01

    Full Text Available Introduction: Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders.  Methods: We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1 how leadership affects patient care; 2 which tools are available to measure leadership; and 3 methods to train physicians to become better leaders. Results: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs

  5. Availability and Utilization of Cardiac Resuscitation Centers

    Directory of Open Access Journals (Sweden)

    Bryn E. Mumma

    2014-11-01

    Full Text Available Introduction: The American Heart Association (AHA recommends regionalized care following out-of-hospital cardiac arrest (OHCA at cardiac resuscitation centers (CRCs. Key level 1 CRC criteria include 24/7 percutaneous coronary intervention (PCI capability, therapeutic hypothermia capability, and annual volume of ≥40 patients resuscitated from OHCA. Our objective was to characterize the availability and utilization of resources relevant to post-cardiac arrest care, including level 1 CRCs in California. Methods: We combined data from the AHA, the California Office of Statewide Health Planning and Development (OSHPD, and surveys to identify CRCs. We surveyed emergency department directors and nurse managers at all 24/7 PCI centers identified by the AHA to determine their post-OHCA care capabilities. The survey included questions regarding therapeutic hypothermia use and specialist availability and was pilot-tested prior to distribution. Cases of OHCA were identified in the 2011 OSHPD Patient Discharge Database using a “present on admission” diagnosis of cardiac arrest (ICD-9-CM code 427.5. We defined key level 1 CRC criteria as 24/7 PCI capability, therapeutic hypothermia, and annual volume ≥40 patients admitted with a “present on admission” diagnosis of cardiac arrest. Our primary outcome was the proportion of hospitals meeting these criteria. Descriptive statistics and 95% CI are presented. Results: Of the 333 acute care hospitals in California, 31 (9.3%, 95% CI 6.4-13% met level 1 CRC criteria. These hospitals treated 25% (1937/7780; 95% CI 24-26% of all admitted OHCA patients in California in 2011. Of the 125 hospitals identified as 24/7 PCI centers by the AHA, 54 (43%, 95% CI 34-52% admitted ≥40 patients following OHCA in 2011. Seventy (56%, 95% CI 47-65% responded to the survey; 69/70 (99%, 95% CI 92-100% reported having a therapeutic hypothermia protocol in effect by 2011. Five percent of admitted OHCA patients (402/7780; 95% CI

  6. Leadership and Teamwork in Trauma and Resuscitation

    Science.gov (United States)

    Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

    2016-01-01

    Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching

  7. Leadership and Teamwork in Trauma and Resuscitation

    Science.gov (United States)

    Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

    2016-01-01

    Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching

  8. History of neonatal resuscitation - part 3: endotracheal intubation.

    Science.gov (United States)

    Obladen, Michael

    2009-01-01

    Endotracheal intubation to resuscitate neonates was used by Scheel in 1798. A century before endotracheal anesthesia was developed, inventive obstetricians constructed devices for endotracheal intubation of infants and mastered their insertion, localization, and airtight sealing. Fell's laryngoscope, Magill's intubation forceps and tissue-friendly materials were significant contributions of the 20th century to endotracheal intubation of the newborn. The striking absence of scientific studies on the most efficient resuscitation techniques for neonates can be explained by the difficulty to adjust for the personal skills of the resuscitator.

  9. Ethics and medico legal aspects of "Not for Resuscitation"

    Directory of Open Access Journals (Sweden)

    Naveen Sulakshan Salins

    2010-01-01

    Full Text Available Not for resuscitation in India still remains an abstract concept with no clear guidelines or legal frame work. Cardiopulmonary resuscitation is a complex medical intervention which is often used inappropriately in hospitalized patients and usually guided by medical decision making rather than patient-directed choices. Patient autonomy still remains a weak concept and relatives are expected to make this big decision in a short time and at a time of great emotional distress. This article outlines concepts around ethics and medico legal aspects of not for resuscitation, especially in Indian setting.

  10. Evaluation of coma patients after cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; YANG Qing-lin; PANG Ying; LV Xiang-ping

    2005-01-01

    Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

  11. Early childhood aggression

    OpenAIRE

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results showed an early childhood aggression curve, with increasing rates of aggression in the second year of life and decreasing rates in the fourth year. One-year stabilities were moderate for 12-month-olds ...

  12. Punishment of elicited aggression.

    Science.gov (United States)

    Azrin, N H

    1970-07-01

    Aversive shocks are known to produce aggression when the shocks are not dependent on behavior and to suppress behavior when the shocks are arranged as a dependent punisher. These two processes were studied by presenting non-dependent shock to monkeys at regular intervals, thereby producing biting attacks on a pneumatic tube. Immediate shock punishment was stimultaneously delivered for each biting attack. The attacks were found to decrease as a function of increasing punishment intensity. These results show that aggression is eliminated by direct punishment of the aggression even when the stimulus that is used as a punisher otherwise causes the aggression. PMID:4988590

  13. Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

    OpenAIRE

    MÀkinen, Marja

    2010-01-01

    Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and ...

  14. The role of simulation in teaching pediatric resuscitation: current perspectives

    Directory of Open Access Journals (Sweden)

    Lin Y

    2015-03-01

    Full Text Available Yiqun Lin,1 Adam Cheng2 1KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada; 2KidSIM-ASPIRE Research Program, Department of Pediatrics, Division of Emergency Medicine, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada Abstract: The use of simulation for teaching the knowledge, skills, and behaviors necessary for effective pediatric resuscitation has seen widespread growth and adoption across pediatric institutions. In this paper, we describe the application of simulation in pediatric resuscitation training and review the evidence for the use of simulation in neonatal resuscitation, pediatric advanced life support, procedural skills training, and crisis resource management training. We also highlight studies supporting several key instructional design elements that enhance learning, including the use of high-fidelity simulation, distributed practice, deliberate practice, feedback, and debriefing. Simulation-based training is an effective modality for teaching pediatric resuscitation concepts. Current literature has revealed some research gaps in simulation-based education, which could indicate the direction for the future of pediatric resuscitation research. Keywords: simulation, pediatric resuscitation, medical education, instructional design, crisis resource management, health care

  15. Vasopressin decreases neuronal apoptosis during cardiopulmonar y resuscitation

    Institute of Scientific and Technical Information of China (English)

    Chi Ma; Zhe Zhu; Xu Wang; Gang Zhao; Xiaoliang Liu; Rui Li

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommend-ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopul-monary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Jun N-terminal kinase and p38 expression were signiifcantly decreased in the hippo-campus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No signiifcant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Jun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation.

  16. The use of pre-hospital mild hypothermia after resuscitation from out-of-hospital cardiac arrest.

    Science.gov (United States)

    Kim, Francis; Olsufka, Michele; Nichol, Graham; Copass, Michael K; Cobb, Leonard A

    2009-03-01

    Hypothermia has emerged as a potent neuroprotective modality following resuscitation from cardiac arrest. Although delayed hospital cooling has been demonstrated to improve outcome after cardiac arrest, in-field cooling begun immediately following the return of spontaneous circulation may be more beneficial. Cooling in the field following resuscitation, however, presents new challenges, in that the cooling method has to be portable, safe, and effective. Rapid infusion of intravenous fluid at 4 degrees C, the use of a cooling helmet, and cooling plates have all been proposed as methods for field cooling, and are all in various stages of clinical and animal testing. Whether field cooling will improve survival and neurologic outcome remains an important unanswered clinical question. PMID:19072587

  17. Girls' Aggressive Behavior

    Science.gov (United States)

    Owens, Larry; Shute, Rosalyn; Slee, Phillip

    2004-01-01

    In contrast to boys' bullying behavior which is often overt and easily visible, girls' aggression is usually indirect and covert. Less research has been conducted on the types of bullying that girls usually engage in. Using focus groups composed of teenaged girls, Dr. Owens and colleagues examine the nature of teenage girls' indirect aggression.

  18. The perception of aggression

    NARCIS (Netherlands)

    Jansen, G; Dassen, T; Moorer, P

    1997-01-01

    Several academic and clinical disciplines are involved in clarifying the concept of aggression by formulating operational and descriptive definitions. In the present paper the validity of the definitions of aggression, reported by nurses in an earlier qualitative study, is examined, using a survey a

  19. Parents’ Aggressive Influences and Children's Aggressive Problem Solutions with Peers

    OpenAIRE

    Duman, Sarah; Margolin, Gayla

    2007-01-01

    This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents’ responses to similar hypothetical social scenarios and parents’ actual marital aggression. The study included 118 9−10 year old children, and their mothers and fathers. Children's aggressive solutions correlated with same-sex parents’ actual marital aggression. For children with mothers who exhibit low actual marital aggression, mothers’ aggressive solutions to hypothetical...

  20. Resuscitation of the trauma patient: tell me a trigger for early haemostatic resuscitation please!

    Science.gov (United States)

    Reed, Matthew J; Lone, Nazir; Walsh, Timothy S

    2011-01-01

    The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We review recent literature relating to predictors of massive transfusions and the relationship between transfusion and mortality. PMID:21371347

  1. Successful application of acute cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Derya ztrk; Erturul Altinbilek; Murat Koyuncu; Bedriye Mge Snmez; ilem altili; Ibrahim Ikzcel; Cemil Kavalci; Glsm Kavalci

    2015-01-01

    Objective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR atŞŞişli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 ± 16) years and 64%of the patients were male. The initial rhythms of the CPR-applied patients were different (P 0.05). The CPR response time was longer in ED (P Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.

  2. 侵袭性牙周炎患者龈沟液中有机酸的研究%Analysis of short chain fatty acids in gingival crevicular fluid of patients with aggressive periodontitis

    Institute of Scientific and Technical Information of China (English)

    路瑞芳; 孟焕新; 高学军; 冯琳; 徐莉

    2008-01-01

    Objective To investigate 7 short chain fatty acids (SCFA) concentrations in gingival crevicular fluid(GCF) of aggressive periodontitis(AgP) and to analyze the relationship between levels of SCFA and AgP clinical parameters. Methods GCF was collected from 152 sites of 38 AgP patients and 56 sites of 14 healthy subjects. Formic acid, succinic acid, acetic acid, lactic acid, propionic acid, butyric acid and isovalerianic acid were detected by high performance capillary ehctrophoresis. Results The concentrations of succiaic acid, acetic acid, lactic acid, propionic acid, butyric acid and isovalerianic acid in GCF were significantly higher in AgP patients than in healthy group, while formic acid was lower in GCF of AgP group compared with healthy group. Correlation analysis showed that formic acid was negtively correlated with bleeding index(BI), probing depth(PD) and attachment loss(AL), while BI was positively correlated with sueeinie acid, acetic acid, lactic acid,propionic acid and butyric acid; PD and AL were positively correlated with succiaic acid, acetic acid, propionic acid, butyric acid and isovalerianic acid. Conclusions The elevation of succinic acid, acetic acid, propionic acid, butyric acid and isovalerianic acid concentrations in GCF may be related with AgP destruction condition, while formic acid concentration was reduced.%检测侵袭性牙周炎(aggressive periodontitis,AgP)患者龈沟液中7种有机酸的浓度,探讨其与AgP的关系.方法应用高效毛细管电泳技术,检测38例AgP患者152个位点和14名牙周健康对照者56个位点龈沟液中甲酸、琥珀酸、乙酸、乳酸、丙酸、丁酸和异戊酸的浓度,比较AgP组和健康对照组之间、AgP患者不同袋深组之间龈沟液中有机酸浓度的差别,分析出血指数(bleedingindex,BI)、探诊深度(probing depth,PD)和附着丧失(attachment loss,AL)与有机酸浓度的相关关系.结果 AgP组龈沟液中琥珀酸(1.00 mmoL/L)、乙酸(24.13 mmol

  3. Aggression in Pretend Play and Aggressive Behavior in the Classroom

    Science.gov (United States)

    Fehr, Karla K.; Russ, Sandra W.

    2013-01-01

    Research Findings: Pretend play is an essential part of child development and adjustment. However, parents, teachers, and researchers debate the function of aggression in pretend play. Different models of aggression predict that the expression of aggression in play could either increase or decrease actual aggressive behavior. The current study…

  4. Aggressive Attitudes Predict Aggressive Behavior in Middle School Students.

    Science.gov (United States)

    McConville, David W.; Cornell, Dewey G.

    2003-01-01

    This prospective study found that self-reported attitudes toward peer aggression among 403 middle school students were both internally consistent and stable over time (7 months). Aggressive attitudes were correlated with four outcome criteria for aggressive behavior: student self-report of peer aggression; peer and teacher nominations of bullying;…

  5. Design of a Functional Training Prototype for Neonatal Resuscitation

    Directory of Open Access Journals (Sweden)

    Sivaramakrishnan Rajaraman

    2014-11-01

    Full Text Available Birth Asphyxia is considered to be one of the leading causes of neonatal mortality around the world. Asphyxiated neonates require skilled resuscitation to survive the neonatal period. The project aims to train health professionals in a basic newborn care using a prototype with an ultimate objective to have one person at every delivery trained in neonatal resuscitation. This prototype will be a user-friendly device with which one can get trained in performing neonatal resuscitation in resource-limited settings. The prototype consists of a Force Sensing Resistor (FSR that measures the pressure applied and is interfaced with Arduino® which controls the Liquid Crystal Display (LCD and Light Emitting Diode (LED indication for pressure and compression counts. With the increase in population and absence of proper medical care, the need for neonatal resuscitation program is not well addressed. The proposed work aims at offering a promising solution for training health care individuals on resuscitating newborn babies under low resource settings.

  6. Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Satvik C. Bansal

    2014-01-01

    Full Text Available Aim. We assessed neonatal resuscitation practices among paediatricians in Gujarat. Methods. Cross-sectional survey of 23 questions based on guidelines of Neonatal Resuscitation Program (NRP and Navjaat Shishu Suraksha Karyakram (NSSK was conducted using web-based tool. Questionnaire was developed and consensually validated by three neonatologists. Results. Total of 142 (21.2% of 669 paediatricians of Gujarat, India, whose e-mail addresses were available, attempted the survey and, from them, 126 were eligible. Of these, 74 (58.7% were trained in neonatal resuscitation. Neonatal Intensive Care Unit with mechanical ventilation facilities was available for 54% of respondents. Eighty-eight (69.8% reported correct knowledge and practice regarding effective bag and mask ventilation (BMV and chest compressions. Knowledge and practice about continuous positive airway pressure use in delivery room were reported in 18.3% and 30.2% reported use of room air for BMV during resuscitation. Suctioning oral cavity before delivery in meconium stained liquor was reported by 27.8% and 38.1% cut the cord after a minute of birth. Paediatricians with NRP training used appropriate method of tracheal suction in cases of nonvigorous newborns than those who were not trained. Conclusions. Contemporary knowledge about neonatal resuscitative practices in paediatricians is lacking and requires improvement. Web-based tools provided low response in this survey.

  7. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    Directory of Open Access Journals (Sweden)

    Evelyn Porter

    2014-07-01

    Full Text Available Introduction: The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods: The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error rate and performed a separate multiple logistic regression analysis on the significant univariate variables to assess the association between the selected variables. Results: We reviewed 49 simulated resuscitations . The final medication error rate for the simulation was 26.5% (95% CI 13.7% - 39.3%. On univariate analysis, statistically significant findings for decreased prescribing medication error rates included senior residents in charge, presence of a pharmacist, sleeping greater than 8 hours prior to the simulation, and a visual analog scale score showing more confidence in caring for critically ill children. Multiple logistic regression analysis using the above significant variables showed only the presence of a pharmacist to remain significantly associated with decreased medication error, odds ratio of 0.09 (95% CI 0.01 - 0.64. Conclusion: Our results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees.

  8. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    International Nuclear Information System (INIS)

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000

  9. Human factors in resuscitation: Lessons learned from simulator studies

    Directory of Open Access Journals (Sweden)

    Hunziker S

    2010-01-01

    Full Text Available Medical algorithms, technical skills, and repeated training are the classical cornerstones for successful cardiopulmonary resuscitation (CPR. Increasing evidence suggests that human factors, including team interaction, communication, and leadership, also influence the performance of CPR. Guidelines, however, do not yet include these human factors, partly because of the difficulties of their measurement in real-life cardiac arrest. Recently, clinical studies of cardiac arrest scenarios with high-fidelity video-assisted simulations have provided opportunities to better delineate the influence of human factors on resuscitation team performance. This review focuses on evidence from simulator studies that focus on human factors and their influence on the performance of resuscitation teams. Similar to studies in real patients, simulated cardiac arrest scenarios revealed many unnecessary interruptions of CPR as well as significant delays in defibrillation. These studies also showed that human factors play a major role in these shortcomings and that the medical performance depends on the quality of leadership and team-structuring. Moreover, simulated video-taped medical emergencies revealed that a substantial part of information transfer during communication is erroneous. Understanding the impact of human factors on the performance of a complex medical intervention like resuscitation requires detailed, second-by-second, analysis of factors involving the patient, resuscitative equipment such as the defibrillator, and all team members. Thus, high-fidelity simulator studies provide an important research method in this challenging field.

  10. Extracorporeal Cardiopulmonary Resuscitation: Predictors of Survival

    Science.gov (United States)

    Kim, Dong Hee; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2016-01-01

    Background The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients. PMID:27525236

  11. Acute posthypoxic myoclonus after cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Bouwes Aline

    2012-08-01

    Full Text Available Abstract Background Acute posthypoxic myoclonus (PHM can occur in patients admitted after cardiopulmonary resuscitation (CPR and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP and electroencephalogram (EEG. Methods Patients with acute PHM (focal myoclonus or status myoclonus within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used. Good outcome was defined as good recovery or moderate disability after 6 months. Results Acute PHM was reported in 79/391 patients (20%. SEPs were available in 51/79 patients and in 27 of them (53% N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64% patients fulfilling criteria for a cortical origin. Nine patients (12% had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment.

  12. Predicting and measuring fluid responsiveness with echocardiography

    Directory of Open Access Journals (Sweden)

    Ashley Miller

    2016-06-01

    Full Text Available Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid esuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately.

  13. 大面积烧伤延迟复苏效果探讨%Study on the Effect of Delayed Resuscitation in Extensive Burn Patients

    Institute of Scientific and Technical Information of China (English)

    张宏; 林国安

    2014-01-01

    Objective To explore the means and efficacy of delayed resuscitation in patients with extensive burns. Method The fluid resuscitation plan for shock stage of burns provided by the 107th Hospital of PLA (hereinafter referred to as 107 Resuscitation Plan) was adopted as the resuscitation treatment in 25 patients with extensive burns and at delayed admission, and the efficacy was observed. Result Twenty three patients were all healed and discharged, two patients died from multi-organ failure 6 days and 34 days after injury respectively. Conclusion The 107 Resuscitation Plan can help es-timate the accumulated loss of fluid and transfusion speed. It can be used in patients who were at shock stage and delayed to be hospitalized.%目的:探讨大面积烧伤患者延迟复苏的方法及其疗效。方法采用中国人民解放军第107医院提出的烧伤休克期液体复苏方案(下称“107复苏方案”)对25例延迟入院的大面积烧伤患者进行复苏治疗,观察治疗效果。结果23例患者痊愈出院,2例患者分别于伤后第6天和第34天死于多器官功能衰竭。结论107复苏方案能够预估累积丢失量和输液速度,可用于延迟入院治疗的烧伤休克期患者。

  14. Cardiopulmonary resuscitation in the elderly: analysis of the events in the emergency department

    Directory of Open Access Journals (Sweden)

    Augusto Tricerri

    2013-10-01

    slightly but significantly lower in comparison with the group of non-intubated patients, thus showing a less aggressive resuscitator behavior in old people. Old people seem to have the same chance for surviving cardiac arrest as young people. Other factors like comorbidity can influence the outcome of a cardiac arrest in the elderly. The results of the present study demonstrate that age itself does not seem to be an independent, unfavorable prognostic factor for the outcome after CPR and that older people must be offered the same chance for surviving cardiac arrest as youngsters.

  15. Successful resuscitation after carbon dioxide embolism during laparoscopy

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Burgdorf, Stefan; Lolle, Ida;

    2012-01-01

    and developed cardiac arrest. Resuscitation was initiated and a precordial ultrasound examination suspected VAE in the right cardiac chambers. The patient was positioned in Durant's position and air was aspirated through a central venous line. The patient was resuscitated and stabilized, and was transferred...... to another hospital, where she received hyperbaric oxygen treatment. The patient was discharged 14 days after surgery without any sequelae. It is important that the general surgeon suspects VAE during laparoscopy whenever the patient develops sudden and unexplained severe hypotension or cardiac arrest during...

  16. History of neonatal resuscitation. Part 2: oxygen and other drugs.

    Science.gov (United States)

    Obladen, Michael

    2009-01-01

    Oxygen was used in neonatal resuscitation from 1780, within 5 years of its detection. It rapidly gained general acceptance and infiltrated delivery rooms and, a century later, neonatal special care units. After 217 years without scientific evidence, the use of oxygen for neonatal resuscitation has recently been questioned. Continuous distending airway pressure for oxygen administration was available at the beginning of the 20th century, but was not widely accepted. Alkali and analeptic drugs gained widespread but short-lived use after the Second World War.

  17. Resuscitation of a Pediatric Drowning in Hypothermic Cardiac Arrest.

    Science.gov (United States)

    Dragann, Brendan N; Melnychuk, Eric M; Wilson, Christopher J; Lambert, Richard L; Maffei, Frank A

    2016-01-01

    The prognosis of pediatric patients who require prolonged resuscitation after ice water drowning and hypothermic cardiac arrest remains guarded. We report a case of successful prolonged resuscitation of a pediatric patient in hypothermic cardiac arrest who showed severe metabolic derangements and went on to make a rapid and full neurologic recovery without the use of extracoproreal rewarming or mechanical cardiac support. Many ground and air medical emergency medical service programs have policies against interfacility transfer of patients in hypothermic cardiac arrest, calling into question the need to revise current protocols. PMID:27021675

  18. Assessing the damage control resuscitation: development, drivers and direction.

    Science.gov (United States)

    Quinn, David; Frith, Daniel

    2015-10-01

    Damage control resuscitation (DCR) has become a more widely adopted acute management strategy over the past decade. A cornerstone of this strategy is the performance of an initial limited surgical intervention for the control of active bleeding and contamination. This technique is indicated where significant physiological compromise exists and immediate surgical intervention is required. This damage control surgery itself is completed judiciously to allow a period of resuscitative stabilisation before later definitive surgical solutions. This discussion describes the three further principles of DCR and then explores the rationale and drivers behind the development of this approach. PMID:26315261

  19. OPTIMIZED FLUID MANAGEMENT IMPROVES OUTCOMES OF PEDIATRIC BURN PATIENTS

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Branski, Ludwik K; Finnerty, Celeste C; Leonard, Katrina R; Jeschke, Marc G

    2012-01-01

    Background One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on bodyweight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is inadequate and that over- and under-resuscitation is associated with increased morbidity and mortality. We hypothesize that optimizing fluid administration during the critical initial phase using a transcardiopulmonary thermo-dilution monitoring device (PiCCO) would have beneficial effects on the outcome of burned patients. Methods A cohort of seventy-six severely burned pediatric patients with burns over 30% total body surface area (TBSA) who received adjusted fluid resuscitation using the PiCCO (P) system were compared to 76 conventionally monitored patients (C). Clinical hemodynamic measurements, organ function (DENVER2 score), and biomarkers were recorded prospectively for the first 20 days after burn injury. Results Both cohorts were similar in demographic and injury characteristics. Patients in the PiCCO group received significantly less fluids (p<0.05) with similar urinary output, resulting in a significantly lower positive fluid balance (p<0.05). The central venous pressure (CVP) in the P group was maintained in a more controlled range (p<0.05), associated with a significantly lower heart rate and significantly lower incidence of cardiac and renal failure, p<0.05. Conclusions Fluid resuscitation guided by transcardiopulmonary thermo-dilution during hospitalization represents an effective adjunct and is associated with beneficial effects on post-burn morbidity. PMID:22703982

  20. Resuscitative Long-Bone Sonography for the Clinician: Usefulness and Pitfalls of Focused Clinical Ultrasound to Detect Long-Bone Fractures During Trauma Resuscitation.

    Science.gov (United States)

    Al-Kadi, Azzam S; Gillman, Lawrence M; Ball, Chad G; Panebianco, Nova L; Kirkpatrick, Andrew W

    2009-08-01

    Bone has one of the highest acoustic densities (AD) in the human body. Traditionally, bone has been considered to be a hindrance to the use of ultrasound (US), as US waves are reflected by the dense matrix and obscure underlying structures. The intense wave reflection, however, can clearly illustrate the cortical bony anatomy of long bones, making cortical disruption obvious. Ultrasound can be used at the bedside concurrently with the overall trauma resuscitation, and may potentially limit the patient's and treating team's exposure to ionizing radiation, corroborate clinical findings, and augment procedural success. The extended focused assessment with sonography for trauma (EFAST) is an essential tool in the resuscitation of severe torso trauma, frequently demonstrating intra- pericardial and intra-peritoneal fluid, inferring hemo/pneumothoraces, and demonstrating cardiac function. Although it is typically considered as a diagnosis of exclusion, multiple long-bone fractures may be a source of shock and can be quickly confirmed at the bedside with EFAST. Further, the early detection of long-bone fractures can also aid in the early stabilization of severely injured patients. Sonographic evaluation for long-bone fractures may be particularly useful in austere environments where other imaging modalities are limited, such as in the battlefield, developing world, and space. While prospective study has been limited, selected series have demonstrated high accuracy among both physician and para-medical clinicians in detecting long-bone fractures. Pitfalls in this technique include reduced accuracy with the small bones of the hands and feet, as well as great reliance on user experience. PMID:26815050

  1. Individual strategies of aggressive and non-aggressive male mice in encounters with trained aggressive residents

    OpenAIRE

    Benus, Rensina F.; Koolhaas, Jaap M.; Oortmerssen, Geert A. van

    1992-01-01

    To determine whether individual differences in offensive behaviour are related to differences in defensive behaviour, the responses of male wild house mice, Mus domesticus, of an aggressive and a non-aggressive line to defeat by physically stronger residents were analysed. Individuals of the aggressive line engaged in more flight behaviour, whereas the males of the non-aggressive line predominantly showed immobility. The higher flight tendency of the aggressive intruders provoked more attacks...

  2. Aggression at Work

    DEFF Research Database (Denmark)

    Høgh, Annie

    .      The three types of aggression: bullying, nasty teasing and violence at work seem to have much in common with regard to social climate at work, personal dispositions, the tendency of repeated exposure and the serious consequences on the victims' health and well being.      In conclusion the results...... of the present thesis show that a substantial number of employees reports exposure to different forms of aggression that may have serious short- and long-term impact on their health and well-being as well as a strong risk of recurrent exposure. Thus, it is very important to initiate research projects that aim......Very few international and no Danish studies investigating the consequences of exposure to both physical and psychological aggression at work have been published. The aim of the present thesis is therefore to investigate the prevalence and consequences of different forms of physical...

  3. Resuscitation effects of catalase on airborne bacteria.

    OpenAIRE

    Marthi, B; Shaffer, B. T.; Lighthart, B; Ganio, L

    1991-01-01

    Catalase incorporation into enumeration media caused a significant increase (greater than 63%) in the colony-forming abilities of airborne bacteria. Incubation for 30 to 60 min of airborne bacteria in collection fluid containing catalase caused a greater than 95% increase in colony-forming ability. However, catalase did not have any effects on enumeration at high relative humidities (80 to 90%).

  4. Kinetics of carbon dioxide during cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Wiklund, L; Söderberg, D; Henneberg, S;

    1986-01-01

    CO2 kinetics during CPR was investigated in 15 anesthetized piglets. BP, blood gases, and acid-base balance were monitored through catheters in the carotid artery and a central vein, as well as in cerebrospinal fluid. Cardiac arrest was induced by a transthoracic direct current shock. CPR was beg...

  5. Retention of Cardiopulmonary Resuscitation Skills in Nigerian Secondary School Students

    Science.gov (United States)

    Onyeaso, Adedamola Olutoyin

    2016-01-01

    Background/Objective: For effective bystander cardiopulmonary resuscitation (CPR), retention of CPR skills after the training is central. The objective of this study was to find out how much of the CPR skills a group of Nigerian secondary school students would retain six weeks after their first exposure to the conventional CPR training. Materials…

  6. QUALITY-OF-LIFE AFTER CARDIOPULMONARY-RESUSCITATION

    NARCIS (Netherlands)

    MIRANDA, DR

    1994-01-01

    Objectives: This study evaluates the influence of Cardiopulmonary Resuscitation (CPR) on the components of quality of life (QOL) of patients after discharge from the hospital. Design: Extracted from a prospective national survey on Dutch intensive care units (ICUs). Setting: Thirty-six ICUs of both

  7. Induction and Resuscitation of Viable Nonculturable Arcobacter butzleri Cells▿

    OpenAIRE

    Fera, M. T.; Maugeri, T. L.; Gugliandolo, C.; La Camera, E.; Lentini, V.; Favaloro, A; Bonanno, D; Carbone, M

    2008-01-01

    Two strains of Arcobacter butzleri, ATCC 49616 and an environmental isolate, became nonculturable in seawater microcosms at 4°C by 20 days and at room temperature by 14 days. Nonculturable cells were viable for up to 270 days of incubation in microcosms. Resuscitation of A. butzleri cells from microcosms at both temperatures was achieved 9 days after nutrient addition.

  8. Neuroprotective role of Batroxobin in cardiopulmonary resuscitation rabbits

    Institute of Scientific and Technical Information of China (English)

    Zhoujun Kang; Hui Cao; Bing Mei

    2007-01-01

    BACKGROUND: Batroxobin has been found to have protective effect on cerebral ischemia-reperfusion,and cardiopulmonary resuscitation (CPR) is the common cause of global brain ischemia-reperfusion.OBJECTIVE: To observe the effect of Batroxobin on the morphological results of cerebral cortex and hippocampus in rabbit models of CPR, and the changes of serum concentration of tumor necrosis factor alpha (TNF- α) after CPR.DESIGN: A randomized controlled observation.SETTING: Laboratory of the Department of Burns, Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA.MATERIALS: Thirty healthy New Zealand rabbits of 2.5 - 3.0 kg, either male or female, were used. Kits for TNF- α determination were provided by LIFEKEY BioMeditech Company (USA).METHODS: The experiments were carried out in the laboratory of Department of Burns, Changhai Hospital from February 2001 to January 2002. The 32 rabbits were randomly divided into sham-operated group (n=8),conventional resuscitation group (n=12) and Batroxobin-treated group (n=12). The animals in the conventional resuscitation group and Batroxobin-treated group were anesthetized, then induced into modified Pittsburg's model of mechanical ventricular fibrillation. Sham-operated group was discharged on the chest wall, which did not cause ventricular fibrillation. Conventional resuscitation group and Batroxobin-treated group were exposed to 6 minutes of cardiac arrest induced by ventricular fibrillation, then the resuscitation began. A dosage of 0.3 Bu/kg of Batroxobin was administered to the rabbits in the Batroxobin-treated group at the beginning of resuscitation. Blood sample was collected at 4 and 12 hours after CPR to determine the concentration of TNF- α in serum. After the second blood collection, brain tissue was taken out immediately,and the forms of nerve cells in cerebral cortex and hippocampal CA1 region were observed under light microscope.MAIN OUTCOME MEASURES: ① TNF-α concentration in

  9. Are female CFOs less tax aggressive? Evidence from tax aggressiveness

    OpenAIRE

    Francis , Bill B; Hasan, Iftekhar; Wu,Qiang; YAN Meng

    2014-01-01

    This paper investigates the effect of CFO gender on corporate tax aggressiveness. Focusing on firms that experience a male-to-female CFO transition, the paper compares those firms’ degree of tax aggressiveness during the pre- and post-transition periods. Using the probability of tax sheltering, the predicted unrecognized tax benefits, and the discretionary permanent book-tax differences to measure tax aggressiveness, we find that female CFOs are associated with less tax aggressiveness as comp...

  10. Witz, Lust und Aggression

    DEFF Research Database (Denmark)

    Rösing, Lilian Munk

    2014-01-01

    Artiklen beskæftiger sig med forholdet mellem vits, lyst og aggression med udgangspunkt i lysten ved aggressiv litterær humor, eksemplificeret ved tekststeder fra Shakespeares Hamlet. Der argumenteres for, at aggressionen eller angrebet er et fælles centralt aspekt ved Sigmund Freuds og Friedrich...

  11. Nutrition, neurotoxicants & aggressive behaviour

    NARCIS (Netherlands)

    Zaalberg, A.

    2015-01-01

    Nutrition, neurotoxicants and aggressive behaviour Antisocial behaviour, such as violence, is explained not only by the social environment, as was long believed. Also nutrients and neurotoxicants might play a role. Whether this is the case was studied in this thesis. In two empirical studies possibl

  12. Neuroimaging and Aggression.

    Science.gov (United States)

    Mills, Shari; Raine, Adrian

    1994-01-01

    Brain imaging research allows direct assessment of structural and functional brain abnormalities, and thereby provides an improved methodology for studying neurobiological factors predisposing to violent and aggressive behavior. This paper reviews 20 brain imaging studies using four different types of neuroimaging techniques that were conducted in…

  13. Early childhood aggression

    NARCIS (Netherlands)

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results show

  14. Aggressiveness and Disobedience

    Science.gov (United States)

    Vaaland, Grete Sorensen; Idsoe, Thormod; Roland, Erling

    2011-01-01

    This study aims to conceptualize disobedient pupil behavior within the more general framework of antisocial behavior and to reveal how two forms of aggressiveness are related to disobedience. Disobedience, in the context of this article, covers disruptive pupil behavior or discipline problems when the pupil is aware of breaking a standard set by…

  15. Relational Aggression among Students

    Science.gov (United States)

    Young, Ellie L.; Nelson, David A.; Hottle, America B.; Warburton, Brittney; Young, Bryan K.

    2011-01-01

    "Relational aggression" refers to harm within relationships caused by covert bullying or manipulative behavior. Examples include isolating a youth from his or her group of friends (social exclusion), threatening to stop talking to a friend (the silent treatment), or spreading gossip and rumors by email. This type of bullying tends to be…

  16. Parents' Aggressive Influences and Children's Aggressive Problem Solutions with Peers

    Science.gov (United States)

    Duman, Sarah; Margolin, Gayla

    2007-01-01

    This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents' responses to similar hypothetical social scenarios and parents' actual marital aggression. The study included 118 children ages 9 to 10 years old and their mothers and fathers. Children's aggressive solutions correlated with…

  17. Relational Aggression and Physical Aggression among Adolescent Cook Islands Students

    Science.gov (United States)

    Page, Angela; Smith, Lisa F.

    2016-01-01

    Both physical and relational aggression are characterised by the intent to harm another. Physical aggression includes direct behaviours such as hitting or kicking; relational aggression involves behaviours designed to damage relationships, such as excluding others, spreading rumours, and delivering threats and verbal abuse. This study extended…

  18. Children's normative beliefs about aggression and aggressive behavior.

    Science.gov (United States)

    Huesmann, L R; Guerra, N G

    1997-02-01

    Normative beliefs have been defined as self-regulating beliefs about the appropriateness of social behaviors. In 2 studies the authors revised their scale for assessing normative beliefs about aggression, found that it is reliable and valid for use with elementary school children, and investigated the longitudinal relation between normative beliefs about aggression and aggressive behavior in a large sample of elementary school children living in poor urban neighborhoods. Using data obtained in 2 waves of observations 1 year apart, the authors found that children tended to approve more of aggression as they grew older and that this increase appeared to be correlated with increases in aggressive behavior. More important, although individual differences in aggressive behavior predicted subsequent differences in normative beliefs in younger children, individual differences in aggressive behavior were predicted by preceding differences in normative beliefs in older children. PMID:9107008

  19. Kinetics of carbon dioxide during cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Wiklund, L; Söderberg, D; Henneberg, S;

    1986-01-01

    CO2 kinetics during CPR was investigated in 15 anesthetized piglets. BP, blood gases, and acid-base balance were monitored through catheters in the carotid artery and a central vein, as well as in cerebrospinal fluid. Cardiac arrest was induced by a transthoracic direct current shock. CPR was begun...... an equivalent amount of tris-buffer mixture. The results of these experiments, as well as previously described circulatory variables during CPR, were analyzed using a computer model describing the CO2 kinetics of the pig. Our main finding was that PaCO2 was positively correlated to cardiac output during CPR...

  20. Aggressive drowsy cache cells

    Science.gov (United States)

    Shawkey, H. A.; El-Dib, D. A.; Abid, Z.

    2010-01-01

    An aggressive drowsy cache block management, where the cache block is forced into drowsy mode all the time except during write and read operations, is proposed. The word line (WL) is used to enable the normal supply voltage (V DD_high) to the cache line only when it is accessed for read or write whereas the drowsy supply voltage (V DD_low) is enabled to the cache cell otherwise. The proposed block management neither needs extra cycles nor extra control signals to wake the drowsy cache cell, thereby reducing the performance penalty associated with traditional drowsy caches. In fact, the proposed aggressive drowsy mode can reduce the total power consumption of the traditional drowsy mode by 13% or even more, depending on the cache access rate, access frequency and the CMOS technology used.

  1. Radiotherapy for aggressive fibromatosis

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate local control with radiotherapy for aggressive fibromatosis. Materials and Methods: Fifty-three patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between March 1975 and June 1992. The minimum length of follow-up was 2 years; 88% of patients had follow-up for at least 5 years. Thirty-nine patients had lesions in an extremity and 14 patients had lesions in the trunk. Twenty-nine patients were treated for gross disease. Patients were treated with total doses between 35 Gy and 70 Gy; 83% of patients received 50 Gy to 60 Gy. Results: Local control was achieved in 23 of 29 patients (79%) treated for postoperative microscopic residual disease. Local control was achieved in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in 8 of 8 patients with previously untreated lesions, and in 13 of 16 patients treated for postoperative gross residual and recurrent disease. Overall, aggressive fibromatosis was locally controlled in 83% of treated patients. All 9 treatment failures occurred with extremity lesions 4 to 68 months after initiation of treatment. Of the 9 recurrences, 4 were out-of-field, 3 were in-field, and 4 occurred at the margin of the irradiated field. Salvage was successful in 8 of 9 patients in whom salvage was attempted with surgery alone or combined with postoperative radiotherapy. A functional limb was maintained in 38 of 39 patients with extremity or limb girdle lesions. The most serious complication of treatment was pathologic fracture, which occurred in 3 of 53 treated patients; all 3 fractures healed with conservative management. Conclusion: Radiotherapy is a valuable adjunct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease

  2. Individual strategies of aggressive and non-aggressive male mice in encounters with trained aggressive residents

    NARCIS (Netherlands)

    Benus, Rensina F.; Koolhaas, Jaap M.; Oortmerssen, Geert A. van

    1992-01-01

    To determine whether individual differences in offensive behaviour are related to differences in defensive behaviour, the responses of male wild house mice, Mus domesticus, of an aggressive and a non-aggressive line to defeat by physically stronger residents were analysed. Individuals of the aggress

  3. [Aggressive fibromatoses in orthopedics].

    Science.gov (United States)

    Adler, C P; Stock, D

    1986-01-01

    Aggressive fibromatoses which may develop either in soft tissue or in the bone present considerable problems for the pathologist trying to establish a diagnosis as well as for the radiologist and surgeon. In radiographs, a destruction of the soft and osseous tissue is seen which suggests a malignant tumor. Histologically a monomorphic connective tissue prevails in the biopsy showing no essential signs of malignancy. Under pathoanatomical aspects often a benign proliferation of the connective tissue is assumed. Surgically the tumor may either be removed in a too radical and mutilating way, or the excision may remain incomplete. Two cases of desmoplastic bone fibroma (aggressive fibromatosis in the ulna and in the sacrum) are described in which the complete tumor removal led to healing, whereas the incomplete excision of the tumor resulted in recurrences. Aggressive fibromatosis represents a semimalignant tumor which has a locally destructive and invasive growth tendency but does not metastasize. The various fibromatoses are defined with regard to their biological growth tendency and the therapeutic consequences are discussed.

  4. Markers of endothelial damage and coagulation impairment in patients with severe sepsis resuscitated with hydroxyethyl starch 130/0.42 vs Ringer acetate

    DEFF Research Database (Denmark)

    Müller, Rasmus Beier; Ostrowski, Sisse Rye; Haase, Nicolai;

    2016-01-01

    PURPOSE: The Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial showed increased mortality in patients resuscitated with hydroxyethyl starch 130/0.42 (HES) vs Ringer acetate. Different effects of the fluids on the endothelium may have contributed to the observed outcome. We aimed...... to investigate associations between HES vs Ringer and changes in plasma biomarkers reflecting endothelial damage and coagulation impairment. MATERIALS AND METHODS: Six biomarkers, including soluble thrombomodulin (sTM) and plasminogen activator inhibitor 1 (PAI-1), were assessed in a subgroup of 208 patients...... significant associated with mortality whereas increase in plasminogen activator inhibitor 1 was (odds ratio for 1-unit increase, 1.04; 95% confidence interval, 1.01-1.08; P = .01). CONCLUSIONS: Resuscitation with HES vs Ringer decreased early endothelial damage. Although this finding should be interpreted...

  5. Association of Kidney Tissue Barrier Disrupture and Renal Dysfunction in Resuscitated Murine Septic Shock.

    Science.gov (United States)

    Stenzel, Tatjana; Weidgang, Clair; Wagner, Katja; Wagner, Florian; Gröger, Michael; Weber, Sandra; Stahl, Bettina; Wachter, Ulrich; Vogt, Josef; Calzia, Enrico; Denk, Stephanie; Georgieff, Michael; Huber-Lang, Markus; Radermacher, Peter; McCook, Oscar

    2016-10-01

    Septic shock-related kidney failure is characterized by almost normal morphological appearance upon pathological examination. Endothelial barrier disrupture has been suggested to be of crucial importance for septic shock-induced organ dysfunction. Therefore, in murine resuscitated cecal ligation and puncture (CLP)-induced septic shock, we tested the hypothesis whether there is a direct relationship between the kidney endothelial barrier injury and renal dysfunction. Anesthetized mice underwent CLP, and 15 h later, were anesthetized again and surgically instrumented for a 5-h period of intensive care comprising lung-protective mechanical ventilation, fluid resuscitation, continuous i.v. norepinephrine to maintain target hemodynamics, and measurement of creatinine clearance (CrCl). Animals were stratified according to low or high CrCl. Nitrotyrosine formation, expression of the inducible isoform of the nitric oxide synthase, and blood cytokine (tumor necrosis factor, interleukin-6, interleukin-10) and chemokine (monocyte chemoattractant protein-1, keratinocyte-derived chemokine) levels were significantly higher in animals with low CrCl. When plotted against CrCl and neutrophil gelatinase-associated lipocalin levels, extravascular albumin accumulation, and tissue expression of the vascular endothelial growth factor and angiopoietin-1 showed significant mathematical relationships related to kidney (dys)function. Preservation of the constitutive expression of the hydrogen sulfide producing enzyme cystathione-γ-lyase was associated with maintenance of organ function. The direct quantitative relation between microvascular leakage and kidney (dys)function may provide a missing link between near-normal tissue morphology and septic shock-related renal failure, thus further highlighting the important role of vascular integrity in septic shock-related renal failure.

  6. Vasopressin during cardiopulmonary resuscitation and different shock states: a review of the literature.

    Science.gov (United States)

    Krismer, Anette C; Dünser, Martin W; Lindner, Karl H; Stadlbauer, Karl H; Mayr, Viktoria D; Lienhart, Hannes G; Arntz, Richard H; Wenzel, Volker

    2006-01-01

    Vasopressin administration may be a promising therapy in the management of various shock states. In laboratory models of cardiac arrest, vasopressin improved vital organ blood flow, cerebral oxygen delivery, the rate of return of spontaneous circulation, and neurological recovery compared with epinephrine (adrenaline). In a study of 1219 adult patients with cardiac arrest, the effects of vasopressin were similar to those of epinephrine in the management of ventricular fibrillation and pulseless electrical activity; however, vasopressin was superior to epinephrine in patients with asystole. Furthermore, vasopressin followed by epinephrine resulted in significantly higher rates of survival to hospital admission and hospital discharge. The current cardiopulmonary resuscitation guidelines recommend intravenous vasopressin 40 IU or epinephrine 1mg in adult patients refractory to electrical countershock. Several investigations have demonstrated that vasopressin can successfully stabilize hemodynamic variables in advanced vasodilatory shock. Use of vasopressin in vasodilatory shock should be guided by strict hemodynamic indications, such as hypotension despite norepinephrine (noradrenaline) dosages >0.5 mug/kg/min. Vasopressin must never be used as the sole vasopressor agent. In our institutional routine, a fixed vasopressin dosage of 0.067 IU/min (i.e. 100 IU/50 mL at 2 mL/h) is administered and mean arterial pressure is regulated by adjusting norepinephrine infusion. When norepinephrine dosages decrease to 0.2 microg/kg/min, vasopressin is withdrawn in small steps according to the response in mean arterial pressure. Vasopressin also improved short- and long-term survival in various porcine models of uncontrolled hemorrhagic shock. In the clinical setting, we observed positive effects of vasopressin in some patients with life-threatening hemorrhagic shock, which had no longer responded to adrenergic catecholamines and fluid resuscitation. Clinical employment of

  7. Contingent leadership and effectiveness of trauma resuscitation teams.

    Science.gov (United States)

    Yun, Seokhwa; Faraj, Samer; Sims, Henry P

    2005-11-01

    This research investigated leadership and effectiveness of teams operating in a high-velocity environment, specifically trauma resuscitation teams. On the basis of the literature and their own ethnographic work, the authors proposed and tested a contingency model in which the influence of leadership on team effectiveness during trauma resuscitation differs according to the situation. Results indicated that empowering leadership was more effective when trauma severity was low and when team experience was high. Directive leadership was more effective when trauma severity was high or when the team was inexperienced. Findings also suggested that an empowering leader provided more learning opportunities than did a directive leader. The major contribution of this article is the linkage of leadership to team effectiveness, as moderated by relatively specific situational contingencies.

  8. Functional systemic approach to the resuscitation and intensive care

    Directory of Open Access Journals (Sweden)

    Sadchikov D.V.

    2014-09-01

    Full Text Available Functional systemic approach to the resuscitation and intensive care may be considered as a direct correlation between analysis and synthesis, induction and deduction, and, in general, between the formal and dialectical categories. The realization of this system should be started with the interaction and formation of the final beneficial result. Therefore the experience assessment on the basis of functional systematic approach will enable us to formulate more precisely the subject and methods of resuscitation from the philosophical point of view taking into consideration the interaction of the human life integrity with death phenomenon as fixed in ontogenesis and will allow to methodically justify the distinguishing of functional systems and standard processes both in sanogenesis and thanatogenesis.

  9. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit.

    Science.gov (United States)

    van Vonderen, Jeroen J; van Zanten, Henriëtte A; Schilleman, Kim; Hooper, Stuart B; Kitchen, Marcus J; Witlox, Ruben S G M; Te Pas, Arjan B

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures, and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant's condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, color, and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnography, and respiratory function monitoring can add objectivity to the clinical assessment. These physiological parameters, with or without the combination of video recordings, can not only be used directly to guide care but also be used later for audit and teaching purposes. Further studies are needed to investigate whether this will improve the quality of delivery room management. In this narrative review, we will give an update of the current developments in monitoring neonatal resuscitation. PMID:27148507

  10. Cardiorespiratory monitoring during neonatal resuscitation for direct feedback and audit

    Directory of Open Access Journals (Sweden)

    Jeroen Johannes van Vonderen

    2016-04-01

    Full Text Available Neonatal resuscitation is one of the most frequently performed procedures and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, colour and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnography and respiratory function monitoring can add objectivity to the clinical assessment. These physiological parameters, with or without the combination of video recordings, can be used directly to guide care, but can also be used later for audit and teaching purposes. Further studies are needed to investigate whether this will improve the quality of delivery room management. In this review we will give an update of the current developments in monitoring neonatal resuscitation.

  11. Voice advisory manikin versus instructor facilitated training in cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Isbye, Dan L; Høiby, Pernilla; Rasmussen, Maria B;

    2008-01-01

    BACKGROUND: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during...... individual training. AIMS: To compare a VAM (ResusciAnne CPR skills station, Laerdal Medical A/S, Norway) with IF training in CPR using a bag-valve-mask (BVM) in terms of skills retention after 3 months. METHODS: Forty-three second year medical students were included and CPR performance (ERC Guidelines...... for Resuscitation 2005) was assessed in a 2 min test before randomisation to either IF training in groups of 8 or individual VAM training. Immediately after training and after 3 months, CPR performance was assessed in identical 2 min tests. Laerdal PC Skill Reporting System 2.0 was used to collect data. To quantify...

  12. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit

    OpenAIRE

    van Vonderen, Jeroen J.; van Zanten, Henriëtte A.; Schilleman, Kim; Hooper, Stuart B.; Kitchen, Marcus J.; Witlox, Ruben S. G. M.; te Pas, Arjan B.

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures, and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, color, and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnograp...

  13. Cardiorespiratory monitoring during neonatal resuscitation for direct feedback and audit

    OpenAIRE

    Jeroen Johannes van Vonderen; van Zanten, Henriëtte A.; Kim eSchilleman; Hooper, Stuart B.; Kitchen, Marcus J.; Ruben SGM Witlox; Arjan Benedictus Te Pas

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, colour and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnograph...

  14. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    OpenAIRE

    Bhavani Shankar Kodali; Urman, Richard D.

    2014-01-01

    Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 ). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlat...

  15. Strategy analysis of cardiopulmonary resuscitation training in the community

    OpenAIRE

    Wang, Jin; Ma, Li; Lu, Yuan-qiang

    2015-01-01

    Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest. This appreciation produced immense efforts by professional organizations to train laypeople for CPR skills. However, the rate of CPR training is low and varies widely across communities. Several strategies are used in order to improve the rate of CPR training and are performed in some advanced countries. The Chinese CPR training in communities could gain enlightenment from them.

  16. Metabolic resuscitation in sepsis: a necessary step beyond the hemodynamic?

    Science.gov (United States)

    Leite, Heitor Pons; de Lima, Lúcio Flávio Peixoto

    2016-07-01

    Despite the advances made in monitoring and treatment of sepsis and septic shock, many septic patients ultimately develop multiple organ dysfunction (MODS) and die, suggesting that other players are involved in the pathophysiology of this syndrome. Mitochondrial dysfunction occurs early in sepsis and has a central role in MODS development. MODS severity and recovery of mitochondrial function have been associated with survival. In recent clinical and experimental investigations, mitochondrion-target therapy for sepsis and septic shock has been suggested to reduce MODS severity and mortality. This intervention, which might be named "metabolic resuscitation", would lead to improved mitochondrial activity afforded by pharmacological and nutritional agents. Of particular interest in this therapeutic strategy is thiamine, a water-soluble vitamin that plays an essential role in cellular energy metabolism. Critical illness associated with hypermetabolic states may predispose susceptible individuals to the development of thiamine deficiency, which is not usually identified by clinicians as a source of lactic acidosis. The protective effects of thiamine on mitochondrial function may justify supplementation in septic patients at risk of deficiency. Perspectives of supplementation with other micronutrients (ascorbic acid, tocopherol, selenium and zinc) and potential metabolic resuscitators [coenzyme Q10 (CoQ10), cytochrome oxidase (CytOx), L-carnitine, melatonin] to target sepsis-induced mitochondrial dysfunction are also emerging. Metabolic resuscitation may probably be a safe and effective strategy in the treatment of septic shock in the future. However, until then, preliminary investigations should be replicated in further researches for confirmation. Better identification of groups of patients presumed to benefit clinically by a certain intervention directed to "mitochondrial resuscitation" are expected to increase driven by genomics and metabolomics. PMID:27501325

  17. Adrenaline and amiodarone dosages in resuscitation: rectifying misinformation.

    Science.gov (United States)

    Botha, Martin; Wells, Mike; Dickerson, Roger; Wallis, Lee; Stander, Melanie

    2013-10-01

    Despite the recognition of specialists in emergency medicine and the professionalisation of prehospital emergency care, international guidelines and consensus are often ignored, and the lag between guideline publication and translation into clinical practice is protracted. South African literature should reflect the latest evidence to guide resuscitation and safe patient care. This article addresses erroneous details regarding life-saving interventions in the South African Medicines Formulary, 10th edition. 

  18. Plasma catecholamines after endotracheal administration of adrenaline during postnatal resuscitation.

    OpenAIRE

    K. O. Schwab; von Stockhausen, H B

    1994-01-01

    To analyse the degradation of adrenaline after cardiopulmonary resuscitation of preterm neonates, free and sulphoconjugated adrenaline, noradrenaline, and dopamine were determined in 31 preterm neonates by a radioenzymatic method. Nine of the neonates received a high dose (250 micrograms/kg) of endotracheally administered adrenaline (1:1000); three of them had more than one dose of adrenaline. With the exception of sulphoconjugated dopamine, the free and sulphoconjugated catecholamine concent...

  19. Family-Witnessed Resuscitation: Perceptions of Nurses and Doctors Working in an Australian Emergency Department

    OpenAIRE

    Angela Bushby; Shane Combs; Rochelle Watkins; Rose Chapman

    2012-01-01

    Inconsistencies abound in the literature regarding staff attitudes and perceptions toward family-witnessed resuscitation. Our study builds on previous research by using a validated tool to investigate emergency department staff perceptions of family-witnessed resuscitation. A cross-sectional survey was distributed to 221 emergency department doctors' and nurses'. We found few differences between doctors and nurses perceptions toward family-witnessed resuscitation. Both nurses and doctors who ...

  20. Marked variation in newborn resuscitation practice: a national survey in the UK

    OpenAIRE

    Mann, Chantelle; Ward, Carole; Grubb, Mark; Hayes-Gill, Barrie; Crowe, John; Marlow, Neil; Sharkey, Don

    2012-01-01

    Abstract Background Although international newborn resuscitation guidance has been in force for some time, there are no UK data on current newborn resuscitation practices. Objective Establish delivery room (DR) resuscitation practices in the UK, and identify any differences between neonatal intensive care units (NICU), and other local neonatal services. Methods We conducted a structured two-stage survey of DR management, among UK neonatal units during 2009–2010 (n = 192). ...

  1. Neonatal Resuscitation Program and Pediatric Advanced Life Support.

    Science.gov (United States)

    Malinowski, C

    1995-05-01

    The need for delivery resuscitation of the newborn cannot be predicted in most cases; therefore it is judicious to train all providers who may be involved in the delivery of newborns to follow guidelines developed to improve outcome, especially in the presence of transitional asphyxia. The Neonatal Resuscitation Program emphasizes basic steps of warming, drying, suctioning, and adequately ventilating the newborn. It also addresses current theories regarding resuscitation of the low birthweight newborns, infants with meconium aspiration, and medication use. The NRP applies to all acute-care hospitals that provide delivery services and those at which a respiratory therapist is likely to be present in the high-risk delivery or unanticipated delivery-room resuscitation. Outcomes have not been well documented and more clinical research is needed to identify which therapeutic strategies promote the best survival in this population. A topic that should be included in the NRP of the future is exogenous surfactant delivery. Respiratory distress syndrome has been a significant cause of death and morbidity in prematurely born neonates. Exogenous surfactant therapy has had a dramatic effect on the death rate of premature infants and on the incidence of respiratory distress syndrome. Current methods of surfactant administration demand that personnel proficient in management of the low birthweight newborn be present. As hospitals with all levels of nurseries continue to receive the prematurely delivered newborn and better methods to administer surfactant are discovered, the NRP could add information and a skills laboratory on surfactant administration. A trained cadre of health professionals who are proficient in the specific resuscitation skills required in pediatric patients can make a difference. The infant and child have different anatomy, physiology, and disease etiology that need to be emphasized and understood by the pediatric caregiver. The Pediatric Advanced Life

  2. Aggressive HIV-1?

    OpenAIRE

    van der Hoek Lia; de Ronde Anthony; Berkhout Ben

    2005-01-01

    Abstract New York City health officials announced on February 11, 2005 that a patient rapidly developed full-blown AIDS shortly after being diagnosed with a rare, drug-resistant strain of HIV-1. The New York City Department of Health issued an alert to all hospitals and doctors and a press conference was held to announce the emergence of an aggressive HIV-1 strain that may be difficult to treat and that appears to trigger rapid progression to AIDS. Is the panic justified?

  3. Automobile Driving and Aggressive Behavior

    OpenAIRE

    Novaco, Raymond W.

    1991-01-01

    Automobile driving and aggressive behavior have had an extensive association. Themes of dominance and territoriality have long been part of automobile driving, which has also involved flagrant assaultive actions. Recent episodes of roadway violence in metropolitan areas have raised community concern about aggressive behavior in driving, although common beliefs about why such violence occurs can be seen as pseudoexplanations. Various themes in the psychology of aggression are presented as they...

  4. Identity Development and Aggressive Lexicon

    OpenAIRE

    Khomyk, Volodymyr; Filippova, Inessa

    2014-01-01

    Abstract. The paper is an attempt to explain the aggressive lexicon of adolescents. This explanation was based on the constructive-developmental theory of R. Kegan. Comparison of empirical data meaning-making evolution of identity predisposed to aggression youths with displays of their aggressive lexicon in intense interpersonal interactions indicate that the lexicon spokesmen of the Imperial stage of development a common with others reality is not shared, meaning the voice of his «...

  5. Aggressive fibromatosis of anterior maxilla

    OpenAIRE

    Shetty, Devi C; Aadithya B Urs; Puneet Ahuja; Seema Sikka

    2011-01-01

    Aggressive fibromatosis is a comparitively rare tumor with unpredictable growth and varying local recurrence rates. It does not develop distant metastases but locally it shows an aggressive and infiltrative behavior. Clinically, aggressive fibromatosis manifests as a painless, firm, often rapidly enlarging mass, fixed to underlying bone or soft tissue. It is never encapsulated. Histologically, it is rich in collagen and fibroblastic cells that are devoid of hyperchromatic or atypical nuclei, ...

  6. Aggressive fibromatosis of anterior maxilla

    Directory of Open Access Journals (Sweden)

    Devi C Shetty

    2011-01-01

    Full Text Available Aggressive fibromatosis is a comparitively rare tumor with unpredictable growth and varying local recurrence rates. It does not develop distant metastases but locally it shows an aggressive and infiltrative behavior. Clinically, aggressive fibromatosis manifests as a painless, firm, often rapidly enlarging mass, fixed to underlying bone or soft tissue. It is never encapsulated. Histologically, it is rich in collagen and fibroblastic cells that are devoid of hyperchromatic or atypical nuclei, but with more variable cellularity in different tumor sections.

  7. Introduction to "Conflict and Aggression"

    OpenAIRE

    Pagani, Camilla; Farnicka, Marzanna; Liberska, Hanna; Ramirez, J. Martin

    2014-01-01

    During the XXXVII CICA we will be talking about Developmental and Social Conditions of Conflict and Aggression. All participants will have the opportunity to listen to two keynote speakers, eight sessions of scientific presentations, one poster session and two panel discussions. All these kinds of activities will be focused on a variety of types of conditionings of aggression and violence, on methods to measure readiness for aggression and on the practical implications of this knowledge to be...

  8. Aggressiveness of childern at lower primary school

    OpenAIRE

    RUIBAROVÁ, Soňa

    2012-01-01

    The bachelor theses deals with the issue of aggression and aggressiveness of children at lower primary school. The teoretical part is aimed at description of the basic terms and at characteristics of aggression and aggressiveness. In detail it is focused on aggression´s manifestation and factors that influence children´s aggressiveness. Among other things prevention and correction of these issues are suggested. The practical part is analysing presence of aggression among children at the fourt...

  9. Aggression in Psychoses

    Directory of Open Access Journals (Sweden)

    Jan Volavka

    2014-01-01

    Full Text Available Most individuals diagnosed with a mental illness are not violent, but some mentally ill patients commit violent acts. PubMed database was searched for articles published between 1980 and November 2013 using the combination of key words “schizophrenia” or “bipolar disorder” with “aggression” or “violence.” In comparison with the general population, there is approximately a twofold increase of risk of violence in schizophrenia without substance abuse comorbidity and ninefold with such comorbidity. The risk in bipolar disorder is at least as high as in schizophrenia. Most of the violence in bipolar disorder occurs during the manic phase. Violence among adults with schizophrenia may follow two distinct pathways: one associated with antisocial conduct and another associated with the acute psychopathology, particularly anger and delusions. Clozapine is the most effective treatment of aggressive behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second most effective treatment. Treatment nonadherence greatly increases the risk of violent behavior, and poor insight as well as hostility is associated with nonadherence. Nonpharmacological methods of treatment of aggression in schizophrenia and bipolar disorder are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone is not sufficient.

  10. RHABDOMYOBLASTS IN CEREBROSPINAL FLUID

    OpenAIRE

    Deepak Nayak; Sushma V

    2013-01-01

    Rhabdomyosarcoma (RMS) is an aggressive soft tissue malignancy, not uncommonly seen in adults. The location of this malignancy is quite ubiquitous. However, a parameningeal location is uncommon and accounts for about 16% of all rhabdomyosarcomas. We report an instance where rhabdomyoblasts were seen infiltrati ng the cerebrospinal fluid (CSF). A 35 year old female patient presented to our hospita l with the primary complaints of bilateral nose block and left side...

  11. Subtypes of Aggressive Behaviors: A Developmental Perspective

    Science.gov (United States)

    Vitaro, Frank; Brendgen, Mara; Barker, Edward D.

    2006-01-01

    Aggressive behaviors in children and adolescents have undergone important conceptual and definitional modifications in the past two decades. In particular, subtypes of aggression have been proposed that separate the form and the function of the aggressive behaviors (i.e., social vs. physical aggression; reactive vs. proactive aggression).…

  12. The Effects of Pornography on Aggressive Behavior.

    Science.gov (United States)

    Stacy, Lauri L.

    This document reviews existing empirical research on the effect of pornography on aggressive behavior. Two types of pornography are distinguished: aggressive pornography and non-aggressive pornography. Conclusions drawn from the research review are presented, including: (1) aggressive pornograpy consistently increases aggressive attitudes and…

  13. Aggression in children and youth towards crime.

    OpenAIRE

    ŠTEFFLOVÁ, Eva

    2013-01-01

    This thesis deals with aggressive children and youth, which leads to crime. It deals with the causes of aggression, factors that influence aggression, but also the type of aggression. The practical part contains specific case studies of individuals whose aggression was one of the causes of crime.

  14. Aggressive angiomyxoma in pregnancy

    Directory of Open Access Journals (Sweden)

    Prashant Goyal

    2014-06-01

    Full Text Available Aggressive angiomyxoma (AA is a rare, slow-growing mesenchymal neoplasm of vulvo-perineal region. Although AA is common in females of reproductive age, only a few cases during pregnancy have been documented in the English literature. It carries a high risk of local recurrence but rarely metastasizes. The high recurrence rate can partially be due to inadequate excision, which may be due to an incorrect preoperative diagnosis. We present a case of 25-year-old pregnant female presenting with a painless and soft mass attached to left labia majora by a stalk. This mass was clinically thought to be a lipoma. It was completely excised and was diagnosed as AA on histopathology. Gynecologists should consider the diagnosis of AA when a young female especially during her pregnancy presents with a vulvo-perineal mass. Incorrect diagnosis may lead to incomplete excision and recurrence.

  15. Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

    OpenAIRE

    Choi, Sang-Sik; Kim, Won Young; Kim, Won; Lim, Kyung-Su

    2012-01-01

    Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine outp...

  16. Does Cardiopulmonary Resuscitation Cause Rib Fractures in Children? A Systematic Review

    Science.gov (United States)

    Maguire, Sabine; Mann, Mala; John, Nia; Ellaway, Bev; Sibert, Jo R.; Kemp, Alison M.

    2006-01-01

    Background: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in…

  17. Defibrillator charging before rhythm analysis significantly reduces hands-off time during resuscitation

    DEFF Research Database (Denmark)

    Hansen, L. K.; Folkestad, L.; Brabrand, M.

    2013-01-01

    BACKGROUND: Our objective was to reduce hands-off time during cardiopulmonary resuscitation as increased hands-off time leads to higher mortality. METHODS: The European Resuscitation Council (ERC) 2005 and ERC 2010 guidelines were compared with an alternative sequence (ALT). Pulseless ventricular...

  18. Characteristics of in-hospital cardiac arrest and cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Josip Ivić

    2009-02-01

    Full Text Available Aim We have studied epidemiology of in-hospital cardiac arrest, characteristics of organizing a reanimationand its,procedures as well as its documenting.Methods We analyzed all resuscitation procedure data where anesthesiology reanimation teams (RT providedcardiopulmonary resuscitation (CPR during one-year period. We included resuscitation attemptsthat were initiated outside the Department of Anesthesiology, excluding incidents in operation rooms andIntensive Care Unit (ICU. Data on every cardiac arrest and CPR were entered in a special form.Results During one-year period 87 CPR were performed. Victims of cardiac arrest were principallyelderly patients (age 60 – 80, mostly male (60%. Most frequent victims were neurological patients(42%, surgical patients (21% and neurosurgical patients (10%. The leading cause of cardiac arrestwas primary heart disease, following neurological diseases and respiration disorders of severe etiology.In over 90% cases CPR was initiated by medical personnel in their respective departments, RT arrivedwithin 5 minutes in 73,56% cases. Initially survival was 32%, but full recovery was accomplished in 4patients out of 87 (4,6%.Conclusion Victims of cardiac arrest are patients whose primary disease contributes to occurrence ofcardiorespiratory complications. High mortality and low percentage of full recovery can be explainedby characteristics of patients (old age, nature and seriousness of primary disease which significantly affectthe outcome of CPR. In some cases a question is raised whether to initiate the CPR at all. We wouldlike to point out that continous monitoring of potentially critical patients may prevent cardiorespiratoryincidents whereas the quality and success of CPR may be improved by training of staff and better technicalequipment on the relevant locations in the in the hospital where such incidents usually occur.

  19. Potential wrist ligament injury in rescuers performing cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Robert Curran

    2013-01-01

    Full Text Available Wrist pain in rescuers performing chest compressions as part of cardiopulmonary resuscitation has been reported anecdotally and recently in the literature. Studies have indicated that rescuers apply as much as 644 N of force to the victim′s chest with each compression, while standards require one hundred compressions per minute. Recent research suggests that forces transmitted through the rescuers′ wrists of less than 10% of those seen during the performance of chest compressions significantly strain the scapholunate ligament. Biomechanical research should be performed to further evaluate this possible correlation. Compensation for worker injury maybe involved.

  20. A method of automatic control procedures cardiopulmonary resuscitation

    Science.gov (United States)

    Bureev, A. Sh.; Zhdanov, D. S.; Kiseleva, E. Yu.; Kutsov, M. S.; Trifonov, A. Yu.

    2015-11-01

    The study is to present the results of works on creation of methods of automatic control procedures of cardiopulmonary resuscitation (CPR). A method of automatic control procedure of CPR by evaluating the acoustic data of the dynamics of blood flow in the bifurcation of carotid arteries and the dynamics of air flow in a trachea according to the current guidelines for CPR is presented. Evaluation of the patient is carried out by analyzing the respiratory noise and blood flow in the interspaces between the chest compressions and artificial pulmonary ventilation. The device operation algorithm of automatic control procedures of CPR and its block diagram has been developed.

  1. 烧伤外科切痂植皮疗法新复苏方案在儿童严重烧伤治疗中的应用%Application of New Resuscitation Scheme of the Escharectomy and Skin Grafting Therapy in the Treatment of Pediatric Severe Burns

    Institute of Scientific and Technical Information of China (English)

    张宏; 林国安

    2015-01-01

    目的:探讨烧伤外科切痂植皮疗法新复苏方案在儿童严重烧伤治疗中的临床效果。方法采用新复苏方案对39例严重烧伤儿童进行液体复苏,并对比分析其与中国烧伤儿童复苏公式的复苏效果。结果本组患儿中除1例死于多器官功能衰竭外,其余38例均平稳度过休克期,其平均补液量为1953 mL,治愈率为97.44%。结论基于控制每小时补液量进行复苏的烧伤外科切痂植皮疗法新复苏方案,能够有效避免补液过程中水负荷对机体内环境和渗透压造成的不利影响,对提高复苏质量和复苏成功率具有重要意义。%Objective Investigate the clinical effects of new resuscitation scheme of the escharectomy and skin grafting therapy on children with severe burns. Methods The new resuscitation scheme was used in treatment of 39 chil⁃dren with severe burns for fluid resuscitation, compared with China pediatric burn resuscitation formula in efficacy. Results Except one patient died from multiple organ failure, the other 38 went through the shock period smoothly, the average vol⁃ume of fluid resuscitation was 1,953 ml, the cure rate was 97. 44%. Conclusion The new resuscitation scheme of the es⁃charectomy and skin grafting therapy which resuscitates based on the control of hourly volume of fluid load can avoid effec⁃tively the adverse effects caused by water load on the osmotic pressure and the body's internal environment, being of great significance to improve the resuscitation quality and the success rate of resuscitation.

  2. Trans fat consumption and aggression.

    Directory of Open Access Journals (Sweden)

    Beatrice A Golomb

    Full Text Available BACKGROUND: Dietary trans fatty acids (dTFA are primarily synthetic compounds that have been introduced only recently; little is known about their behavioral effects. dTFA inhibit production of omega-3 fatty acids, which experimentally have been shown to reduce aggression. Potential behavioral effects of dTFA merit investigation. We sought to determine whether dTFA are associated with aggression/irritability. METHODOLGY/PRINICPAL FINDINGS: We capitalized on baseline dietary and behavioral assessments in an existing clinical trial to analyze the relationship of dTFA to aggression. Of 1,018 broadly sampled baseline subjects, the 945 adult men and women who brought a completed dietary survey to their baseline visit are the target of this analysis. Subjects (seen 1999-2004 were not on lipid medications, and were without LDL-cholesterol extremes, diabetes, HIV, cancer or heart disease. Outcomes assessed adverse behaviors with impact on others: Overt Aggression Scale Modified-aggression subscale (primary behavioral endpoint; Life History of Aggression; Conflict Tactics Scale; and self-rated impatience and irritability. The association of dTFA to aggression was analyzed via regression and ordinal logit, unadjusted and adjusted for potential confounders (sex, age, education, alcohol, and smoking. Additional analyses stratified on sex, age, and ethnicity, and examined the prospective association. Greater dTFA were strongly significantly associated with greater aggression, with dTFA more consistently predictive than other assessed aggression predictors. The relationship was upheld with adjustment for confounders, was preserved across sex, age, and ethnicity strata, and held cross-sectionally and prospectively. CONCLUSIONS/SIGNIFICANCE: This study provides the first evidence linking dTFA with behavioral irritability and aggression. While confounding is always a concern in observational studies, factors including strength and consistency of association

  3. Instrumental and Social Outcome Expectations of High-Aggressive and Low-Aggressive Boys.

    Science.gov (United States)

    Cillessen, Antonius H. N.; Hubbard, Julie A.

    This study examined high-aggressive and low-aggressive boys' ratings of the effectiveness of aggressive and assertive strategies for solving social problems involving hypothetical peers and actual peers. Subjects were 66 third-grade boys (11 groups of 6 boys each for a total of 22 high-aggressive, 22 low-aggressive, and 22 average aggressive boys)…

  4. Aggressive Erotica and Violence against Women.

    Science.gov (United States)

    Donnerstein, Edward

    1980-01-01

    Examines the effects of aggressive-erotic stimuli on male aggression toward females. Male subjects' deliveries of electric shocks to males or females after viewing either a neutral, erotic, or aggressive-erotic film were measured. (Author/SS)

  5. Involvement in internet aggression during early adolescence.

    Science.gov (United States)

    Werner, Nicole E; Bumpus, Matthew F; Rock, Daquarii

    2010-06-01

    The current study examined concurrent and longitudinal predictors of early adolescents' involvement in Internet aggression. Cross-sectional results (N = 330; 57% female) showed that the likelihood of reporting Internet aggression was higher among youth who spent more time using Internet-based technologies to communicate with friends and who were themselves targets of Internet aggression. Offline relational aggression and beliefs supportive of relational and physical aggression also predicted concurrent involvement in Internet aggression. We used longitudinal data (N = 150; 51% female) to distinguish between youth who were aggressive in traditional contexts only (i.e., school) from those who were aggressive both online and offline. These results indicated that youth who were aggressive both online and offline were older at the initial assessment, were targets of Internet aggression, and held beliefs more supportive of relational aggression than youth who were aggressive offline only. Implications and directions for future research are discussed.

  6. Comparing 1997 Resuscitation Council (UK) recovery position with recovery position of 1992 European Resuscitation Council guidelines: a user's perspective.

    Science.gov (United States)

    Doxey, J

    1998-12-01

    Both the 1992 and the 1997 recovery positions were demonstrated to 100 employees attending for Basic Life Support resuscitation training at a district general hospital (Chesterfield and North Derbyshire Royal Hospital NHS Trust). They used both positions, experiencing being the first-aider and the casualty and then completed a closed questionnaire. The results were evaluated from this 100% response. In every aspect the 1992 or 'How' position was preferred both in terms of ease of use and comfort during the procedure by the majority of each sample group. In every comparison the 1992 position was preferred highly significantly, (P < 0.001) using chi-square statistical analysis. PMID:10078805

  7. Family presence during cardiopulmonary resuscitation: who should decide?

    Science.gov (United States)

    Lederman, Zohar; Garasic, Mirko; Piperberg, Michelle

    2014-05-01

    Whether to allow the presence of family members during cardiopulmonary resuscitation (CPR) has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation (FPDR), many healthcare professionals still oppose it. One of the main arguments espoused by the latter is that family members should not be allowed for the sake of the patient's best interests, whether it is to increase his chances of survival, respect his privacy or leave his family with a last positive impression of him. In this paper, we examine the issue of FPDR from the patient's point of view. Since the patient requires CPR, he is invariably unconscious and therefore incompetent. We discuss the Autonomy Principle and the Three-Tiered process for surrogate decision making, as well as the Beneficence Principle and show that these are limited in providing us with an adequate tool for decision making in this particular case. Rather, we rely on a novel principle (or, rather, a novel specification of an existing principle) and a novel integrated model for surrogate decision making. We show that this model is more satisfactory in taking the patient's true wishes under consideration and encourages a joint decision making process by all parties involved. PMID:23557910

  8. Age-related changes in chest geometry during cardiopulmonary resuscitation.

    Science.gov (United States)

    Dean, J M; Koehler, R C; Schleien, C L; Michael, J R; Chantarojanasiri, T; Rogers, M C; Traystman, R J

    1987-06-01

    We studied alterations of chest geometry during conventional cardiopulmonary resuscitation in anesthetized immature swine. Pulsatile force was applied to the sternum in increments to determine the effects of increasing compression on chest geometry and intrathoracic vascular pressures. In 2-wk- and 1-mo-old piglets, permanent changes in chest shape developed due to incomplete recoil of the chest along the anteroposterior axis, and large intrathoracic vascular pressures were generated. In 3-mo-old animals, permanent chest deformity did not develop, and large intrathoracic vascular pressures were not produced. We propose a theoretical model of the chest as an elliptic cylinder. Pulsatile displacement along the minor axis of an ellipse produces a greater decrease in cross-sectional area than displacement of a circular cross section. As thoracic cross section became less circular due to deformity, greater changes in thoracic volume, and hence pressure, were produced. With extreme deformity at high force, pulsatile displacement became limited, diminishing pressure generation. We conclude that changes in chest geometry are important in producing intrathoracic intravascular pressure during conventional cardiopulmonary resuscitation in piglets. PMID:3610916

  9. Survival after Perioperative Cardiopulmonary Resuscitation: Providing an Evidence Base for Ethical Management of Do-not-resuscitate Orders.

    Science.gov (United States)

    Kalkman, Shona; Hooft, Lotty; Meijerman, Johanne M; Knape, Johannes T A; van Delden, Johannes J M

    2016-03-01

    Automatic suspension of do-not-resuscitate (DNR) orders during general anesthesia does not sufficiently address a patient's right to self-determination and is a practice still observed among anesthesiologists today. To provide an evidence base for ethical management of DNR orders during anesthesia and surgery, the authors performed a systematic review of the literature to quantify the survival after perioperative cardiopulmonary resuscitation (CPR). Results show that the probability of surviving perioperative CPR ranged from 32.0 to 55.7% when measured within the first 24 h after arrest with a neurologically favorable outcome expectancy between 45.3 and 66.8% at follow-up, which suggests a viable survival of approximately 25%. Because CPR generally proves successful in less than 15% of out-of-hospital cardiac arrests, the altered outcome probabilities that the conditions in the operating room bring on warrant reevaluation of DNR orders during the perioperative period. By preoperatively communicating the evidence to patients, they can make better informed decisions while reducing the level of moral distress that anesthesiologists may experience when certain patients decide to retain their DNR orders.

  10. Gender differences in reactive and proactive aggression.

    Science.gov (United States)

    Connor, Daniel F; Steingard, Ronald J; Anderson, Jennifer J; Melloni, Richard H

    2003-01-01

    The purpose of our investigation was to study gender differences in proactive and reactive aggression in a sample of 323 clinically referred children and adolescents (68 females and 255 males). Proactive aggression and reactive aggression were assessed using the Proactive/Reactive Aggression Scale. Demographic, historical, family, diagnostic, and treatment variables were entered into stepwise regression analyses to determine correlates of proactive and reactive aggression in males and females. Results reveal high rates of aggression in both males and females in the sample. Self reported drug use, expressed hostility, and experiences of maladaptive parenting were correlated with proactive aggression for both genders. Hyperactive/impulsive behaviors were correlated with male reactive aggression. An early age of traumatic stress and a low verbal IQ were correlated with female proactive aggression. Gender differences in correlates of proactive and reactive aggression may provide possible targets for research, prevention, and treatment efforts focused on reducing maladaptive aggression in clinically referred youth. PMID:12723901

  11. Neonatal resuscitation 3: manometer use in a model of face mask ventilation

    Science.gov (United States)

    O'Donnell, C; Davis, P; Lau, R; Dargaville, P; Doyle, L; Morley, C

    2005-01-01

    Background: Adequate ventilation is the key to successful neonatal resuscitation. Positive pressure ventilation (PPV) is initiated with manual ventilation devices via face masks. These devices may be used with a manometer to measure airway pressures delivered. The expiratory tidal volume measured at the mask (VTE(mask)) is a good estimate of the tidal volume delivered during simulated neonatal resuscitation. Aim: To assess the effect of viewing a manometer on the peak inspiratory pressures used, the volume delivered, and leakage from the face mask during PPV with two manual ventilation devices in a model of neonatal resuscitation. Methods: Participants gave PPV to a modified resuscitation mannequin using a Laerdal infant resuscitator and a Neopuff infant resuscitator at specified pressures ensuring adequate chest wall excursion. Each participant gave PPV to the mannequin with each device twice, viewing the manometer on one occasion and unable to see the manometer on the other. Data from participants were averaged for each device used with the manometer and without the manometer separately. Results: A total of 7767 inflations delivered by the 18 participants were recorded and analysed. Peak inspiratory pressures delivered were lower with the Laerdal device. There were no differences in leakage from the face mask or volumes delivered. Whether or not the manometer was visible made no difference to any measured variable. Conclusions: Viewing a manometer during PPV in this model of neonatal resuscitation does not affect the airway pressure or tidal volumes delivered or the degree of leakage from the face mask. PMID:15871988

  12. Quantifying Aggressive Behavior in Zebrafish.

    Science.gov (United States)

    Teles, Magda C; Oliveira, Rui F

    2016-01-01

    Aggression is a complex behavior that influences social relationships and can be seen as adaptive or maladaptive depending on the context and intensity of expression. A model organism suitable for genetic dissection of the underlying neural mechanisms of aggressive behavior is still needed. Zebrafish has already proven to be a powerful vertebrate model organism for the study of normal and pathological brain function. Despite the fact that zebrafish is a gregarious species that forms shoals, when allowed to interact in pairs, both males and females express aggressive behavior and establish dominance hierarchies. Here, we describe two protocols that can be used to quantify aggressive behavior in zebrafish, using two different paradigms: (1) staged fights between real opponents and (2) mirror-elicited fights. We also discuss the methodology for the behavior analysis, the expected results for both paradigms, and the advantages and disadvantages of each paradigm in face of the specific goals of the study. PMID:27464816

  13. ``Aggressive`` renal angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Cittadini, G. Jr. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, F. [Univ. of Trieste (Italy). Dept. of Radiology; Danza, F.M. [Catholic Sacro Cuore Univ., Rome (Italy). Dept. of Radiology; Derchi, L.E. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, R.S. [Univ. of Trieste (Italy). Dept. of Radiology

    1996-11-01

    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an `aggressive` appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG).

  14. Mathematical Model of Age Aggression

    OpenAIRE

    Golovinski, P. A.

    2013-01-01

    We formulate a mathematical model of competition for resources between representatives of different age groups. A nonlinear kinetic integral-differential equation of the age aggression describes the process of redistribution of resources. It is shown that the equation of the age aggression has a stationary solution, in the absence of age-dependency in the interaction of different age groups. A numerical simulation of the evolution of resources for different initial distributions has done. It ...

  15. Why are small males aggressive?

    OpenAIRE

    Morrell, Lesley J.; Lindström, Jan; Ruxton, Graeme D

    2005-01-01

    Aggression is ubiquitous in the animal kingdom, whenever the interests of individuals conflict. In contests between animals, the larger opponent is often victorious. However, counter intuitively, an individual that has little chance of winning (generally smaller individuals) sometimes initiates contests. A number of hypotheses have been put forward to explain this behaviour, including the ‘desperado effect’ according to which, the likely losers initiate aggression due to lack of alternative o...

  16. The psychobiology of aggressive behaviour.

    OpenAIRE

    Träskman Bendz, Lil; Westling, Sofie

    2005-01-01

    Among psychiatric illnesses, genetically determined disorders usually have an early onset and a severe and complicated course. Gene-environmental interaction is of importance for aggressive impulsive behaviour. For example, alcoholism type II has a high family loading, a severe course, and is often associated with antisocial behaviour. In order to gain further understanding of aggressive and impulsive behaviour, genes determining serotonin metabolism, neurosteroids and carbohydrate metabolism...

  17. Aggression, Pleasure, and Cognitive Dissonance

    OpenAIRE

    Alvarado Izquierdo, Jesús María; J. Martín Ramírez

    2014-01-01

    The relationship between aggression, pleasure and decision-making is analyzed applying a mediation model of structural equation modeling (SEM). The study explored it in two samples of similar age: young offenders and university students. A close relationship between aggression and pleasure was found in both populations. But, whereas in the case of university students, this congruence leads to a normal or adjusted behavior, in the case of young offenders, however, a mismatched evaluation of c...

  18. Cooling strategies and transport theories for brain hypothermia resuscitation

    Institute of Scientific and Technical Information of China (English)

    LIU Jing

    2007-01-01

    The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen.Unlike skeletal muscles that can survive for hours without oxygen,neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency.With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest,an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain.Meanwhile,the cooling function of the blood flow on the hot tissue will be stopped,while metabolic heat generation in the tissues still keeps running for awhile.Under such adverse situations,the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands.The reason can be attributed to the decreased metabolic requirements of the cold brain tissues,which allows a longer duration for the brain to endure reduced oxygen delivery.It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines,especially in cerebral damage,anoxia,circulatory arrest,respiratory occlusion,etc.However,although brain cooling has been found uniquely significant in clinical practices,the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation.Compared with the expanded trials in clinics,only very limited efforts were made to probe the engineering issues involved,which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation.From the viewpoint of biothermal medical engineering,the major theories and strategies for administering brain cooling can generally be classified into three categories:heat transfer

  19. Novel Approaches to Neonatal Resuscitation and the Impact on Birth Asphyxia.

    Science.gov (United States)

    Te Pas, Arjan B; Sobotka, Kristina; Hooper, Stuart B

    2016-09-01

    Historically, recommendations for neonatal resuscitation were largely based on dogma, but there is renewed interest in performing resuscitation studies at birth. The emphasis for resuscitation following birth asphyxia is administering effective ventilation, as adequate lung aeration leads not only to an increase in oxygenation but also increased pulmonary blood flow and heart rate. To aerate the lung, an initial sustained inflation can increase heart rate, oxygenation, and blood pressure recovery much faster when compared with standard ventilation. Hyperoxia should be avoided, and extra oxygen given to restore cardiac function and spontaneous breathing should be titrated based on oxygen saturations. PMID:27524447

  20. Music, Substance Use, and Aggression

    Science.gov (United States)

    Chen, Meng-Jinn; Miller, Brenda A.; Grube, Joel W.; Waiters, Elizabeth D.

    2016-01-01

    Objective This study investigated whether young people’s substance use and aggressive behaviors are related to their listening to music containing messages of substance use and violence. Method Data were collected using self-administered questionnaires and from a sample of community college students aged 15-25 (N = 1056; 43% male). A structural equation modeling method was used to simultaneously assess the associations between listening to various genres of music, alcohol use, illicit drug use, and aggressive behaviors, taking into account respondents’ age, gender, race/ethnicity, and level of sensation seeking. Results Listening to rap music was significantly and positively associated with alcohol use, problematic alcohol use, illicit drug use, and aggressive behaviors when all other variables were controlled. Additionally, alcohol and illicit drug use were positively associated with listening to musical genres of techno and reggae. Control variables such as sensation seeking, age, gender and race/ethnicity were significantly related to substance use and aggressive behaviors. Conclusion The findings suggest that young people’s substance use and aggressive behaviors may be related to their frequent exposure to music containing references to substance use and violence. Conversely, music listening preference may reflect some personal predispositions or lifestyle preferences. Alternatively, substance use, aggression and music preference are independent constructs, but share common “third factors.” PMID:16608146

  1. Do Teachers Misbehave? Aggression in School Teams

    Science.gov (United States)

    Ben Sasson, Dvora; Somech, Anit

    2015-01-01

    Purpose: Despite growing research on school aggression, significant gaps remain in the authors' knowledge of team aggression, since most studies have mainly explored aggression on the part of students. The purpose of this paper is to focus on understanding the phenomenon of workplace aggression in school teams. Specifically, the purpose of the…

  2. [Virtual educational proposal in cardiopulmonary resuscitation for the neonate care].

    Science.gov (United States)

    Gonçalves, Gilciane Ribeiro; Peres, Heloisa Helena Ciqueto; Rodrigues, Rita de Cássia; Tronchin, Daisy Maria Rizatto; Pereira, Irene Mari

    2010-06-01

    The purpose of this study was to develop an educational proposal using virtual multimedia resources, to innovate, stimulate and diversify areas of communication and interaction, facilitating nurses' autonomous and reflexive process of teaching and learning. This is an applied research, following the cyclical and interactive phases of designing, planning, developing and implementing. The educational proposal was developed on the TelEduc platform, using specific tools for content organization and communication between students and administrator. The teaching modules were on the following themes: Module 1--Fundamentals of the heart anatomy and physiology in newborns; Module 2--Risk factors for the occurrence of cardiorespiratory arrest in newborns; Module 3--Planning nursing care; Module 4--Medications used in cardiopulmonary arrests in newborns; and Module 5--Cardiorespiratory arrest care in newborns. This study may contribute to innovating teaching in nursing from a virtual educational proposal on the important issue of newborn cardiopulmonary resuscitation care. PMID:20642055

  3. Hemostatic resuscitation in postpartum hemorrhage - a supplement to surgery

    DEFF Research Database (Denmark)

    Ekelund, Kim; Hanke, Gabriele; Stensballe, Jakob;

    2015-01-01

    : This review summarizes the background, current evidence and recommendations with regard to the role of fibrinogen, tranexamic acid, prothrombin complex concentrate, desmopressin, and recombinant factor VIIa in the treatment of patients with postpartum hemorrhage. The benefits and evidence behind traditional...... be considered when hypofibrinogenemia is identified. Early administration of 1-2 g of tranexamic acid is recommended, followed by an additional dose in case of ongoing bleeding. Uncontrolled hemorrhage requires early balanced transfusion. CONCLUSION: Despite the lack of conclusive evidence for optimal...... hemostatic resuscitation in postpartum hemorrhage, the use of viscoelastic hemostatic assays, fibrinogen, tranexamic acid and balanced transfusion therapy may prove to be potentially pivotal in the treatment of postpartum hemorrhage. This article is protected by copyright. All rights reserved....

  4. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

    Directory of Open Access Journals (Sweden)

    Wohlfart Björn

    2010-10-01

    Full Text Available Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005 for cardiopulmonary resuscitation (CPR. The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8 or LUCAS-CPR (n = 8 was started and run for 20 minutes. Professional paramedics gave manual chest compression's alternating in 2-minute periods. Ventilation, one breath for each 10 compressions, was given to all animals. Defibrillation and, if needed, adrenaline were given to obtain a return of spontaneous circulation (ROSC. Results The mean coronary perfusion pressure was significantly (p Conclusions LUCAS-CPR gave significantly higher coronary perfusion pressure and significantly fewer rib fractures than manual CPR in this porcine model.

  5. Cardiopulmonary resuscitation in the elderly: a clinical and ethical perspective

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The daily practice of cardiopulmonary resuscitation (CPR) in elderly patients has brought up the attention of outcome research and resource allocation. Determinants to predict survival have been well identified. There has been empirical evidence that CPR is of doubtful utility in the geriatric population, more studies have showed controversial data. Sometimes situations in which CPR needs to be given in the elderly, causes stress to healthcare providers, due to lack of communication of the patient's wishes and the belief that it will not be successful. It is of importance to state that we have the duty to identify on time the patients that will most likely benefit from CPR, and find out the preferences of the same. Whenever it is possible to institute these guidelines, we will avoid patient suffering.

  6. Cardiopulmonary resuscitation: biomedical and biophysical analysis (Chapter XXX)

    DEFF Research Database (Denmark)

    Noordergraaf, G.J; Ottesen, Johnny T.; Scheffer, G.J.;

    2004-01-01

    presentation of coronary artery disease is sudden death, typically in (western) men. [Anonymous, 2000, ID-469] However, achieving a clear understanding of why CPR saves some lives remains shrouded in mist; mist made even thicker by contradictory reports, different school of thought and persistently low....... Survival rates as low as a few percent and extending upwards to 30%, (most frequently ±10%) survival for ‘out-of-hospital’ resuscitation have been reported, without a clear understanding of why some patients do and others do not survive when given the same care. CPR is a technique taught to tens...... and the contributions of science to this development will be presented, with emphasis on the cardiovascular system and only on the artificial respiratory aspects when needed. Schools of thought, chronologically organized, with the effects of physical and experimental models on their development and validity will allow...

  7. [Virtual educational proposal in cardiopulmonary resuscitation for the neonate care].

    Science.gov (United States)

    Gonçalves, Gilciane Ribeiro; Peres, Heloisa Helena Ciqueto; Rodrigues, Rita de Cássia; Tronchin, Daisy Maria Rizatto; Pereira, Irene Mari

    2010-06-01

    The purpose of this study was to develop an educational proposal using virtual multimedia resources, to innovate, stimulate and diversify areas of communication and interaction, facilitating nurses' autonomous and reflexive process of teaching and learning. This is an applied research, following the cyclical and interactive phases of designing, planning, developing and implementing. The educational proposal was developed on the TelEduc platform, using specific tools for content organization and communication between students and administrator. The teaching modules were on the following themes: Module 1--Fundamentals of the heart anatomy and physiology in newborns; Module 2--Risk factors for the occurrence of cardiorespiratory arrest in newborns; Module 3--Planning nursing care; Module 4--Medications used in cardiopulmonary arrests in newborns; and Module 5--Cardiorespiratory arrest care in newborns. This study may contribute to innovating teaching in nursing from a virtual educational proposal on the important issue of newborn cardiopulmonary resuscitation care.

  8. Metabolic resuscitation in sepsis: a necessary step beyond the hemodynamic?

    Science.gov (United States)

    de Lima, Lúcio Flávio Peixoto

    2016-01-01

    Despite the advances made in monitoring and treatment of sepsis and septic shock, many septic patients ultimately develop multiple organ dysfunction (MODS) and die, suggesting that other players are involved in the pathophysiology of this syndrome. Mitochondrial dysfunction occurs early in sepsis and has a central role in MODS development. MODS severity and recovery of mitochondrial function have been associated with survival. In recent clinical and experimental investigations, mitochondrion-target therapy for sepsis and septic shock has been suggested to reduce MODS severity and mortality. This intervention, which might be named “metabolic resuscitation”, would lead to improved mitochondrial activity afforded by pharmacological and nutritional agents. Of particular interest in this therapeutic strategy is thiamine, a water-soluble vitamin that plays an essential role in cellular energy metabolism. Critical illness associated with hypermetabolic states may predispose susceptible individuals to the development of thiamine deficiency, which is not usually identified by clinicians as a source of lactic acidosis. The protective effects of thiamine on mitochondrial function may justify supplementation in septic patients at risk of deficiency. Perspectives of supplementation with other micronutrients (ascorbic acid, tocopherol, selenium and zinc) and potential metabolic resuscitators [coenzyme Q10 (CoQ10), cytochrome oxidase (CytOx), L-carnitine, melatonin] to target sepsis-induced mitochondrial dysfunction are also emerging. Metabolic resuscitation may probably be a safe and effective strategy in the treatment of septic shock in the future. However, until then, preliminary investigations should be replicated in further researches for confirmation. Better identification of groups of patients presumed to benefit clinically by a certain intervention directed to “mitochondrial resuscitation” are expected to increase driven by genomics and metabolomics. PMID:27501325

  9. Kindergarten Children's Genetic Vulnerabilities Interact with Friends' Aggression to Promote Children's Own Aggression

    Science.gov (United States)

    van Lier, Pol; Boivin, Michel; Dionne, Ginette; Vitaro, Frank; Brendgen, Mara; Koot, Hans; Tremblay, Richard E.; Perusse, Daniel

    2007-01-01

    Objective: To examine whether kindergarten children's genetic liability to physically aggress moderates the contribution of friends' aggression to their aggressive behaviors. Method: Teacher and peer reports of aggression were available for 359 6-year-old twin pairs (145 MZ, 212 DZ) as well as teacher and peer reports of aggression of the two best…

  10. High Mortality in Severe Sepsis and Septic Shock Patients with Do-Not-Resuscitate Orders in East Asia

    Science.gov (United States)

    Huang, Chun-Ta; Chuang, Yu-Chung; Tsai, Yi-Ju; Ko, Wen-Je; Yu, Chong-Jen

    2016-01-01

    Background Severe sepsis is a potentially deadly illness and always requires intensive care. Do-not-resuscitate (DNR) orders remain a debated issue in critical care and limited data exist about its impact on care of septic patients, particularly in East Asia. We sought to assess outcome of severe sepsis patients with regard to DNR status in Taiwan. Methods A retrospective cohort study was conducted in intensive care units (ICUs) between 2008 and 2010. All severe sepsis patients were included for analysis. Primary outcome was association between DNR orders and ICU mortality. Volume of interventions was used as proxy indicator to indicate aggressiveness of care. Results Sixty-seven (9.4%) of 712 patients had DNR orders on ICU admission, and these patients were older and had higher disease severity compared with patients without DNR orders. Notably, DNR patients experienced high ICU mortality (90%). Multivariate analysis revealed that the presence of DNR orders was independently associated with ICU mortality (odds ratio: 6.13; 95% confidence interval: 2.66–14.10). In propensity score-matched cohort, ICU mortality rate (91%) in the DNR group was statistically higher than that (62%) in the non-DNR group (p <0.001). Regarding ICU interventions, arterial and central venous catheterization were more commonly used in DNR patients than in non-DNR patients. Conclusions From the Asian perspective, septic patients placed on DNR orders on ICU admission had exceptionally high mortality. In contrast to Western reports, DNR patients received more ICU interventions, reflecting more aggressive approach to dealing with this patient population. The findings in some ways reflect differences between East and West cultures and suggest that DNR status is an important confounder in ICU studies involving severely septic patients. PMID:27416064

  11. "In the beginning...": tools for talking about resuscitation and goals of care early in the admission.

    Science.gov (United States)

    White, Jocelyn; Fromme, Erik K

    2013-11-01

    Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care. PMID:23236089

  12. Changing attitudes to cardiopulmonary resuscitation in older people: a 15-year follow-up study.

    LENUS (Irish Health Repository)

    Cotter, P E

    2009-03-01

    while it is well established that individual patient preferences regarding cardiopulmonary resuscitation (CPR) may change with time, the stability of population preferences, especially during periods of social and economic change, has received little attention.

  13. "In the beginning...": tools for talking about resuscitation and goals of care early in the admission.

    Science.gov (United States)

    White, Jocelyn; Fromme, Erik K

    2013-11-01

    Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care.

  14. Nurses' responses to do-not-resuscitate orders in the neonatal intensive care unit.

    Science.gov (United States)

    Savage, T A; Cullen, D L; Kirchhoff, K T; Pugh, E J; Foreman, M D

    1987-01-01

    A statewide survey of nurses in perinatal centers was conducted to assess the prevalence of do-not-resuscitate (DNR) policies in neonatal intensive care units (NICUs) and to examine factors influencing nurses in those centers in their compliance with DNR orders. Three nurses in each of 10 perinatal centers were asked to complete a questionnaire on DNR policies and nurses' compliance and to respond to four hypothetical clinical situations. Eighteen of the 27 responding nurses reported the existence of a DNR policy. Factors affecting compliance with DNR orders were agreement that the infant should not be resuscitated (n = 24) or respect for the parents' wishes (n = 19). Nurses' intention to resuscitate despite a DNR order varied, depending on the description of the infant. Multiple regression analyses showed that subjective norms (beta = .41 to .82) rather than attitudes (beta = .17 to .39) exerted a more powerful influence on nurses' decisions not to resuscitate.

  15. Protective Effects of Estradiol on Myocardial Contractile Function Following Hemorrhagic Shock and Resuscitation in Rats

    Institute of Scientific and Technical Information of China (English)

    Mona Soliman

    2015-01-01

    Background:Hemorrhagic shock (HS) results in myocardial contractile dysfunction.Studies showed that 17β-estradiol protects the myocardium against contractile dysfunction.The study investigated the cardioprotective effects of treatment with 17β-estradiol before resuscitation following 1 h of HS and resuscitation.Methods:Male Sprague-Dawley rats were assigned to 2 sets of experimental protocols:Ex vivo and in vivo treatment and resuscitation.Each set had three experimental groups (n =6 per group):Normotensive (N),HS and resuscitation (HS-R) and HS rats treated with 17β-estradiol (E) and resuscitated (HS-E-R).Rats were hemorrhaged over 60-min to reach a mean arterial blood pressure of 40 mmHg.In the ex vivo group,hearts were resuscitated by perfusion in the Langendorff system.In the 17β-estradiol treated group,17β-estradiol 280 μg/kg was added for the first 5 min.Cardiac function was measured.Left ventricular generated pressure (LVGP) and +dP/dt were calculated.In the in vivo group,rats were treated with 17β-estradiol 280 μg/kg s.c.after 60-min HS.Resuscitation was performed in vivo by the reinfusion of the shed blood for 30-min to restore normotension.Results:Treatment with 17β-estradiol before resuscitation in ex vivo treated and resuscitated isolated hearts and in the in vivo treated and resuscitated rats following HS improved myocardial contractile function.In the in vivo treated group,LVGP and +dP/dt max were significantly higher in 17β-estradiol treated rats compared to the untreated group (LVGP 136.40 ± 6.61 compared to 47.58 ± 17.55,and +dP/dt 661.85 ± 49.88 compared to 88.18 ± 0.85).Treatment with 17β-estradiol improved LVGP following HS.Conclusions:The results indicate that treatment with 17β-estradiol before resuscitation following HS protects the myocardium against dysfunction.

  16. 1. Predictors of cardio pulmonary resuscitation outcome in post-operative cardiac children

    OpenAIRE

    Nasser, B.

    2016-01-01

    Outcome of cardiopulmonary resuscitation (CPR) in children with congenital heart disease has improved and many children survived after in hospital cardiac arrestthe purpose of this study is to determine predictor of poor outcome after CPR in critical children undergoing cardiac surgerywe conducted a retrospective chart review and data analysis of all CPR records and charts of all postoperative cardiac children who had cardiac arrest and required resuscitation from 2012 till 2015. Demographic,...

  17. Resuscitation prior to emergency endotracheal intubation: results of a national survey

    OpenAIRE

    Green, Robert S.; Fergusson, Dean A; Turgeon, Alexis F; McIntyre, Lauralyn A; Kovacs, George J.; Griesdale, Donald E.; Zarychanski, Ryan; Butler, Michael B.; Kureshi, Nelofar; Erdogan, Mete

    2016-01-01

    Introduction: Respiratory failure is a common problem in emergency medicine (EM) and critical care medicine (CCM). However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI). Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian...

  18. Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study

    OpenAIRE

    Kalz, Marco; Lenssen, Niklas; Felzen, Marco; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max

    2014-01-01

    Background: No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. Objective: The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from exper...

  19. Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

    OpenAIRE

    Christ M; Dierschke W; von Auenmueller KI; van Bracht M; Grett M; Trappe HJ

    2014-01-01

    Martin Christ, Wolfgang Dierschke, Katharina Isabel von Auenmueller, Marc van Bracht, Martin Grett, Hans-Joachim Trappe Department of Cardiology and Angiology, Marienhospital Herne, Ruhr – University Bochum, Herne, Germany Objectives: Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates. Materi...

  20. Avoiding hyperoxemia during neonatal resuscitation: time to response of different SpO2 monitors

    OpenAIRE

    Baquero, Hernando; Alviz, Ramiro; Castillo, Armando; Neira, Fredy; Sola, Augusto

    2011-01-01

    Aim To assess the time to obtain reliable oxygen saturation readings by different pulse oximeters during neonatal resuscitation in the delivery room or NICU. Methods Prospective study comparing three different pulse oximeters: Masimo Radical-7 compared simultaneously with Ohmeda Biox 3700 or with Nellcor N395, in newborn infants who required resuscitation. Members of the research team placed the sensors for each of the pulse oximeters being compared simultaneously, one sensor on each foot of ...

  1. Cardiopulmonary resuscitation quality and beyond: the need to improve real-time feedback and physiologic monitoring

    OpenAIRE

    Lin, Steve; Scales, Damon C.

    2016-01-01

    High-quality cardiopulmonary resuscitation (CPR) has been shown to improve survival outcomes after cardiac arrest. The current standard in studies evaluating CPR quality is to measure CPR process measures—for example, chest compression rate, depth, and fraction. Published studies evaluating CPR feedback devices have yielded mixed results. Newer approaches that seek to optimize CPR by measuring physiological endpoints during the resuscitation may lead to individualized patient care and improve...

  2. Hypothermia and room air resuscitation in NT2-N neurons, immature rats and newborn pigs

    OpenAIRE

    2011-01-01

    Perinatal asphyxia remains one of the major causes of perinatal mortality and morbidity worldwide. Mild therapeutic hypothermia reduces brain injury after perinatal asphyxia. There is an ongoing search for strategies to further improve outcome, including best practice resuscitation and interventions that can be used in combination with hypothermia. The use of supplemental oxygen during resuscitation causes a number of harmful effects including increased cerebral injury. It is not known whethe...

  3. Resuscitering av skredoffer: : eit litteraturstudie om patofysiologi og dokumentasjon av dagens anbefalingar

    OpenAIRE

    2011-01-01

    Background and objective Every year, between 100 and 250 people die in snow avalanches in Europe and North America. Rescue missions are dangerous and difficult, and resuscitation of avalanche victims often proves to be non-successful. European Resuscitation Council (ERC) guidelines for 2010 included specific advice concerning avalanche victims. In this student assignment I attempt to describe the pathophysiology and documentation for these guidelines, with special emphasis on time factors, ...

  4. Biomarkers of aggression in dementia.

    Science.gov (United States)

    Gotovac, Kristina; Nikolac Perković, Matea; Pivac, Nela; Borovečki, Fran

    2016-08-01

    Dementia is a clinical syndrome defined by progressive global impairment of acquired cognitive abilities. It can be caused by a number of underlying conditions. The most common types of dementia are Alzheimer's disease (AD), frontotemporal dementia (FTD), vascular cognitive impairment (VCI) and dementia with Lewy bodies (DLB). Despite the fact that cognitive impairment is central to the dementia, noncognitive symptoms, most commonly described nowadays as neuropsychiatric symptoms (NPS) exist almost always at certain point of the illness. Aggression as one of the NPS represents danger both for patients and caregivers and the rate of aggression correlates with the loss of independence, cognitive decline and poor outcome. Therefore, biomarkers of aggression in dementia patients would be of a great importance. Studies have shown that different genetic factors, including monoamine signaling and processing, can be associated with various NPS including aggression. There have been significant and multiple neurotransmitter changes identified in the brains of patients with dementia and some of these changes have been involved in the etiology of NPS. Aggression specific changes have also been observed in neuropathological studies. The current consensus is that the best approach for development of such biomarkers may be incorporation of genetics (polymorphisms), neurobiology (neurotransmitters and neuropathology) and neuroimaging techniques. PMID:26952705

  5. Comparison of the T-piece resuscitator with other neonatal manual ventilation devices: A qualitative review.

    LENUS (Irish Health Repository)

    2012-01-31

    AIM: To review the literature surrounding various aspects of T-piece resuscitator use, with particular emphasis on the evidence comparing the device to other manual ventilation devices in neonatal resuscitation. DATA SOURCES: The Medline, EMBASE, Cochrane databases were searched in April 2011. Ongoing trials were identified using www.clinicaltrials.gov and www.controlled-trials.com. Additional studies from reference lists of eligible articles were considered. All studies including T-piece resuscitator use were eligible for inclusion. RESULTS: Thirty studies were included. There were two randomised controlled trials in newborn infants comparing the devices, one of which addressed short and intermediate term morbidity and mortality outcomes and found no difference between the T-piece resuscitator and self inflating bag. From manikin studies, advantages to the T-piece resuscitator include the delivery of inflating pressures closer to predetermined target pressures with least variation, the ability to provide prolonged inflation breaths and more consistent tidal volumes. Disadvantages include a technically more difficult setup, more time required to adjust pressures during resuscitation, a larger mask leak and less ability to detect changes in compliance. CONCLUSIONS: There is a need for appropriately designed randomised controlled trials in neonates to highlight the efficacy of one device over another. Until these are performed, healthcare providers should be appropriately trained in the use of the device available in their departments, and be aware of its own limitations.

  6. Aggressive Jungen und gewalthaltige Computerspiele

    OpenAIRE

    Kristen, Astrid

    2010-01-01

    Does playing violent video games increase aggressive behavior over time or is it aggressive children who increasingly seek out (and play) these violent video games? To study such long-term effects a longitudinal design is necessary. Within a field study in a large German city (Kinder, Computer, Hobby, Lernen – KUHL, Freie Universtität Berlin) about 115 elementary school boys attending in the beginning (t1) classrooms of the third and fourth grade and twelve months later (t2) classrooms of the...

  7. Albumin and artificial colloids in fluid management: where does the clinical evidence of their utility stand?

    OpenAIRE

    Groeneveld, Johan AB

    2000-01-01

    Key questions remain unresolved regarding the advantages and limitations of colloids for fluid resuscitation despite extensive investigation. Elucidation of these questions has been slowed, in part, by uncertainty as to the optimal endpoints that should be monitored in assessing patient response to administered fluid. Colloids and crystalloids do not appear to differ notably in their effects on preload recruitable stroke volume or oxygen delivery. Limited evidence nevertheless suggests that c...

  8. Successful Resuscitation of an Extremely Low Birth Weight Premature Infant in Delma Island Community Hospital, United Arab Emirates

    OpenAIRE

    Saeed, Zahra’a Mohamed; Shubbar, Imad Ibrahim

    2012-01-01

    Because of their physical size and physiological immaturity, resuscitation of extremely very low birth weight premature infants is a big dilemma for neonatologists in any hospital. The resuscitation may present an additional challenge to the caregiver if it is undertaken in a remote community hospital with limited technical facilities and health personnel. We present the case of successful resuscitation of a 23-week-old premature infant, with a birth weight of 650 g, at Delma Island Community...

  9. Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

    Directory of Open Access Journals (Sweden)

    Christ M

    2014-06-01

    Full Text Available Martin Christ, Wolfgang Dierschke, Katharina Isabel von Auenmueller, Marc van Bracht, Martin Grett, Hans-Joachim Trappe Department of Cardiology and Angiology, Marienhospital Herne, Ruhr – University Bochum, Herne, Germany Objectives: Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates. Material and methods: In-hospital cardiac arrest teams at our hospital were instructed to complete a questionnaire following every emergency call between July 2011 and June 2013. Data on all resuscitation attempts were collected and analyzed. Results: A total of 65 in-hospital resuscitations were recorded in 42 males (64.6% and 23 females (35.4% (mean age 72.0±14.3 years. A total of 54 (83.1% cardiac arrests were witnessed; seven (10.8% showed a shockable rhythm at the time of the first ECG. Resuscitation attempts lasted 29.3±41.3 minutes, and 4.1±3.1 mg epinephrine was given. Return of spontaneous circulation could be achieved in 38 patients (58.5%; 29 (44.6% survived the first day, 23 (35.4% the seventh day, and 15 patients (23.1% were discharged alive. Significantly more in-hospital resuscitations were obtained for those performed during non-regular working hours (P<0.001, with higher neuron-specific enolase levels at 72 hours after resuscitation during nonregular working hours (P=0.04. Patients who were discharged alive were significantly younger (P=0.01, presented more often with an initial shockable rhythm (P=0.04, and had a shorter duration of resuscitation (P<0.001 with the need of a lower dose of epinephrine (P<0.001. Discussion: Survival rates following in-hospital resuscitation were poor at any time, but appear to depend less on time-dependent effects of the quality of resuscitation and more on time-dependent effects of recognition of cardiac arrests

  10. Enrichment and aggression in primates.

    Science.gov (United States)

    Honess, P E; Marin, C M

    2006-01-01

    There is considerable evidence that primates housed under impoverished conditions develop behavioural abnormalities, including, in the most extreme example, self-harming behaviour. This has implications for all contexts in which primates are maintained in captivity from laboratories to zoos since by compromising the animals' psychological well-being and allowing them to develop behavioural abnormalities their value as appropriate educational and research models is diminished. This review examines the extensive body of literature documenting attempts to improve living conditions with a view to correcting behavioural abnormalities and housing primates in such a way that they are encouraged to exhibit a more natural range and proportion of behaviours, including less self-directed and social aggression. The results of housing, feeding, physical, sensory and social enrichment efforts are examined with specific focus on their effect on aggressive behaviour and variation in their use and efficacy. It is concluded that while inappropriate or poorly distributed enrichment may encourage aggressive competition, enrichment that is species, sex, age and background appropriate can dramatically reduce aggression, can eliminate abnormal behaviour and substantially improve the welfare of primates maintained in captivity.

  11. Personal standards for judging aggression by a relationship partner: How much aggression is too much?

    Science.gov (United States)

    Arriaga, Ximena B; Capezza, Nicole M; Daly, Christine A

    2016-01-01

    What determines whether people tolerate partner aggression? This research examined how norms, relationship experiences, and commitment predict personal standards for judging aggressive acts by a partner. Studies 1a and 1b (n = 689) revealed that experiencing aggression in a current relationship and greater commitment predicted greater tolerance for common partner aggression. Study 2 longitudinally tracked individuals who had never experienced partner aggression (n = 52). Once aggression occurred, individuals adopted more tolerant standards, but only if they were highly committed. Study 3 involved experimentally manipulating the relevance of partner aggression among individuals who reported current partner aggression (n = 73); they were more tolerant of aggressive acts imagined to occur by their partner (vs. the same acts by a stranger), but only if they were highly committed. Personal standards for judging partner aggression are dynamic. They shift toward greater tolerance when committed people experience aggression in a current relationship.

  12. How we developed a comprehensive resuscitation-based simulation curriculum in emergency medicine.

    Science.gov (United States)

    Dagnone, Jeffrey Damon; McGraw, Robert; Howes, Daniel; Messenger, David; Bruder, Eric; Hall, Andrew; Chaplin, Timothy; Szulewski, Adam; Kaul, Tom; O'Brien, Terrence

    2016-01-01

    Over the past decade, simulation-based education has emerged as a new and exciting adjunct to traditional bedside teaching and learning. Simulation-based education seems particularly relevant to emergency medicine training where residents have to master a very broad skill set, and may not have sufficient real clinical opportunities to achieve competence in each and every skill. In 2006, the Emergency Medicine program at Queen's University set out to enhance our core curriculum by developing and implementing a series of simulation-based teaching sessions with a focus on resuscitative care. The sessions were developed in such as way as to satisfy the four conditions associated with optimum learning and improvement of performance; appropriate difficulty of skill, repetitive practice, motivation, and immediate feedback. The content of the sessions was determined with consideration of the national training requirements set out by the Royal College of Physicians & Surgeons of Canada. Sessions were introduced in a stepwise fashion, starting with a cardiac resuscitation series based on the AHA ACLS guidelines, and leading up to a more advanced resuscitation series as staff became more adept at teaching with simulation, and as residents became more comfortable with this style of learning. The result is a longitudinal resuscitation curriculum that begins with fundamental skills of resuscitation and crisis resource management (CRM) in the first 2 years of residency and progresses through increasingly complex resuscitation cases where senior residents are expected to play a leadership role. This paper documents how we developed, implemented, and evaluated this resuscitation-based simulation curriculum for Emergency Medicine postgraduate trainees, with discussion of some of the challenges encountered. PMID:25410350

  13. Impact of a nationwide training program for neonatal resuscitation in China

    Institute of Scientific and Technical Information of China (English)

    XU Tao; MA Yi; William Keenan; Susan Niermeyer; WANG Hui-shan; YE Hong-mao; YU Ren-jie; HUANG Xing-hua; WANG Dan-hua; Wang Li-xin; FENG Qi; GONG Li-min

    2012-01-01

    Background Seventeen million births occur in China each year.Neonatal mortality is the leading cause of under 5-year-old child deaths,and intrapartum-related injury accounts for much of mental retardation in young children.The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth.The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program (NRP) on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants.Methods The Chinese NRP incorporated policy change,professional education,and creation of a sustainable health system infrastructure for resuscitation.Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade.The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality.Program evaluation data came from 322 representative hospitals in those provinces.Results Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure.From 2004 through 2009 more than 110659 professionals received NRP training in the 20 target provinces,with 94% of delivery facilities and 99% of counties reached.Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4per 10000 from 2003 to 2008,and the incidence of Apgar ≤7 at 1 minute decreased from 6.3% to 2.9%.Conclusions The Chinese NRP achieved policy changes promoting resuscitation,trained large numbers of professionals,and contributed to reduction in delivery room mortality.Improved adherence to the resuscitation algorithm,extension of training to the township level,and coverage of births now occurring outside health facilities can further increase the number of lives saved.

  14. Emergency room resuscitative thoracotomy: when is it indicated?

    Science.gov (United States)

    Boyd, M; Vanek, V W; Bourguet, C C

    1992-11-01

    This study was designed to examine the results of emergency room resuscitative thoracotomy (ERRT) and to formulate cost-effective indications for this procedure. A retrospective study was performed of 28 patients who had ERRT at St. Elizabeth Hospital Medical Center, Youngstown, Ohio, during the 4 years from July 1985 through June 1989. The prognostic factors analyzed included mechanism and site of injury, signs of life (SOL), vital signs (VS), age, gender, and prehospital care. The overall survival rate of ERRT was 7% (2 of 28 patients). The survival rate was 18% (2 of 11 patients) with penetrating trauma, and 0% (none of 17 patients) with blunt trauma. The best survival rate was 66% in the subgroup of patients with penetrating trauma and SOL present at the scene and in the emergency room (ER), (two of three patients). Our observations were combined with those of 23 studies from the literature involving 2294 trauma patients who had ERRT. Using meta-analysis, the survival rate was 11% overall. Improved survival was noted for patients with penetrating trauma compared with patients with blunt trauma (14% vs. 2%, p ERRTs performed by 41% without decreasing the number of neurologically intact survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1464921

  15. Trainers’ Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training

    Directory of Open Access Journals (Sweden)

    M. Mäkinen

    2016-01-01

    Full Text Available Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D, Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185 focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree. Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation, Nurse’s Role, Nontechnical Skill, Usefulness, Restrictions, Personal, and Organisation. Cronbach’s alphas were 0.92–0.51. Statistics were Student’s t-test, ANOVA, stepwise regression analysis, and Pearson Correlation. Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with the Nontechnical Skills scale (p<0.01. Participants scoring high on Hesitation scale (p<0.01 were less confident about their Nurse’s Role (p<0.01 and Nontechnical Skills (p<0.01. Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.

  16. Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

    International Nuclear Information System (INIS)

    Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 ± 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations

  17. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Kodali

    2014-01-01

    Full Text Available Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 . Most recent Advanced Cardiac Life Support (ACLS guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR. Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO 2 (PETCO 2 and cardiac output that can indicate the return of spontaneous circulation (ROSC. Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO 2 values can guide the initiation of extracorporeal life support (ECLS in refractory cardiac arrest (RCA. There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO 2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

  18. The Iranian physicians attitude toward the do not resuscitate order

    Science.gov (United States)

    Fallahi, Masood; Banaderakhshan, Homayion; Abdi, Alireza; Borhani, Fariba; Kaviannezhad, Rasool; Karimpour, Hassan Ali

    2016-01-01

    Background Physicians are responsible for making decisions about the do not resuscitate (DNR) order of patients; however, most of them are faced with some uncertainty in decision making and ethical aspects. Moreover, there are differences on decision making related to the DNR order among physicians, which may be related to the different attitudes toward this issue. Considering the lack of information, this study was performed to investigate doctors’ attitude about DNR order for patients in their final phases of life. Methods In a descriptive–analytical study, 152 physicians were enrolled as quota sampling subjects from educational hospitals affiliated to the Kermanshah University of Medical Sciences. The tool used was a researcher-developed questionnaire. Data were analyzed using SPSS 16 software by descriptive and inferential statistics. Results The mean of attitude toward DNR was 3.22, for which the univariate t-test showed a significant positive attitude toward DNR (P=0.002); the mean of attitude number toward DNR was higher in physicians with higher education level (P=0.002). But this difference was not found in terms of age group, sex, and experiences in participating in DNR decisions. Conclusion Due to the positive attitude of doctors toward DNR orders and lack of identified guidance, clear guidelines that comply with the Iranian Islamic culture are necessary to be established. Implementing this directive requires comprehensive training to various groups, including patients, doctors, nurses, administrators, and policy makers of the health system. PMID:27418832

  19. Emergency room resuscitative thoracotomy: when is it indicated?

    Science.gov (United States)

    Boyd, M; Vanek, V W; Bourguet, C C

    1992-11-01

    This study was designed to examine the results of emergency room resuscitative thoracotomy (ERRT) and to formulate cost-effective indications for this procedure. A retrospective study was performed of 28 patients who had ERRT at St. Elizabeth Hospital Medical Center, Youngstown, Ohio, during the 4 years from July 1985 through June 1989. The prognostic factors analyzed included mechanism and site of injury, signs of life (SOL), vital signs (VS), age, gender, and prehospital care. The overall survival rate of ERRT was 7% (2 of 28 patients). The survival rate was 18% (2 of 11 patients) with penetrating trauma, and 0% (none of 17 patients) with blunt trauma. The best survival rate was 66% in the subgroup of patients with penetrating trauma and SOL present at the scene and in the emergency room (ER), (two of three patients). Our observations were combined with those of 23 studies from the literature involving 2294 trauma patients who had ERRT. Using meta-analysis, the survival rate was 11% overall. Improved survival was noted for patients with penetrating trauma compared with patients with blunt trauma (14% vs. 2%, p ERRTs performed by 41% without decreasing the number of neurologically intact survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    U. Ayala

    2014-01-01

    Full Text Available Interruptions in cardiopulmonary resuscitation (CPR compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies.

  1. Effect of different resuscitation strategies on post-resuscitation brain damage in a porcine model of prolonged cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Gu Wei; Hou Xiaomin; Li Chunsheng

    2014-01-01

    Background The choice of a defibrillation or a cardiopulmonary resuscitation (CPR)-first strategy in the treatment of prolonged cardiac arrest (CA) is still controversial.The purpose of this study was to compare the effects of defibrillation or CPR administered first on neurological prognostic markers in a porcine model of prolonged CA.Methods After 8 minutes of untreated ventricular fibrillation (VF),24 inbred Chinese Wuzhishan minipigs were randomized to receive either defibrillation first (ID group,n=12) or chest compression first (IC group,n=12).In the ID group,a shock was delivered immediately.If defibrillation failed to attain restoration of spontaneous circulation (ROSC),manual chest compressions were rapidly initiated at a rate of 100 compressions/min and a compression-to-ventilation ratio of 30:2.If VF persisted after five cycles of CPR,a second defibrillation attempt was made.In the IC group,chest compressions were delivered first,followed by a shock.After successful ROSC,hemodynamic status and blood samples were obtained at 0.5,1,2,4,6,and 24 hours after ROSC.Porcine-specific neuron-specific enolase (NSE) and S100B were measured from sera using enzyme-linked immunosorbent assays.Porcine cerebral performance category scores were used to evaluate preliminary neurological function following 24 hours recovery.Surviving pigs were sacrificed at 24 hours after ROSC and brains were removed for electron microscopy analysis.Results The number of shocks,total defibrillation energy,and time to ROSC were significantly lower in the ID group compared with the IC group.Compared with the IC group,S100B expression was decreased at 2 and 4 hours after ROSC,and NSE expression decreased at 6 and 24 hours after ROSC in the ID group.Brain tissue analysis showed that injury was attenuated in the ID group compared with the IC group.There were no significant differences between 6 and 24 hours survival rates.Conclusion Defibrillation first may result in a shorter time to ROSC and

  2. Psychological features of aggression in adolescence

    Directory of Open Access Journals (Sweden)

    .O. Kuznetsova

    2014-08-01

    Full Text Available We present the results of empirical study of the psychological characteristics of aggression and frustration response in adolescents with different types of socialization. We describe the qualitative and quantitative aspects of aggression in adolescence. We show the nature of the relationship of a aggressiveness features with type of socialization in adolescents. The described study involved 125 male adolescents aged 13-14 years, enrolled in the VIII grade (56 cadets and 69 students. We used methods of testing, survey, subjective scaling. In cadets, we found elevated rates of aggression and hostility, the prevalence of physical aggression, high scores on Irritation, Verbal aggression and Suspicion, as well as the prevalence in situations of frustration of extrapunitive reactions with “fixation on self-defense”. In the group of students of secondary school, the levels of aggression and hostility an on upper limit of test norms, impunitive reactions, indirect aggression, guilt, constructive reaction with “fixation on meeting needs” prevail.

  3. Aggressive Driving Behavior: Undergraduate Students Study

    OpenAIRE

    Rungson Chomeya

    2010-01-01

    Problem statement: The main purposes of this research were (1) to study the aggressive driving behavior of graduate students, (2) to develop aggressive driving behavior standard test, (3) to compare the aggressive driving behavior between gender, years of study, academic achievement, driving confidence and driving experience and (4) to study the relationship among aggressive driving behavior, driving confidence, driving experience and accident experience. Approach: The subjects consisted of 4...

  4. Understanding and Preventing Aggressive Responses in Youth.

    Science.gov (United States)

    Studer, Jeannine

    1996-01-01

    Fighting violence requires a networking approach among schools, community, and parents. This article advises elementary school counselors: (a) focus on the causes of aggression; (b) identify children with the propensity for behaving aggressively; and (c) prevent aggressive responses in children and adolescents by introducing techniques and…

  5. Neurobiology of escalated aggression and violence

    NARCIS (Netherlands)

    Miczek, Klaus A.; de Almeida, Rosa M. M.; Kravitz, Edward A.; Rissman, Emilie F.; de Boer, Sietse F.; Raine, Adrian

    2007-01-01

    Psychopathological violence in criminals and intense aggression in fruit flies and rodents are studied with novel behavioral, neurobiological, and genetic approaches that characterize the escalation from adaptive aggression to violence. One goal is to delineate the type of aggressive behavior and it

  6. Fantasy Aggression and the Catharsis Phenomenon

    Science.gov (United States)

    Spiegel, Sharon Baron; Zelin, Martin

    1973-01-01

    The purpose of this study was to explore the effects of fantasy aggression on blood pressure, affective states, and probability of subsequent aggression. The results are inconclusive because of the limited range of fantasy stimuli used and the short amount of time allowed for aggression to occur. (Author/KM)

  7. Aggression induced by intermittent positive reinforcement.

    Science.gov (United States)

    Looney, T A; Cohen, P S

    1982-01-01

    Mammalian and non-mammalian species engage in aggressive behavior toward animate and inanimate targets when exposed to intermittent access to a positive reinforcer. This behavior, called extinction- or schedule-induced aggression, typically includes a biting or striking topography that inflicts damage on a target. This paper critically reviews research and theoretical issues concerning such aggression and suggests directions for future investigation.

  8. Social Aggression on Television and Its Relationship to Children's Aggression in the Classroom

    Science.gov (United States)

    Martins, Nicole; Wilson, Barbara J.

    2012-01-01

    A survey was conducted with over 500 children in grades K-5 to examine whether exposure to socially aggressive content was related to children's use of social aggression. The results of the survey revealed a significant relationship between exposure to televised social aggression and increased social aggression at school, but only for girls and…

  9. Fat embolism with the use of intraosseous infusion during cardiopulmonary resuscitation.

    Science.gov (United States)

    Fiallos, M; Kissoon, N; Abdelmoneim, T; Johnson, L; Murphy, S; Lu, L; Masood, S; Idris, A

    1997-08-01

    The objective of this prospective study was to assess the incidence and magnitude of fat emboli after cardiopulmonary resuscitation and intraosseous infusions. An animal laboratory at a university center was used to study 33 mixed-breed piglets. The piglets underwent hypoxic cardiac arrest followed by chest compressions and mechanical ventilation for a minimum of 30 minutes. The animals were divided in groups: group 1 (n = 5), which had no intraosseous cannulas, group 2 (n = 6), which had intraosseous cannulas with infusion, groups 3 (n = 6), 4 (n = 6), and 5 (n = 8), which had intraosseous cannulas with infusion of epinephrine, normal saline, and sodium bicarbonate respectively, and group 6 (n = 2), which was a sham group with no intraosseous cannulas and no cardiopulmonary resuscitation. At cessation of cardiopulmonary resuscitation, representative lung samples were collected from upper and lower lobes of each lung and observed for fat globules and bone marrow elements. Fat globules were seen in the peribronchial blood vessels and intravascular areas throughout all lung fields of groups 1 through 5. There was no difference in appearance or distribution of fat globules among the 5 treatment groups. Analysis of variance showed no statistical significance (P fat embolization over cardiopulmonary resuscitation alone in this animal model. The benefits of using this procedure in critically ill children as a means of rapid vascular access for resuscitation is well established. However, the risk of fat embolism in this population needs further study. PMID:9258208

  10. Therapeutic effect of cisapride on gastric injury following hemorrhagic shock resuscitation in rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lian-yang; WANG Zheng-guo; ZHU Pei-fang; XU Yan

    2005-01-01

    Objective: To investigate the therapeutic effect of cisapride on gastric injury following hemorrhagic shock resuscitation.Methods: 108 Wistar rats weighing (200 g±30 g) were randomly divided into a sham shock (SS) group (n=36), a hemorrhagic shock resuscitation (HS) group (n=36) and a hemorrhagic shock cisapride treated (HSC) group (n=36). Sampling at 1, 2 and 4 hours after resuscitation was done and 6 samples for each observation item were taken. The gastric blood flow volume was measured by isotope label biological microglobulin. Gastric pHi, gastric emptying, MDA and Na+-K+-ATPase of gastric mucosa were measured.Results: In the HSC group, the relative residual rate of gastric pigment decreased significantly, the gastric blood flow volume elevated; gastric pHi increased significantly at 2 hours; the level of mucosal MDA decreased at 4 hours, the activity of Na+-K+-ATPase increased and the lactic acid level in the portal vein decreased significantly compared to the HS group.Conclusions: After hemorrhagic shock resuscitation, cisapride contained the following functions,1) promoting gastric emptying, 2) increasing the blood flow of gastric blood flow volume and gastric pHi, 3) depressing the lactic acid concentration of the portal vein and improving MDA volume and Na+-K+ -ATPase activity of gastric mucosa. It suggests that after comple menting effective circulating blood volume for hemorrhagic shock resuscitation, early use of cisapride for gastric motility is helpful for an improvement of lasting ischemia and hypoxia in stomach.

  11. Read anything mean lately? associations between reading aggression in books and aggressive behavior in adolescents.

    Science.gov (United States)

    Stockdale, Laura A; Coyne, Sarah M; Nelson, David A; Padilla-Walker, Laura M

    2013-01-01

    Although there have been hundreds of studies on media violence, few have focused on literature, with none examining novels. Accordingly, the aim of the current study was to examine whether reading physical and relational aggression in books was associated with aggressive behavior in adolescents. Participants consisted of 223 adolescents who completed a variety of measures detailing their media use and aggressive behavior. A non-recursive structural equation model revealed that reading aggression in books was positively associated with aggressive behavior, even after controlling for exposure to aggression in other forms of media. Associations were only found for congruent forms of aggression. Implications regarding books as a form of media are discussed.

  12. Old age and poor prognosis increase the likelihood of disagreement between cancer patients and their oncologists on the indication for resuscitation attempt

    DEFF Research Database (Denmark)

    Saltbaek, Lena; Michelsen, Hanne M; Nelausen, Knud M;

    2013-01-01

    The do-not-resuscitate decision is a common ethical problem. However, the concordance between patients' preferences and physicians' assessments of the indication for cardiopulmonary resuscitation attempt (CPR) has only been modestly investigated....

  13. Aggression: peculiarities of manifestation and coping strategies in adolescence

    OpenAIRE

    Budykin A.V.; Budykin S.V.; Zhigachev A.S.

    2014-01-01

    Aggression management is becoming increasingly important task in modern society, as the number of situations that provoke aggression increases. Particular attention should be paid to aggression in adolescence. The world economic crisis contributes to the increase in the level of aggressiveness. The incidence of auto-aggression also increases. Suppressed aggression leads to the development of psychosomatic disorders. Experts agree that aggression is bad, but just suppressing aggressive reactio...

  14. Knowledge and Attitude of Radiology Technologists Towards Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    Behroozi

    2015-04-01

    Full Text Available Background The number of casualties and critically ill patients referred to radiology departments increased during the past decade, which caused the risk of cardiac arrest in radiology departments to increase considerably. Objectives The current study aimed to evaluate the knowledge and attitude of radiology technologists regarding Cardiopulmonary Resuscitation (CPR. Patients and Methods After approval a cross sectional study was designed. Ninety five radiology technologists (male and female were selected in four tertiary referral hospitals in Ahvaz, Iran. Accordingly, 87 radiologic technologists of which agreed to participate in the study. The researchers developed a questionnaire. The questionnaire consisted of three distinct sections including demographic data, attitude, and technical knowledge questions. Reliability of the technical knowledge questions were evaluated using Cronbach’s alpha (76%. Data collection was performed using interview method. Results Of the total 87 questionnaires, one was incomplete. None of the participants had attended a training program since employment. The average scores of attitude towards CPR and technical knowledge were 80 ± 8.9 and 8.8 ± 2.3, respectively. A correlation was observed between age and work experience (r = 0.866, P ≤ 0.0001, age and technical knowledge (r = 0.380, P ≤ 0.0001, work experience and technical knowledge (r = 0.317, P = 0.003, and attitude and technical knowledge (r = 0.397, P ≤ 0.0001. Also a correlation was observed between work experience and attitude (r = 0.385, P ≤ 0.0001. No significant difference was observed between male and female subjects’ technical knowledge (P ≥ 0.05 and attitude (P ≥ 0.05. Conclusions It can be concluded that, although the attitude of participants towards CPR was positive in general, their technical knowledge was poor. This finding should urge decision-makers to consider delivering in-service training courses to radiology technologists

  15. Hydrogen sulfide improves neural function in rats following cardiopulmonary resuscitation

    Science.gov (United States)

    LIN, JI-YAN; ZHANG, MIN-WEI; WANG, JIN-GAO; LI, HUI; WEI, HONG-YAN; LIU, RONG; DAI, GANG; LIAO, XIAO-XING

    2016-01-01

    The alleviation of brain injury is a key issue following cardiopulmonary resuscitation (CPR). Hydrogen sulfide (H2S) is hypothesized to be involved in the pathophysiological process of ischemia-reperfusion injury, and exerts a protective effect on neurons. The aim of the present study was to investigate the effects of H2S on neural functions following cardiac arrest (CA) in rats. A total of 60 rats were allocated at random into three groups. CA was induced to establish the model and CPR was performed after 6 min. Subsequently, sodium hydrosulfide (NaHS), hydroxylamine or saline was administered to the rats. Serum levels of H2S, neuron-specific enolase (NSE) and S100β were determined following CPR. In addition, neurological deficit scoring (NDS), the beam walking test (BWT), prehensile traction test and Morris water maze experiment were conducted. Neuronal apoptosis rates were detected in the hippocampal region following sacrifice. After CPR, as the H2S levels increased or decreased, the serum NSE and S100β concentrations decreased or increased, respectively (P<0.0w. The NDS results of the NaHS group were improved compared with those of the hydroxylamine group at 24 h after CPR (P<0.05). In the Morris water maze experiment, BWT and prehensile traction test the animals in the NaHS group performed best and rats in the hydroxylamine group performed worst. At day 7, the apoptotic index and the expression of caspase-3 were reduced in the hippocampal CA1 region, while the expression of Bcl-2 increased in the NaHS group; and results of the hydroxylamine group were in contrast. Therefore, the results of the present study indicate that H2S is able to improve neural function in rats following CPR. PMID:26893650

  16. Hemostatic resuscitation with plasma and platelets in trauma

    Directory of Open Access Journals (Sweden)

    Pär I Johansson

    2012-01-01

    Full Text Available Background: Continued hemorrhage remains a major contributor of mortality in massively transfused patients and controversy regarding the optimal management exists although recently, the concept of hemostatic resuscitation, i.e., providing large amount of blood products to critically injured patients in an immediate and sustained manner as part of an early massive transfusion protocol has been introduced. The aim of the present review was to investigate the potential effect on survival of proactive administration of plasma and/or platelets (PLT in trauma patients with massive bleeding. Materials and Methods: English databases were searched for reports of trauma patients receiving massive transfusion (10 or more red blood cell (RBC within 24 hours or less from admission that tested the effects of administration of plasma and/or PLT in relation to RBC concentrates on survival from January 2005 to November 2010. Comparison between highest vs lowest blood product ratios and 30-day mortality was performed. Results: Sixteen studies encompassing 3,663 patients receiving high vs low ratios were included. This meta-analysis of the pooled results revealed a substantial statistical heterogeneity (I 2 = 58% and that the highest ratio of plasma and/or PLT or to RBC was associated with a significantly decreased mortality (OR: 0.49; 95% confidence interval: 0.43-0.57; P<0.0001 when compared with lowest ratio. Conclusion: Meta-analysis of 16 retrospective studies concerning massively transfused trauma patients confirms a significantly lower mortality in patients treated with the highest fresh frozen plasma (FFP and/or PLT ratio when compared with the lowest FFP and/or PLT ratio. However, optimal ranges of FFP: RBC and PLT : RBC should be established in randomized controlled trials.

  17. Imaging features of aggressive angiomyxoma

    International Nuclear Information System (INIS)

    AIM: To describe the imaging features of aggressive angiomyxoma in a rare benign mesenchymal tumour most frequently arising from the perineum in young female patients. MATERIALS AND METHODS: We reviewed the computed tomography (CT) and magnetic resonance (MR) imaging features of patients with aggressive angiomyxoma who were referred to our hospital. The imaging features were correlated with clinical information and pathology in all patients. RESULTS: Four CT and five MR studies were available for five patients (all women, mean age 39, range 24-55). Three patients had recurrent tumour at follow-up. CT and MR imaging demonstrated a well-defined mass-displacing adjacent structures. The tumour was of low attenuation relative to muscle on CT. On MR, the tumour was isointense relative to muscle on T1-weighted image, hyperintense on T2-weighted image and enhanced avidly after gadolinium contrast with a characteristic 'swirled' internal pattern. MR imaging demonstrates the extent of the tumour and its relation to the pelvic floor. Recurrent tumour has a similar appearance to the primary lesion. CONCLUSION: The MR appearances of aggressive angiomyxomas are characteristic, and the diagnosis should be considered in any young woman presenting with a well-defined mass arising from the perineum. Jeyadevan, N. N. etal. (2003). Clinical Radiology58, 157--162

  18. Imaging features of aggressive angiomyxoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeyadevan, N.N.; Sohaib, S.A.A.; Thomas, J.M.; Jeyarajah, A.; Shepherd, J.H.; Fisher, C

    2003-02-01

    AIM: To describe the imaging features of aggressive angiomyxoma in a rare benign mesenchymal tumour most frequently arising from the perineum in young female patients. MATERIALS AND METHODS: We reviewed the computed tomography (CT) and magnetic resonance (MR) imaging features of patients with aggressive angiomyxoma who were referred to our hospital. The imaging features were correlated with clinical information and pathology in all patients. RESULTS: Four CT and five MR studies were available for five patients (all women, mean age 39, range 24-55). Three patients had recurrent tumour at follow-up. CT and MR imaging demonstrated a well-defined mass-displacing adjacent structures. The tumour was of low attenuation relative to muscle on CT. On MR, the tumour was isointense relative to muscle on T1-weighted image, hyperintense on T2-weighted image and enhanced avidly after gadolinium contrast with a characteristic 'swirled' internal pattern. MR imaging demonstrates the extent of the tumour and its relation to the pelvic floor. Recurrent tumour has a similar appearance to the primary lesion. CONCLUSION: The MR appearances of aggressive angiomyxomas are characteristic, and the diagnosis should be considered in any young woman presenting with a well-defined mass arising from the perineum. Jeyadevan, N. N. etal. (2003). Clinical Radiology58, 157--162.

  19. Rural neighborhoods and child aggression.

    Science.gov (United States)

    Bowen, Natasha K; Wretman, Christopher J

    2014-12-01

    Structural equation modeling with latent variables was used to evaluate the direct and mediated effects of a neighborhood risk factor (negative teen behaviors) on the parent-report aggressive behavior of 213 students in grades 3 through 5 attending a school in a low-income, rural community. Contagion and social control hypotheses were examined as well as hypotheses about whether the neighborhood served as a microsystem or exosystem for rural pre-adolescents. Analyses took into account the clustering of students and ordinal nature of the data. Findings suggest that rural neighborhoods may operate as both a microsystem and exosystem for children, with direct contagion effects on their aggressive behaviors as well as indirect social control effects through parenting practices. Direct effects on aggression were also found for parenting practices and child reports of friends' negative behaviors. Pre-adolescence may be a transitional stage, when influences of the neighborhood on child behavior begin to compete with influences of caregivers. Findings can inform the timing and targets of violence prevention in rural communities. PMID:25205545

  20. THE RESUSCITATION OF THE CENTRAL NERVOUS SYSTEM OF MAMMALS.

    Science.gov (United States)

    Stewart, G N; Guthrie, C C; Burns, R L; Pike, F H

    1906-03-26

    the same side as the stimulus, crossing of reflexes, to involve the other side, not occurring till later. As a rule, all reflexes return, and a short period of quiet follows. The anterior part of the cord again becomes irritable to strychnine, but succumbs to its action before the normal part. Spasms, of tonic, clonic, or mixed type, then appear, terminating in (a) death, (b) partial or (c) complete recovery. In partial recovery, disturbances of locomotion, such as walking in a circle, paralysis, dementia, loss of sight, hearing, and general intelligence, characterize the post-convulsive period. After complete recovery, there is a return to normal deportment. No gross lesions of the nervous system, other than a congested appearance of the previously anaemic area, were observed. Transection of the spinal cord stops the spasms below the level of section. Hemisection of the cord stops the spasms on the same side, below the level of section. Death, without any return of the reflexes after release of the cerebral arteries, has followed an occlusion of seven and one-half minutes. Respiration has returned after an occlusion of one hour. Five animals have recovered completely after an occlusion of seven minutes or more. Only one animal has recovered completely after an occlusion of fifteen minutes. No animal has recovered completely after an occlusion of twenty minutes. In Herzen's (26) resuscitation of an animal after several hours of cerebral anaemia, there must have been some anastomotic channels to the brain. Mayer's (27) limit of ten to fifteen minutes of cerebral anaemia, beyond which resuscitation is not practicable, is close to the correct one. It appears to us that, in cases of resuscitation two hours after cessation of the heart-beat, (Prus., loc.cit.) the auricles must have kept up a slow but, in some degree, an efficient movement of the blood through the brain. The truth of this suggestion might be tested by introducing some easily recognized, non

  1. [Pharmacological treatment of syndromes of aggressivity].

    Science.gov (United States)

    Itil, T M

    1978-01-01

    In the treatment of violent-aggressive behavior, four major groups of drugs emerged: 1. Major tranquilizers in the treatment of aggressive-violent behavior associated with psychotic syndromes. 2. Anti-epileptic drugs such as diphenylhydantoin and barbiturates in the treatment of aggressive-violent behavior within the epileptic syndrome. 3. Psychostimulants in the treatment of aggressive behavior of adolescents and children within behavior disturbances. 4. Anti-male hormones such as cyproterone acetate in the treatment of violent-aggressive behavior associated with pathological sexual hyperactivity. Whereas each category of drug is predominantly effective in one type of aggressive syndrome, it may also be effective in other conditions as well. Aggression as a result of a personality disorder is most difficult to treat with drugs. PMID:34189

  2. [Pharmacological treatment of syndromes of aggressivity].

    Science.gov (United States)

    Itil, T M

    1978-01-01

    In the treatment of violent-aggressive behavior, four major groups of drugs emerged: 1. Major tranquilizers in the treatment of aggressive-violent behavior associated with psychotic syndromes. 2. Anti-epileptic drugs such as diphenylhydantoin and barbiturates in the treatment of aggressive-violent behavior within the epileptic syndrome. 3. Psychostimulants in the treatment of aggressive behavior of adolescents and children within behavior disturbances. 4. Anti-male hormones such as cyproterone acetate in the treatment of violent-aggressive behavior associated with pathological sexual hyperactivity. Whereas each category of drug is predominantly effective in one type of aggressive syndrome, it may also be effective in other conditions as well. Aggression as a result of a personality disorder is most difficult to treat with drugs.

  3. Promoting physiologic transition at birth: re-examining resuscitation and the timing of cord clamping.

    Science.gov (United States)

    Niermeyer, Susan; Velaphi, Sithembiso

    2013-12-01

    Delayed clamping of the umbilical cord is recommended for term and preterm infants who do not require resuscitation. However, the approach to the newly born infant with signs of fetal compromise, prematurity and extremely low birthweight, or prolonged apnea is less clear. Human and experimental animal data show that delaying the clamping of the umbilical cord until after the onset of respirations promotes cardiovascular stability in the minutes immediately after birth. Rather than regarding delayed cord clamping as a fixed time period before resuscitation begins, a more physiologic concept of transition at birth should encompass the relative timing of onset of respirations and cord occlusion. Further research to explore the potential benefits of resuscitation with the cord intact is needed. PMID:24055300

  4. Prolonged Intraoperative Cardiac Resuscitation Complicated by Intracardiac Thrombus in a Patient Undergoing Orthotopic Liver Transplantation.

    Science.gov (United States)

    Kim, Sang; DeMaria, Samuel; Cohen, Edmond; Silvay, George; Zerillo, Jeron

    2016-09-01

    We report the case of successful resuscitation after prolonged cardiac arrest during orthotopic liver transplantation. After reperfusion, the patient developed ventricular tachycardia, complicated by intracardiac clot formation and massive hemorrhage. Transesophageal echocardiography demonstrated stunned and nonfunctioning right and left ventricles, with developing intracardiac clots. Treatment with heparin, massive transfusion and prolonged cardiopulmonary resuscitation ensued for 51 minutes. Serial arterial blood gases demonstrated adequate oxygenation and ventilation during cardiopulmonary resuscitation. Cardiothoracic surgery was consulted for potential use of extracorporeal membrane oxygenation, however, the myocardial function improved and the surgery was completed without further intervention. On postoperative day 6, the patient was extubated without neurologic or cardiac impairment. The patient continues to do well 2 years posttransplant, able to perform independent daily activities of living and his previous job. This case underscores the potential for positive outcomes with profoundly prolonged, effective advanced cardiovascular life support in patients who experience postreperfusion syndrome. PMID:27233818

  5. [Tension pneumomediastinum and tension pneumothorax following tracheal perforation during cardiopulmonary resuscitation].

    Science.gov (United States)

    Buschmann, C T; Tsokos, M; Kurz, S D; Kleber, C

    2015-07-01

    Tension pneumothorax can occur at any time during cardiopulmonary resuscitation (CPR) with external cardiac massage and invasive ventilation either from primary or iatrogenic rib fractures with concomitant pleural or parenchymal injury. Airway injury can also cause tension pneumothorax during CPR. This article presents the case of a 41-year-old woman who suffered cardiopulmonary arrest after undergoing elective mandibular surgery. During CPR the upper airway could not be secured by orotracheal intubation due to massive craniofacial soft tissue swelling. A surgical airway was established with obviously unrecognized iatrogenic tracheal perforation and subsequent development of tension pneumomediastinum and tension pneumothorax during ventilation. Neither the tension pneumomediastinum nor the tension pneumothorax were decompressed and accordingly resuscitation efforts remained unsuccessful. This case illustrates the need for a structured approach to resuscitate patients with ventilation problems regarding decompression of tension pneumomediastinum and/or tension pneumothorax during CPR. PMID:26036317

  6. [Tension pneumomediastinum and tension pneumothorax following tracheal perforation during cardiopulmonary resuscitation].

    Science.gov (United States)

    Buschmann, C T; Tsokos, M; Kurz, S D; Kleber, C

    2015-07-01

    Tension pneumothorax can occur at any time during cardiopulmonary resuscitation (CPR) with external cardiac massage and invasive ventilation either from primary or iatrogenic rib fractures with concomitant pleural or parenchymal injury. Airway injury can also cause tension pneumothorax during CPR. This article presents the case of a 41-year-old woman who suffered cardiopulmonary arrest after undergoing elective mandibular surgery. During CPR the upper airway could not be secured by orotracheal intubation due to massive craniofacial soft tissue swelling. A surgical airway was established with obviously unrecognized iatrogenic tracheal perforation and subsequent development of tension pneumomediastinum and tension pneumothorax during ventilation. Neither the tension pneumomediastinum nor the tension pneumothorax were decompressed and accordingly resuscitation efforts remained unsuccessful. This case illustrates the need for a structured approach to resuscitate patients with ventilation problems regarding decompression of tension pneumomediastinum and/or tension pneumothorax during CPR.

  7. Protective and biogenesis effects of sodium hydrosulfide on brain mitochondria after cardiac arrest and resuscitation.

    Science.gov (United States)

    Pan, Hao; Xie, Xuemeng; Chen, Di; Zhang, Jincheng; Zhou, Yaguang; Yang, Guangtian

    2014-10-15

    Mitochondrial dysfunction plays a critical role in brain injury after cardiac arrest and cardiopulmonary resuscitation (CPR). Recent studies demonstrated that hydrogen sulfide (H2S) donor compounds preserve mitochondrial morphology and function during ischemia-reperfusion injury. In this study, we sought to explore the effects of sodium hydrosulfide (NaHS) on brain mitochondria 24h after cardiac arrest and resuscitation. Male Sprague-Dawley rats were subjected to 6min cardiac arrest and then resuscitated successfully. Rats received NaHS (0.5mg/kg) or vehicle (0.9% NaCl, 1.67ml/kg) 1min before the start of CPR intravenously, followed by a continuous infusion of NaHS (1.5mg/kg/h) or vehicle (5ml/kg/h) for 3h. Neurological deficit was evaluated 24h after resuscitation and then cortex was collected for assessments. As a result, we found that rats treated with NaHS revealed an improved neurological outcome and cortex mitochondrial morphology 24h after resuscitation. We also observed that NaHS therapy reduced intracellular reactive oxygen species generation and calcium overload, inhibited mitochondrial permeability transition pores, preserved mitochondrial membrane potential, elevated ATP level and ameliorated the cytochrome c abnormal distribution. Further studies indicated that NaHS administration increased mitochondrial biogenesis in cortex at the same time. Our findings suggested that administration of NaHS 1min prior CPR and followed by a continuous infusion ameliorated neurological dysfunction 24h after resuscitation, possibly through mitochondria preservation as well as by promoting mitochondrial biogenesis.

  8. Role of Endoplasmic Reticulum Stress in Brain Damage After Cardiopulmonary Resuscitation in Rats.

    Science.gov (United States)

    Zhang, Jincheng; Xie, Xuemeng; Pan, Hao; Wu, Ziqian; Lu, Wen; Yang, Guangtian

    2015-07-01

    Postcardiac arrest syndrome yields poor neurological outcomes, but the mechanisms underlying this condition remain poorly understood. This study investigated whether endoplasmic reticulum (ER) stress-mediated apoptosis is induced in injured brain after resuscitation. Sprague-Dawley rats were subjected to 6 min of cardiac arrest (CA) and then resuscitated successfully. In the first experiment, animals were sacrificed 1, 3, 6, 12, or 24 h (n = 3 per group) after successful cardiopulmonary resuscitation. Brain tissues were analyzed by real-time polymerase chain reaction and Western blotting. In the second experiment, either dimethyl sulfoxide or salubrinal (Sal; 1 mg/kg), an ER stress inhibitor, was injected 30 min before the induction of CA (n = 10 per group). Neurological deficits were evaluated 24 h after CA. Brain specimens were analyzed using electron microscopy, terminal deoxynucleotidyl transferase dUTP nick end labeling assays and immunohistochemistry. We found that the messenger RNA and protein levels of glucose-regulated protein 78, X-box binding protein 1, C/EBP homologous protein, and caspase 12 were significantly elevated after resuscitation. We also observed that rats treated with Sal exhibited an improved neurological deficit score (32.3 ± 15.5 in the Sal group vs. 49.8 ± 20.9 in controls, P < 0.05). In addition, morphological improvements in the hippocampal ER were observed in the Sal group compared with the dimethyl sulfoxide group 24 h after reperfusion. Furthermore, in situ immunostaining revealed that markers of ER stress were significantly inhibited by Sal pretreatment. Our findings suggested that ER stress and the associated apoptotic pathways were activated in the hippocampus after resuscitation. Administration of Sal 30 min before cardiopulmonary resuscitation ameliorated neurological dysfunction 24 h after CA, possibly through the inhibition of ER stress after postresuscitation brain injury. PMID:25705860

  9. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest

    Directory of Open Access Journals (Sweden)

    Ya-hua LIU

    2012-03-01

    Full Text Available Objective To observe the effects of four cardiopulmonary resuscitation (CPR methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR, compression under the diaphragm CPR (D-CPR, abdominal compression CPR (A-CPR, and abdominal wall lifting and compression CPR (L-CPR. Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of suxamethonium. Instantly after respiratory arrest, one of the 4 CPR methods was performed immediately on the groups of pigs respectively. After 2min of CPR, compression was stopped. The experimental pigs were given assisted respiration using a ventilator until autonomous respiration recovered. The tidal volume (VT in basic status and that during resuscitation by the four respective resuscitation methods was determined, and minute ventilation (MV was calculated. Furthermore, heart rate (HR, mean arterial blood pressure, and recovery time of autonomous respiration were compared between all the groups. Results In basic status, there was no statistical difference (P > 0.05 in VT and MV between the four groups. Approximately 2min after resuscitation, the VT and MV of D-CPR were higher than that of C-CPR; that of A-CPR was higher than that of D-CPR; and that of L-CPR was higher than that of A-CPR. The differences were statistically significant (P 0.05. HR in C-CPR and D-CPR were notably lower than the basic value (P < 0.01. Two minutes after resuscitation, mechanical ventilation was given, and HR in all the groups was close to the basic value 5 min after resuscitation. In the respiratory arrest pig model, L-CPR could provide more effective VT and MV than the other methods. Conclusion For the porcine respiratory arrest model, L-CPR can provide more effective lung ventilation than the other methods.

  10. Health care professionals' willingness to do mouth-to-mouth resuscitation.

    OpenAIRE

    Horowitz, B Z; Matheny, L

    1997-01-01

    To assess the willingness of physicians and nurses with training in basic cardiac life support to provide mouth-to-mouth resuscitation in both hospital and out-of-hospital settings, we surveyed all attendees at a monthly advanced life support course over a 1-year period. Of 622 attendees, 379 (61%) responded to our survey describing a variety of cardiac arrest scenarios. Less than half of the participants surveyed were willing to do mouth-to-mouth resuscitation on an unknown adult, male or fe...

  11. District nurse responsibilities in relation to 'do not attempt resuscitation' decisions.

    Science.gov (United States)

    Griffith, Richard

    2014-07-01

    The Court of Appeal has ruled that patients and their relatives have the right to be consulted prior to a 'do not attempt resuscitation' notice being placed on file by a health professional. Failing to do so would be in breach of the patient's right to respect for a private and family life under the European Convention of Human Rights, article 8. This article sets out the steps that district nurses must take to ensure that 'do not attempt resuscitation' notices placed on the file of their patients are lawful.

  12. THE EFFECT OF ANISODAMINE ON CEREBRAL RESUSCITATION OF RATS IN ACUTE CEREBRAL ISCHEMIA FROM CARDIAC ARREST

    Institute of Scientific and Technical Information of China (English)

    彭新琦; 曹苏谊; 可君

    1995-01-01

    In order to investigate the mechanisms of acute cerebral ischemia,and to look for effective drugs on cerebral resuscitation,we made a model of acute complete global brain ischemia,reperfusion and resuscita-tion on rats according to Garavilla's method.Our results showed that the event of cerebral ischemia and reperfusion injury could result in the in-crease of total brain calcium content,and anisodamine has the same reducing brain calcium contents as dil-tiazem's,while improving neurological outcome and alleviating injury to neurons.

  13. Student nurses' perceptions of aggression: An exploratory study of defensive styles, aggression experiences, and demographic factors.

    Science.gov (United States)

    Bilgin, Hulya; Keser Ozcan, Neslihan; Tulek, Zeliha; Kaya, Fadime; Boyacioglu, Nur Elcin; Erol, Ozgul; Arguvanli Coban, Sibel; Pazvantoglu, Ozan; Gumus, Kubra

    2016-06-01

    Throughout the clinical learning process, nursing students' perception of aggression might have implications in terms of their future professional behavior toward patients. Using a descriptive cross-sectional design, we investigated the relationships between student nurses' perceptions of aggression and their personal characteristics, defense styles, and a convenience sample of 1539 experiences of aggressive behavior in clinical practice. Information about the students' personal features, their clinical practice, and experiences of aggressive behavior was obtained by questionnaire. The Turkish version of the Perception of Aggression Scale and Defense Styles Questionnaire-40 were also used. Students were frequently exposed to verbal aggression from patients and their relatives. And perceived patient aggression negatively, perception of aggression were associated with sex, defense styles, feelings of safety, and experiences of aggressions during clinical practice. Of interest is the reality that student nurses should be prepared for untoward events during their training. PMID:26916604

  14. 肠内输入高渗电解质葡萄糖液对犬35%总体表面积烧伤复苏效果的研究%The curative effect of 1.8% hypertonic electrolyte glucose solution in enteral resuscitation of burn shock

    Institute of Scientific and Technical Information of China (English)

    胡泉; 胡森; 柴家科; 沈小鹏; 车晋伟; 盛志勇

    2009-01-01

    Objective To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock. Methods Eighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (Ⅰ group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/ TBSA)]. The hacmedynarnie parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na~+, and intestine mueosa blood flow were continuously assessed. Results The cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P 0.05);高渗液组补液后血浆渗透浓度明显升高,显著高于其他两组(P<0.05);烧伤后两补液组肠道对复苏液中的水分和钠离子的吸收速率均逐渐增加,高渗液组肠道对水分吸收速率低于等渗液组(P<0.05),钠离子吸收速率则高于等渗液组(P<0.05).结论 35%TBSA烧伤后0.5 h通过肠内补充HEGS可以被肠道有效吸收,并在减少1/2补液量的前提下,基本维持有效血容量,达到肠内补充等渗液体复苏相似的血流动力学效果.

  15. Aggressive and acute periodontal diseases.

    Science.gov (United States)

    Albandar, Jasim M

    2014-06-01

    Inflammatory periodontal diseases are highly prevalent, although most of these diseases develop and progress slowly, often unnoticed by the affected individual. However, a subgroup of these diseases include aggressive and acute forms that have a relatively low prevalence but show a rapid-course, high rate of progression leading to severe destruction of the periodontal tissues, or cause systemic symptoms that often require urgent attention from healthcare providers. Aggressive periodontitis is an early-onset, destructive disease that shows a high rate of periodontal progression and distinctive clinical features. A contemporary case definition of this disease is presented. Population studies show that the disease is more prevalent in certain geographic regions and ethnic groups. Aggressive periodontitis is an infectious disease, and recent data show that in affected subjects the subgingival microbiota is composed of a mixed microbial infection, with a wide heterogeneity in the types and proportions of microorganisms recovered. Furthermore, there are significant differences in the microbiota of the disease among different geographic regions and ethnicities. There is also evidence that the Aggregatibacter actinomycetemycomitans-JP2 clone may play an important role in the development of the disease in certain populations. The host response plays an important role in the susceptibility to aggressive periodontitis, where the immune response may be complex and involve multiple mechanisms. Also, genetic factors seem to play an important role in the pathogenesis of this disease, but the mechanisms of increased susceptibility are complex and not yet fully understood. The available data suggest that aggressive periodontitis is caused by mutations either in a few major genes or in multiple small-effect genes, and there is also evidence of gene-gene and gene-environment interaction effects. Diagnostic methods for this disease, based on a specific microbiologic, immunologic or

  16. Fluid Mechanics.

    Science.gov (United States)

    Drazin, Philip

    1987-01-01

    Outlines the contents of Volume II of "Principia" by Sir Isaac Newton. Reviews the contributions of subsequent scientists to the physics of fluid dynamics. Discusses the treatment of fluid mechanics in physics curricula. Highlights a few of the problems of modern research in fluid dynamics. Shows that problems still remain. (CW)

  17. What lies beneath the face of aggression?

    Science.gov (United States)

    Carré, Justin M; Murphy, Kelly R; Hariri, Ahmad R

    2013-02-01

    Recent evidence indicates that a sexually dimorphic feature of humans, the facial width-to-height ratio (FWHR), is positively correlated with reactive aggression, particularly in men. Also, predictions about the aggressive tendencies of others faithfully map onto FWHR in the absence of explicit awareness of this metric. Here, we provide the first evidence that amygdala reactivity to social signals of interpersonal challenge may underlie the link between aggression and the FWHR. Specifically, amygdala reactivity to angry faces was positively correlated with aggression, but only among men with relatively large FWHRs. The patterns of association were specific to angry facial expressions and unique to men. These links may reflect the common influence of pubertal testosterone on craniofacial growth and development of neural circuitry underlying aggression. Amygdala reactivity may also represent a plausible pathway through which FWHR may have evolved to represent an honest indicator of conspecific threat, namely by reflecting the responsiveness of neural circuitry mediating aggressive behavior. PMID:22198969

  18. 牙周基础治疗对侵袭性牙周炎患者唾液和龈沟液中牙周致病菌的作用%Effect of non-surgical periodontal therapy on putative periodontal pathogens in saliva and gingival crevicular fluids in patients with aggressive periodontitis

    Institute of Scientific and Technical Information of China (English)

    路瑞芳; 冯向辉; 徐莉; 孟焕新

    2012-01-01

    Objective To analyze the effect of non-surgical periodontal treatment on the prevalence of putative periodontal pathogens in saliva and gingival crevicular fluids (GCF) in patients with aggressive periodontitis(AgP).Methods Sixteen patients with AgP received non-surgical periodontal treatment,and un-stimulated saliva and GCF were collected before treatment and 2 weeks,2 months,4 months,6 months post-treatment.Periodontal pathogens including Aggregatibacter actinomycetemcomitans (Aa),Porphyromonas gingivalis (Pg),Tannerella forsythia (Tf),Treponema denticola (Td),Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn) were detected by polymerase chain reaction.Results The Aa,Pg,Tf,Td,Pi and Fn in saliva were detected in 7,16,13,14,9 and 14 patients respectively at baseline,and in 3,9,5,4,4 and 7 patients 2 weeks post-treatment.The prevalence of the 6 periodontal pathogens showed a tendency to increase at 2 months post-treatment,and was almost the same as that of baseline at 6 months post-treatment.While in GCF the prevalence of Aa,Pg,Tf,Td,Pi and Fn were 17% (11/64),95% (61/64),84% (54/64),72% (46/64),41% (26/64) and 56% (36/64) at baseline,and reduced to 8% (5/64),75% (48/64),28% (18/64),14% (9/64),16% (10/64) and 23% (15/64) at 2 weeks post-treatment (P < 0.05).The prevalence of the 6 periodontal pathogens remained a relatively low level [13% (8/64),73% (47/64),42% (27/64),23% (15/64),8% (5/64) and 38% (24/64)respectively] at 6 months post-treatment in GCF(P < 0.05) compared with baseline except Aa.There was difference of periodontal pathogens detection between saliva and GCF.Conclusions Non-surgical periodontal treatment can reduce pocket depth as well as periodontal pathogens in saliva and GCF.Periodontal ruaintenance every 2 months can keep the periodontal pathogens in GCF at a relatively low level.The periodontal pathogen detection in saliva can not completely replace the site detection.%目的 分析侵袭性牙周炎(aggressive

  19. Understanding Aggressive Behavior Across the Life Span

    OpenAIRE

    Liu, Jianghong; Lewis, Gary; Evans, Lois

    2012-01-01

    Aggressive behavior is the observable manifestation of aggression and is often associated with developmental transitions and a range of medical and psychiatric diagnoses across the lifespan. As healthcare professionals involved in the medical and psychosocial care of patients from birth through death, nurses frequently encounter—and may serve as—both victims and perpetrators of aggressive behavior in the workplace. While the nursing literature has continually reported research on prevention a...

  20. Aggression, anger and violence in South Africa

    OpenAIRE

    M.J. Masango

    2004-01-01

    This article traces the roots of aggression, anger and violence in South Africa and the rest of the world. The paper is divided into four parts: Aggression, Anger, Catharsis and Violence. As a result of violence against other human beings, especially women and children, a profound respect for human dignity has been lost. People have become extremely aggressive. The last few decades have created a culture of violence because of the suppression or oppression of feelings. The article argues that...

  1. Aggressive posterior retinopathy of prematurity classification

    OpenAIRE

    A.V. Tereshchenko,; Yu. A. Belyy; M. S. Tereshchenkova; I. G. Trifanenkova

    2013-01-01

    ABSTRACT Based on dynamic monitoring of 133 premature infants (266 eyes) with aggressive posterior retinopathy of prematurity (ROP), digital retinoscopy and computer morphometry the disease clinical and morphometric features were revealed and systematized, and their consecutive replacement was fixed. As a result the separate classification of aggressive posterior disease was worked up. In aggressive posterior ROP course the next consecutive stages were marked out: subclinical, early ...

  2. Neurobiological Basis of Reactive Aggression: A Review

    OpenAIRE

    Shiina A

    2015-01-01

    Reactive aggression is a response to salient threats that may have evolved as a strategy for survival. The likelihood of its outburst is mediated by several factors including the activity of serotonin and other neurotransmitters that regulate reactive aggression through the corticolimbic circuit. Specifically, this circuit is modulated by monoamine oxidase A (MAOA) such that low levels of activity incline an animal to impulsive behavior. Evidence also indicates that aggressive ...

  3. What lies beneath the face of aggression?

    OpenAIRE

    Carré, Justin M.; Murphy, Kelly R.; Hariri, Ahmad R.

    2011-01-01

    Recent evidence indicates that a sexually dimorphic feature of humans, the facial width-to-height ratio (FWHR), is positively correlated with reactive aggression, particularly in men. Also, predictions about the aggressive tendencies of others faithfully map onto FWHR in the absence of explicit awareness of this metric. Here, we provide the first evidence that amygdala reactivity to social signals of interpersonal challenge may underlie the link between aggression and the FWHR. Specifically, ...

  4. Prosocial video games reduce aggressive cognitions

    OpenAIRE

    Greitemeyer, Tobias; Osswald, Silvia

    2009-01-01

    Abstract Previous research has shown that playing violent video games increased aggressive tendencies. However, as pointed out by the General Learning Model (GLM) (Buckley & Anderson, 2006), depending on their content, video games do not inevitably increase but may also decrease aggressive responses. Accordingly, the present research tested the hypothesis that playing prosocial video games decreases aggressive cognitions. In fact, playing a prosocial (relative to a neutral) video g...

  5. Implementation of a High-Performance Cardiopulmonary Resuscitation Protocol at a Collegiate Emergency Medical Services Program

    Science.gov (United States)

    Stefos, Kathryn A.; Nable, Jose V.

    2016-01-01

    Out-of-hospital cardiac arrest (OHCA) is a significant public health issue. Although OHCA occurs relatively infrequently in the collegiate environment, educational institutions with on-campus emergency medical services (EMS) agencies are uniquely positioned to provide high-quality resuscitation care in an expedient fashion. Georgetown University's…

  6. Design of a game-based pre-hospital resuscitation training for first responders

    NARCIS (Netherlands)

    Kalz, Marco; Schmitz, Birgit; Biermann, Henning; Klemke, Roland; Ternier, Stefaan; Specht, Marcus

    2013-01-01

    Kalz, M., Schmitz, B., Biermann, H., Klemke, R., Ternier, S., & Specht, M. (2013). Design of a game-based pre-hospital resuscitation training for first responders. In A. Holzinger, M. Ziefle, & V. Glavinić (Eds.), SouthCHI 2013, LNCS 7946 (pp. 363-372). Germany: Springer, Heidelberg.

  7. Effects of Age, Gender, School Class on Cardiopulmonary Resuscitation Skills of Nigerian Secondary School Students

    Science.gov (United States)

    Onyeaso, Adedamola Olutoyin; Onyeaso, Chukwudi Ochi

    2016-01-01

    Background: The need for training of schoolchildren on cardiopulmonary resuscitation (CPR) as potential bystander CPR providers is growing globally but Nigeria is still behind and lacks basic necessary data. Purpose: The purpose of this study was to investigate the effects of age, gender and school class on CPR skills of Nigerian secondary school…

  8. Mechanical cardiopulmonary resuscitation in in-hospital cardiac arrest : a systematic review

    NARCIS (Netherlands)

    Lameijer, Heleen; Immink, Rosa S.; Broekema, Josien J.; Ter Maaten, Jan C.

    2015-01-01

    With increasing rates of in-hospital cardiac arrest, improving resuscitation outcomes is essential. Mechanical chest compressors seem to be related to improved outcome in out-of hospital cardiac arrest; however, the literature on its use in in-hospital cardiac arrest is scarce. We used the Medline p

  9. Imaging the human microcirculation during cardiopulmonary resuscitation in a hypothermic victim of submersion trauma

    NARCIS (Netherlands)

    P.W.G. Elbers; A.J. Craenen; A. Driessen; M.C. Stehouwer; L. Munsterman; M. Prins; M. van Iterson; P. Bruins; C. Ince

    2010-01-01

    The microcirculation is essential for delivery of oxygen and nutrients to tissue. However, the human microvascular response to cardiopulmonary resuscitation (CPR) is unknown. We report on the first use of sidestream dark field imaging to assess the human microcirculation during CPR with a mechanical

  10. Do Not Attempt Resuscitation (DNAR)--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Tuck, Christine M.; Jordan, Alicia; Lambert, Patrice; Porter, Jessica

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that each student with a Do Not Attempt Resuscitation (DNAR) order have an Individualized Healthcare Plan (IHP) and an Emergency Care Plan (ECP) developed by the registered professional school nurse (hereinafter referred to as school nurse) with input from parents or guardians,…

  11. Apps4CPR: A review study of mobile applications for cardiopulmonary resuscitation training and support

    NARCIS (Netherlands)

    Kalz, Marco

    2013-01-01

    Kalz, M. (2013, 23 September). Apps4CPR: A review study of mobile applications for cardiopulmonary resuscitation training and support. Presentation given during the 6th World Congress on Social Media, Mobile Apps and Internet/Web 2.0 in Medicine, Health, and Biomedical Research, London, UK.

  12. Prolonged cardiopulmonary resuscitation and outcomes after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Rajan, Shahzleen; Folke, Fredrik; Kragholm, Kristian;

    2016-01-01

    of spontaneous circulation (ROSC). METHODS: We included 1316 adult OHCA individuals with pre-hospital ROSC (2005-2011) handled by the largest nationwide ambulance provider in Denmark. Patients were stratified into 0-5, 6-10, 11-15, 16-20, 21-25 and >25min of cardiopulmonary resuscitation (CPR) by emergency...

  13. Cardiopulmonary resuscitation of apparently stillborn infants: survival and long-term outcome.

    Science.gov (United States)

    Jain, L; Ferre, C; Vidyasagar, D; Nath, S; Sheftel, D

    1991-05-01

    To determine the outcome of apparently stillborn infants who received cardiopulmonary resuscitation, we studied the short- and long-term outcome of 93 infants who had an Apgar score of 0 at 1 minute of age and were resuscitated at birth. Sixty-two (66.6%) responded and left the delivery room alive; 26 (42%) of the 62 infants died in the neonatal period and 36 infants were discharged home; of the 36 infants, three subsequently died during infancy. Of the 33 survivors, ten were lost to follow-up after discharge. Developmental assessment of 23 of 33 long-term survivors revealed normal outcome in 14 (61.7%), abnormal results in 6 (26%), and suspect status in 3 (13%). Fifty-eight infants had an Apgar score of 0 at greater than or equal to 10 minutes of age and all except one died; the surviving infant has an abnormal developmental outcome. We conclude that 39% of apparently stillborn infants who were resuscitated survived beyond the neonatal period and that 61% of the 23 survivors who were available for developmental follow-up had normal development at the time of last examination. Survival was unlikely if there was no response after 10 minutes of resuscitation.

  14. The presence of resuscitation equipment and influencing factors at General Practitioners' offices in Denmark

    DEFF Research Database (Denmark)

    Niegsch, Mark L; Krarup, Nikolaj T; Clausen, Niels Erikstrup

    2013-01-01

    Automated external defibrillators (AEDs) have proven effective when used by GPs. Despite this and the latest guidelines from the European Resuscitation Council, there are no recommendations for Danish GPs regarding proper equipment to treat cardiac arrest. Currently, there are no published data on...

  15. Animation shows promise in initiating timely cardiopulmonary resuscitation: results of a pilot study.

    Science.gov (United States)

    Attin, Mina; Winslow, Katheryn; Smith, Tyler

    2014-04-01

    Delayed responses during cardiac arrest are common. Timely interventions during cardiac arrest have a direct impact on patient survival. Integration of technology in nursing education is crucial to enhance teaching effectiveness. The goal of this study was to investigate the effect of animation on nursing students' response time to cardiac arrest, including initiation of timely chest compression. Nursing students were randomized into experimental and control groups prior to practicing in a high-fidelity simulation laboratory. The experimental group was educated, by discussion and animation, about the importance of starting cardiopulmonary resuscitation upon recognizing an unresponsive patient. Afterward, a discussion session allowed students in the experimental group to gain more in-depth knowledge about the most recent changes in the cardiac resuscitation guidelines from the American Heart Association. A linear mixed model was run to investigate differences in time of response between the experimental and control groups while controlling for differences in those with additional degrees, prior code experience, and basic life support certification. The experimental group had a faster response time compared with the control group and initiated timely cardiopulmonary resuscitation upon recognition of deteriorating conditions (P < .0001). The results demonstrated the efficacy of combined teaching modalities for timely cardiopulmonary resuscitation. Providing opportunities for repetitious practice when a patient's condition is deteriorating is crucial for teaching safe practice.

  16. Peer-led training in basic life support and resuscitation using an automatic external defibrillator

    DEFF Research Database (Denmark)

    Løfgren, Bo; Petersen, Christina Børlum; Mikkelsen, Ronni;

    2009-01-01

    Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students....

  17. Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study

    NARCIS (Netherlands)

    Kalz, Marco; Lenssen, Niklas; Felzen, Marco; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max

    2014-01-01

    Background: No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the persp

  18. [Motives and interpersonal functions of aggression].

    Science.gov (United States)

    Ohbuchi, K

    1987-06-01

    In this review, the author theoretically and empirically examined motives and interpersonal functions of aggression. A factor-analysis of Averill's questionnaire items on anger revealed that motives involved in aggressive responses were clustered into two groups: the hostile and the instrumental. It was also clarified that an individual is likely to engage in aggression particularly when some hostile motives are evoked. Concerning the interpersonal functions, the author proposed that aggression might serve four principal goals. (1) Aggression can be generated as an avoidance response to an aversive stimulus, such as frustration, annoyance, or pain, and so on. It depends on the severity of the stimulus. It was however emphasized that aggression is also mediated by social cognition, such as an attribution of intent to a harm-doer. (2) Aggression can be used as a means of coercing the other person into doing something. An individual is likely to use such a power strategy if he/she is lacking in self-confidence or a perspective for influencing the target person by more peaceful strategies. (3) Aggression can be interpreted as a punishment when it is directed toward a transgressor. In this case, aggression is motivated by restoration of a social justice, and thus its intensity is determined by the perceived moral responsibility of the transgressor. Further, it was indicated that aggression is intensified if it is justified as a sanctional conduct against the immoral. (4) Aggression can be also evoked when an individual's social identity is threatened. It was suggested that impression management motives are involved in aggression by an unexpected finding that the presence of audience or the identifiability rather facilitated retaliative aggression. The aggression-inhibition effect of apology was also explained in terms of impression management. In conclusion, it was presented that aggression is a behavioral strategy as an attempt to resolve interpersonal conflicts

  19. Video media-induced aggressiveness in children.

    Science.gov (United States)

    Cardwell, Michael Steven

    2013-09-01

    Transmission of aggressive behaviors to children through modeling by adults has long been a commonly held psychological concept; however, with the advent of technological innovations during the last 30 years, video media-television, movies, video games, and the Internet-has become the primary model for transmitting aggressiveness to children. This review explores the acquisition of aggressive behaviors by children through modeling behaviors in violent video media. The impact of aggressive behaviors on the child, the family, and society is addressed. Suggestive action plans to curb this societal ill are presented. PMID:24002556

  20. Video media-induced aggressiveness in children.

    Science.gov (United States)

    Cardwell, Michael Steven

    2013-09-01

    Transmission of aggressive behaviors to children through modeling by adults has long been a commonly held psychological concept; however, with the advent of technological innovations during the last 30 years, video media-television, movies, video games, and the Internet-has become the primary model for transmitting aggressiveness to children. This review explores the acquisition of aggressive behaviors by children through modeling behaviors in violent video media. The impact of aggressive behaviors on the child, the family, and society is addressed. Suggestive action plans to curb this societal ill are presented.

  1. Gibbon Aggression During Introductions: An International Survey.

    Science.gov (United States)

    Harl, Heather; Stevens, Lisa; Margulis, Susan W; Petersen, Jay

    2016-01-01

    Little is known regarding the prevalence of aggression seen during introductions of captive gibbons (Hylobatidae). In this study, an online survey was developed to quantify and collect contextual details regarding the frequency and types of aggression seen during introductions of captive gibbons (Hylobatidae). Nineteen percent of institutions (17 institutions) reported observing aggression, and 6 of these institutions recorded multiple instances of aggression, though a vast majority of these cases resulted in mild injuries or none at all. The female was the primary aggressor in 23% of cases, the male was the primary aggressor in 58% of cases, and both were the primary aggressor in 1 case. Although these aggressive interactions were often not associated with a known cause, 27% of cases were associated with food displacement. In most cases, management changes, including trying new pairings, greatly reduced situational aggression, suggesting that individual personalities may play a factor in aggression. These data begin to explain the extent of aggression observed in captive gibbons; future studies will address possible correlations with aggression and introduction techniques. PMID:26963568

  2. Discourses of aggression in forensic mental health

    DEFF Research Database (Denmark)

    Berring, Lene L; Pedersen, Liselotte; Buus, Niels

    2015-01-01

    aggression is communicated in forensic mental health nursing records. The aim of the study was to gain insight into the discursive practices used by forensic mental health nursing staff when they record observed aggressive incidents. Textual accounts were extracted from the Staff Observation Aggression Scale....... These antecedents, combined with the aggression incident itself, created stereotyping representations of forensic psychiatric patients as deviant, unpredictable and dangerous. Patient and staff identities were continually (re)produced by an automatic response from the staff that was solely focused on the patient...

  3. Aggression and coexistence in female caribou

    Science.gov (United States)

    Weckerly, Floyd W.; Ricca, Mark A.

    2014-01-01

    Female caribou (Rangifer tarandus) are highly gregarious, yet there has been little study of the behavioral mechanisms that foster coexistence. Quantifying patterns of aggression between male and female, particularly in the only cervid taxa where both sexes grow antlers, should provide insight into these mechanisms. We asked if patterns of aggression by male and female caribou followed the pattern typically noted in other polygynous cervids, in which males display higher frequencies and intensity of aggression. From June to August in 2011 and 2012, we measured the frequency and intensity of aggression across a range of group sizes through focal animal sampling of 170 caribou (64 males and 106 females) on Adak Island in the Aleutian Archipelago, Alaska. Males in same-sex and mixed-sex groups and females in mixed-sex groups had higher frequencies of aggression than females in same-sex groups. Group size did not influence frequency of aggression. Males displayed more intense aggression than females. Frequent aggression in mixed-sex groups probably reflects lower tolerance of males for animals in close proximity. Female caribou were less aggressive and more gregarious than males, as in other polygynous cervid species.

  4. Effects of viewing relational aggression on television on aggressive behavior in adolescents: A three-year longitudinal study.

    Science.gov (United States)

    Coyne, Sarah M

    2016-02-01

    Most researchers on media and aggression have examined the behavioral effects of viewing physical aggression in the media. Conversely, in the current study, I examined longitudinal associations between viewing relational aggression on TV and subsequent aggressive behavior. Participants included 467 adolescents who completed a number of different questionnaires involving media and aggression at 3 different time points. Results revealed that viewing relational aggression on TV was longitudinally associated with future relational aggression. However, early levels of relational aggression did not predict future exposure to televised relational aggression. Conversely, there was a bidirectional relationship between TV violence and physical aggression over time. No longitudinal evidence was found for a general effect of viewing TV, as all significant media effects were specific to the type of aggression viewed. These results support the general aggression model and suggest that viewing relational aggression in the media can have a long-term effect on aggressive behavior during adolescence. PMID:26595354

  5. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  6. Aggression in children with behavioural/emotional difficulties: seeing aggression on television and video games

    OpenAIRE

    Mitrofan, Oana; Paul, Moli; Weich, Scott; Spencer, Nicholas

    2014-01-01

    Background Mental health professionals are often asked to give advice about managing children’s aggression. Good quality evidence on contributory environmental factors such as seeing aggression on television and in video games is relatively lacking, although societal and professional concerns are high. This study investigated possible associations between seeing aggression in such media and the aggressive behaviour of children attending specialist outpatient child and adolescent mental health...

  7. Adolescent Aggression: The Role of Peer Group Status Motives, Peer Aggression, and Group Characteristics

    OpenAIRE

    Faris, Robert; Ennett, Susan

    2012-01-01

    Recent studies of youth aggression have emphasized the role of network-based peer influence processes. Other scholars have suggested that aggression is often motivated by status concerns. We integrate these two veins of research by considering the effects of peer status motivations on subsequent adolescent aggression, net of their own status motivations, prior aggression, and peer behavior. We also explore different levels at which peer effects may occur, considering the effects of reciprocat...

  8. Behavioural strategies of aggressive and non-aggressive male mice in active shock avoidance

    OpenAIRE

    Benus, R.F.; Bohus, B.; Koolhaas, J.M.; Oortmerssen, G.A. van

    1989-01-01

    The hypothesis, partly based on findings in social interactions, that aggressive mice generally adopt an active behavioural strategy (cf. fight-flight) in threatening situations, while non-aggressive ones generally assume a passive strategy (cf. conservation-withdrawal) was tested using a two-way active shock avoidance paradigm. Overall, aggressive mice were found to be better active shock avoiders than non-aggressive animals, a finding that is consistent with our hypothesis. However, within ...

  9. The Influence of Classroom Aggression and Classroom Climate on Aggressive-Disruptive Behavior

    OpenAIRE

    Thomas, Duane E.; Bierman, Karen L.; Powers, CJ

    2011-01-01

    Research suggests that early classroom experiences influence the socialization of aggression. Tracking changes in the aggressive behavior of 4179 children from kindergarten to second-grade (ages 5–8) this study examined the impact of two important features of the classroom context–aggregate peer aggression and climates characterized by supportive teacher-student interactions. The aggregate aggression scores of children assigned to first-grade classrooms predicted the level of classroom aggres...

  10. Acute Ethanol Gavage Attenuates Hemorrhage/Resuscitation-Induced Hepatic Oxidative Stress in Rats

    Directory of Open Access Journals (Sweden)

    B. Relja

    2012-01-01

    Full Text Available Acute ethanol intoxication increases the production of reactive oxygen species (ROS. Hemorrhagic shock with subsequent resuscitation (H/R also induces ROS resulting in cellular and hepatic damage in vivo. We examined the role of acute ethanol intoxication upon oxidative stress and subsequent hepatic cell death after H/R. 14 h before H/R, rats were gavaged with single dose of ethanol or saline (5 g/kg, EtOH and ctrl; H/R_EtOH or H/R_ctrl, resp.. Then, rats were hemorrhaged to a mean arterial blood pressure of 30±2 mmHg for 60 min and resuscitated. Two control groups underwent surgical procedures without H/R (sham_ctrl and sham_EtOH, resp.. Liver tissues were harvested at 2, 24, and 72 h after resuscitation. EtOH-gavage induced histological picture of acute fatty liver. Hepatic oxidative (4-hydroxynonenal, 4-HNE and nitrosative (3-nitrotyrosine, 3-NT stress were significantly reduced in EtOH-gavaged rats compared to controls after H/R. Proapoptotic caspase-8 and Bax expressions were markedly diminished in EtOH-gavaged animals compared with controls 2 h after resuscitation. EtOH-gavage increased antiapoptotic Bcl-2 gene expression compared with controls 2 h after resuscitation. iNOS protein expression increased following H/R but was attenuated in EtOH-gavaged animals after H/R. Taken together, the data suggest that acute EtOH-gavage may attenuate H/R-induced oxidative stress thereby reducing cellular injury in rat liver.

  11. Management of burn injuries – recent developments in resuscitation, infection control and outcomes research

    Directory of Open Access Journals (Sweden)

    Dries David J

    2009-03-01

    Full Text Available Abstract Introduction Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. Methods A selected review of recent reports published by the American Burn Association is provided. Results The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. Conclusion Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue

  12. 限制性输液复苏法对失血性休克孕兔血流动力学变化的影响%Effect of limited volume resuscitation on hemodynamic changes in pregnant rabbit with hemorrhagic shock

    Institute of Scientific and Technical Information of China (English)

    余艳红; 赵克森; 龚时鹏

    2008-01-01

    Objective To determine the effects of two fluid resuscitation strategies on the changes of hemodynamic variables,serum concentration of tumor necrosis factor-alpha(TNF-α)and interleukin-6 (IL-6)in a clinically relevant model of uncontrolled hemorrhagic shock in pregnant rabbits.Methods Hemorrhagic shock was induced by bleeding via carotied artery,followed by transection of a medium vessel in gestational sac.Experimental design consisted of three phases,shock phase(0-30 min),prehospital phase(30-90 min)and hospital phase(90-180 min).Twenty pregnant rabbits were randomly divided into two groups(n=10/group),aggressive fluid resuscitation group(PNL group)and limited volume resuscitation group(PLH group).In the shock phase,animals were hemorrhaged by blood withdrawal to mean arterial pressure(MAP)of 40-45 mm Hg(1 mm Hg=0.133 kPa)via carotid artery.In the prehospital phase,a medium vessel in the gestational sac was transected,then the animals in the PNL group and PLH group were resuscitated with 0.9% normal saline(NS)and shed blood to MAP of 80,60 mm Hg respectively.In the hospital phase,bleeding was controlled by surgical intervention and all the animals were reinfused with shed blood and NS to MAP 80 mm Hg.Hemodvnamic variables and respiration rate were monitored and blood samples were collected for TNF-α and IL-6 measurement.and finally subsequent volume resuscitation and survival rate were recorded.Results (1)At 120 min,the respiration rate and heart rate in the animals assigned to PLH group was(66±16)bpm,(235±41)bpm respectively,which were significantly lower than those in PNL group(P<0.01),while MAP and central venous pressure in the PLH group was(80.4±7.2)mm Hg,(8.0±4.4)cm H2O,respectively,which were significantly higher than those in PNL group(P<0.01);(2)The serum concentration of TNF-α,IL-6 of all the animals were markedly increased after hemorrhagic shock.and peak at 24 min.The serum concentration of TNF-α,IL-6 in animals assigned to PLH group were

  13. Effects of matrix metalloproteinase 9 inhibition on the blood brain barrier and inflammation in rats following cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    HE Zhi-jie; HUANG Zi-tong; CHEN Xiao-tong; ZOU Zi-jun

    2009-01-01

    Background Neuroprotective strategies following cardiopulmonary resuscitation (CPR) are an important focus in emergency and critical care medicine. Matrix metalloproteinases (MMPs), especially MMP9 attracted much attention because of its function in focal brain ischemia/reperfusion injury. In the focal cerebral ischemia model in rats, SB-3CT can suppress the expression of MMP9, relieving brain edema, and there was no studies on global cerebral ischemia-reperfusion injury after CPR.Methods One hundred and twenty rats were randomly assigned to sham-operated (n=40), resuscitation treatment (n= 40), and resuscitation control (n= 40) groups. Sham-operated group rats were anesthetized only and intubated tracheally, while the resuscitation treatment and resuscitation control groups also received cardiac arrest by asphyxiation. In the resuscitation treatment group, SB-3CT was injected intraperitoneally after restoring spontaneous circulation (ROSC), defined as restoration of supraventricular rhythm and mean arterial pressure (MAP) ≥ 60 mm Hg for more than 5 minutes. The resuscitation control group also implemented ROSC without injection of SB-3CT. The rats were executed and samples were taken immediately after death, then at 3, 9, 24, and 48 hours (n=8). Brain tissue expression of MMP9 protein, MMP9 mRNA, water content, Evans blue content, TNF-a, IL-1, and IL-6 was measured, and the brain tissue ultramicrostructure studied with electron microscopy.Results In the resuscitation control group, brain tissue expression of MMP9 protein and mRNA, water content, Evans blue content, TNF-a, IL-1, and IL-6 were significantly elevated at 3 hours, and peaked at 24 hours after resuscitation, when compared with the sham-operated group (P <0.05). Tissue ultramicrostructure also changed in the resuscitation control group. By contrast, although all these indexes were increased in the resuscitation treatment group compared with the sham-operated group (P<0.05), they were lower than in the

  14. Predicting Aggressive Behavior in Children with the Help of Measures of Implicit and Explicit Aggression

    Science.gov (United States)

    Grumm, Mandy; Hein, Sascha; Fingerle, Michael

    2011-01-01

    Aggressive behavior between children in schools is a topic that receives much interest as violence and aggressive behavior cause many maladaptive social outcomes in the school setting. In the current study the Implicit Association Test (IAT) was adapted as a measure of children's implicit aggression, by assessing the association of the self…

  15. Competitive Aggression without Interaction: Effects of Competitive versus Cooperative Instructions on Aggressive Behavior in Video Games.

    Science.gov (United States)

    Anderson, Craig A.; Morrow, Melissa

    1995-01-01

    Extended and tested Deutsch's theory of competition effects. Predicted that people view competitive situations as inherently more aggressive than cooperative ones. Predicted that leading people to think of an aggressive situation in competitive terms would increase aggressive behavior. Increase of kill ratio occurred in absence of changes in…

  16. Media depictions of physical and relational aggression: connections with aggression in young adults' romantic relationships.

    Science.gov (United States)

    Coyne, Sarah M; Nelson, David A; Graham-Kevan, Nicola; Tew, Emily; Meng, K Nathan; Olsen, Joseph A

    2011-01-01

    Various studies have found that viewing physical or relational aggression in the media can impact subsequent engagement in aggressive behavior. However, this has rarely been examined in the context of relationships. Accordingly, the aim of this study was to examine the connection between viewing various types of aggression in the media and perpetration of aggression against a romantic partner. A total of 369 young adults completed a variety of questionnaires asking for their perpetration of various forms of relationship aggression. Participants' exposure to both physical and relational aggression in the media was also assessed. As a whole, we found a relationship between viewing aggression in the media and perpetration of aggression; however, this depended on the sex of the participant and the type of aggression measured. Specifically, exposure to physical violence in the media was related to engagement in physical aggression against their partner only for men. However, exposure to relational aggression in the media was related to romantic relational aggression for both men and women. PMID:21046605

  17. Behavioural strategies of aggressive and non-aggressive male mice in response to inescapable shock

    NARCIS (Netherlands)

    Benus, R.F.; Bohus, B.; Koolhaas, J.M.; Oortmerssen, G.A. van

    1990-01-01

    The effect of exposure to inescapable long-duration shocks of moderate intensity on intershock activity and on subsequent escape or avoidance performance was studied in aggressive and non-aggressive male mice. The activity of the non-aggressive mice was severely suppressed during the inescapable sho

  18. Daily associations among anger experience and intimate partner aggression within aggressive and nonaggressive community couples.

    Science.gov (United States)

    Crane, Cory A; Testa, Maria

    2014-10-01

    Anger is an empirically established precipitant to aggressive responding toward intimate partners. The current investigation examined the effects of anger, as experienced by both partners, as well as gender and previous aggression, on in vivo intimate-partner aggression (IPA) using a prospective daily diary methodology. Participants (N = 118 couples) individually provided 56 consecutive, daily reports of affective experience and partner aggression. Multilevel models were estimated using the actor-partner interdependence model (APIM) framework to analyze the daily associations between anger and partner-aggression perpetration among participating men and women, as moderated by aggression history. Results revealed that both actor and partner anger were generally associated with subsequently reported daily conflict. Further, increases in daily partner anger were associated with corresponding increases in partner aggression among both women who reported high levels of anger and men, regardless of their own anger experience. Increases in actor anger were associated with increases in daily partner aggression only among previously aggressive women. Previously aggressive men and women consistently reported greater perpetration than their nonaggressive counterparts on days of high levels of actors' anger experiences. Results emphasize the importance of both actor and partner factors in partner aggression and suggest that female anger may be a stronger predictor of both female-to-male and male-to-female partner aggression than male anger, when measured at the daily level.

  19. Subjective aggression during alcohol and cannabis intoxication before and after aggression exposure

    NARCIS (Netherlands)

    De Sousa Fernandes Perna, E B; Theunissen, E L; Kuypers, K P C; Toennes, S W; Ramaekers, J G

    2016-01-01

    RATIONALE: Alcohol and cannabis use have been implicated in aggression. Alcohol consumption is known to facilitate aggression, whereas a causal link between cannabis and aggression has not been clearly demonstrated. OBJECTIVES: This study investigated the acute effects of alcohol and cannabis on sub

  20. The Relationship of Aggression and Bullying to Social Preference: Differences in Gender and Types of Aggression

    Science.gov (United States)

    Lee, Eunju

    2009-01-01

    With 338 fifth-grade students as subjects, this study found the variations in the relation between school bullying and social preference as a function of gender and types of aggressive behavior utilized. Aggressive boys were likely to be rejected by peers, whereas aggressive girls were both rejected and accepted by peers. Children nominated…

  1. Relational and Overt Aggression in Urban India: Associations with Peer Relations and Best Friends' Aggression

    Science.gov (United States)

    Bowker, Julie C.; Ostrov, Jamie M.; Raja, Radhi

    2012-01-01

    This study explored the associations between relational and overt aggression and social status, and tested whether the peer correlates of aggression vary as a function of best friends' aggression during early adolescence in urban India. One hundred and ninety-four young adolescents from primarily middle-to-upper-class families in Surat, India…

  2. Stability of Aggression during Early Adolescence as Moderated by Reciprocated Friendship Status and Friend's Aggression

    Science.gov (United States)

    Adams, Ryan E.; Bukowski, William M.; Bagwell, Catherine

    2005-01-01

    The effect of friendship reciprocation and friend aggression on the stability of aggression across a 6-month period following the transition to secondary school was studied in a sample of 298 Grade 6 children from a predominately white, middle-class, Midwestern American community. The stability of aggression was generally high but it varied as a…

  3. Prehospital resuscitation with hypertonic saline-dextran modulates inflammatory, coagulation and endothelial activation marker profiles in severe traumatic brain injured patients

    Directory of Open Access Journals (Sweden)

    Morrison Laurie J

    2010-01-01

    Full Text Available Abstract Background Traumatic brain injury (TBI initiates interrelated inflammatory and coagulation cascades characterized by wide-spread cellular activation, induction of leukocyte and endothelial cell adhesion molecules and release of soluble pro/antiinflammatory cytokines and thrombotic mediators. Resuscitative care is focused on optimizing cerebral perfusion and reducing secondary injury processes. Hypertonic saline is an effective osmotherapeutic agent for the treatment of intracranial hypertension and has immunomodulatory properties that may confer neuroprotection. This study examined the impact of hypertonic fluids on inflammatory/coagulation cascades in isolated head injury. Methods Using a prospective, randomized controlled trial we investigated the impact of prehospital resuscitation of severe TBI (GCS vs 0.9% normal saline (NS, on selected cellular and soluble inflammatory/coagulation markers. Serial blood samples were drawn from 65 patients (30 HSD, 35 NS at the time of hospital admission and at 12, 24, and 48-h post-resuscitation. Flow cytometry was used to analyze leukocyte cell-surface adhesion (CD62L, CD11b and degranulation (CD63, CD66b molecules. Circulating concentrations of soluble (sL- and sE-selectins (sL-, sE-selectins, vascular and intercellular adhesion molecules (sVCAM-1, sICAM-1, pro/antiinflammatory cytokines [tumor necrosis factor (TNF-α and interleukin (IL-10], tissue factor (sTF, thrombomodulin (sTM and D-dimers (D-D were assessed by enzyme immunoassay. Twenty-five healthy subjects were studied as a control group. Results TBI provoked marked alterations in a majority of the inflammatory/coagulation markers assessed in all patients. Relative to control, NS patients showed up to a 2-fold higher surface expression of CD62L, CD11b and CD66b on polymorphonuclear neutrophils (PMNs and monocytes that persisted for 48-h. HSD blunted the expression of these cell-surface activation/adhesion molecules at all time-points to

  4. Individualizing management of aggressive fibromatoses

    International Nuclear Information System (INIS)

    Purpose: To examine prognostic indicators in aggressive fibromatoses that may be used to optimize case-specific management strategy. Methods and Materials: One hundred and seven fibromatoses presenting between 1971 and 1992 were analyzed. The following treatment modalities were utilized: (a) surgery alone for 51 tumors; (b) radiation alone for 15 tumors; and (c) radiation and surgery (combined modality) for 41 tumors. Outcome analysis was based on 5-year actuarial local control rates. Results: Control rates among surgery, radiation therapy, and combined modality groups were 69%, 93%, and 72%. Multivariate analysis identified age 60 Gy was seen in patients with unresected or gross residual disease. Of the patients, 23 with disease involving the plantar region had a control rate of 62%, with significantly worse outcomes in children. Conclusions: These results are consistent with those found in the relevent literature. They support primary resection with negative margins when feasible. Radiation is a highly effective alternative in situations where surgery would result in major functional or cosmetic defects. When negative surgical margins are not achieved in recurrent tumors, radiation is recommended. Perioperative radiation should be considered in other high-risk groups (recurrent disease, positive margins, and plantar tumors in young patients). Doses of 60-65 Gy for gross disease and 50-60 Gy for microscopic residual are recommended. Observation may be considered for primary tumors with disease remaining in situ when they are located such that progression would not cause significant morbidity. Although plantar lesions in children may represent a group at high risk for recurrence or aggressive behavior, the greater potential for radiation-induced morbidity in this group must also temper its use. Given the inconsistent nature and treatment response of this tumor, it is fundamental that treatment recommendations should be made based on the risk:benefit analysis for

  5. MRI diagnosis of aggressive fibromatosis

    International Nuclear Information System (INIS)

    Objective: To analyze the MRI features of aggressive fibromatosis (AF) in order to improve its diagnostic accuracy. Method: The clinical files and MRI appearances of 66 AF patients (primary 19 cases, recurrent 47 cases) were reviewed and compared with the postoperative pathological findings. Results: The median age of all patients was 31 years (-range, 11-60 years) with a male-to-female sex ratio of 1 : 3.4. Eighty tumors were discovered. There were 5 superficial fibromatosis and 75 deep fibromatosis in which 2 lesions were intraabdominal, 6 lesions in the abdominal wall and 67 lesions extraabdominal. The average long diameter of all lesions was (8.7±5.4) cm, of superficial lesions (5.7± 2.8)cm, of deep lesions (8.9±5.5) cm. Of the 80 tumors, 79 were displayed as space-occupying intramuscular lesions, 47 (58.8%) were ovoid or lobulated and 22 (27.5%) were infiltrative in shape; 48 (60%) lesions had a well-defined margin, of which 4 formed a pseudocapsule as they enlarged by compressing normal tissue. To compare with the muscle signal intensity on MRI, 75 lesions demonstrated isointensity, mild hyperintensity or hypointensity on T1WI , heterogeneous high intensity on T2WI, and avid heterogeneous enhancement after contrast administration. There was no necrosis or surrounding edema in all lesions. Tumors destroyed bone in 2, cases. Conclusion: Aggressive fibromatosis has characteristic features on MRI, and MRI is valuable in diagnosing AF and evaluating the extend of lesion and involvement of adjacent structures. (authors)

  6. Desensitization to media violence: links with habitual media violence exposure, aggressive cognitions, and aggressive behavior.

    Science.gov (United States)

    Krahé, Barbara; Möller, Ingrid; Huesmann, L Rowell; Kirwil, Lucyna; Felber, Juliane; Berger, Anja

    2011-04-01

    This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings of anxious and pleasant arousal were obtained after each clip. Following the clips, participants completed a lexical decision task to measure accessibility of aggressive cognitions and a competitive reaction time task to measure aggressive behavior. Habitual media violence exposure correlated negatively with SCL during violent clips and positively with pleasant arousal, response times for aggressive words, and trait aggression, but it was unrelated to anxious arousal and aggressive responding during the reaction time task. In path analyses controlling for trait aggression, normative beliefs, and trait arousability, habitual media violence exposure predicted faster accessibility of aggressive cognitions, partly mediated by higher pleasant arousal. Unprovoked aggression during the reaction time task was predicted by lower anxious arousal. Neither habitual media violence usage nor anxious or pleasant arousal predicted provoked aggression during the laboratory task, and SCL was unrelated to aggressive cognitions and behavior. No relations were found between habitual media violence viewing and arousal in response to the sad and funny film clips, and arousal in response to the sad and funny clips did not predict aggressive cognitions or aggressive behavior on the laboratory task. This suggests that the observed desensitization effects are specific to violent content. PMID:21186935

  7. Aggressive and foraging behavioral interactions among ruffe

    Science.gov (United States)

    Savino, Jacqueline F.; Kostich, Melissa J.

    2000-01-01

    The ruffe, Gymnocephalus cernuus, is a nonindigenous percid in the Great Lakes. Ruffe are aggressive benthivores and forage over soft substrates. Laboratory studies in pools (100 cm in diameter, 15 cm water depth) were conducted to determine whether fish density (low = 2, medium = 4, high = 6 ruffe per pool) changed foraging and aggressive behaviors with a limited food supply of chironomid larvae. All fish densities demonstrated a hierarchy based on aggressive interactions, but ruffe were most aggressive at low and high fish densities. Time spent in foraging was lowest at the low fish density. The best forager at the low fish density was the most aggressive individual, but the second most aggressive fish at the medium and high fish density was the best forager and also the one chased most frequently. A medium fish density offered the best energetic benefits to ruffe by providing the lowest ratio of time spent in aggression to that spent foraging. Based on our results, ruffe should grow best at an intermediate density. With high ruffe densities, we would also expect disparity in size as the more aggressive fish are able to garner a disproportionate amount of the resources. Alternatively, as the Great Lakes are a fairly open system, ruffe could migrate out of one area to colonize another as populations exceed optimal densities.

  8. The Barrier within: Relational Aggression among Women

    Science.gov (United States)

    Brock, Barbara L.

    2010-01-01

    Relational aggression among women presents an overlooked barrier to women's quest for advancement in the workplace. Although research on women's leadership extols their ability to collaborate and form lasting, supportive relationships, one cannot assume that all women are supportive of other women. Research reveals that relational aggression,…

  9. How food controls aggression in Drosophila.

    Directory of Open Access Journals (Sweden)

    Rod S Lim

    Full Text Available How animals use sensory information to weigh the risks vs. benefits of behavioral decisions remains poorly understood. Inter-male aggression is triggered when animals perceive both the presence of an appetitive resource, such as food or females, and of competing conspecific males. How such signals are detected and integrated to control the decision to fight is not clear. For instance, it is unclear whether food increases aggression directly, or as a secondary consequence of increased social interactions caused by attraction to food. Here we use the vinegar fly, Drosophila melanogaster, to investigate the manner by which food influences aggression. We show that food promotes aggression in flies, and that it does so independently of any effect on frequency of contact between males, increase in locomotor activity or general enhancement of social interactions. Importantly, the level of aggression depends on the absolute amount of food, rather than on its surface area or concentration. When food resources exceed a certain level, aggression is diminished, suggestive of reduced competition. Finally, we show that detection of sugar via Gr5a+ gustatory receptor neurons (GRNs is necessary for food-promoted aggression. These data demonstrate that food exerts a specific effect to promote aggression in male flies, and that this effect is mediated, at least in part, by sweet-sensing GRNs.

  10. Treatment of Aggressive NK-Cell Leukemia

    DEFF Research Database (Denmark)

    Boysen, Anders Kindberg; Jensen, Paw; Johansen, Preben;

    2011-01-01

    Aggressive NK-cell leukemia is a rare malignancy with neoplastic proliferation of natural killer cells. It often presents with constitutional symptoms, a rapid declining clinical course, and a poor prognosis with a median survival of a few months. The disease is usually resistant to cytotoxic...... literature concerning treatment of aggressive NK-cell leukemia....

  11. Involvement in Internet Aggression during Early Adolescence

    Science.gov (United States)

    Werner, Nicole E.; Bumpus, Matthew F.; Rock, Daquarii

    2010-01-01

    The current study examined concurrent and longitudinal predictors of early adolescents' involvement in Internet aggression. Cross-sectional results (N = 330; 57% female) showed that the likelihood of reporting Internet aggression was higher among youth who spent more time using Internet-based technologies to communicate with friends and who were…

  12. Relational Aggression and Victimization in College Students

    Science.gov (United States)

    Dahlen, Eric R.; Czar, Katherine A.; Prather, Emily; Dyess, Christy

    2013-01-01

    For this study we explored relational aggression and victimization in a college sample (N = 307), examining potential gender and race differences, correlates, and the link between relational aggression and common emotional and behavioral problems, independent of relational victimization. Gender and race differences were observed on relational…

  13. Textured fluids

    OpenAIRE

    Guenther, Gerhard K.

    1995-01-01

    The rheology and development morphology of textured fluids have been investigated. The first fluid considered in this work was a liquid crystalline polymer consisting of isotropic and anisotropic solutions of poly-p-phenyleneterephthalamide (PPT) in sulfuric acid. The second textured fluid considered in this work was an immiscible polymer blend consisting of poly(ethylene terephthalate) (PET) and nylon 6,6. The role played by liquid crystalline order (LCO) and a polydomain ...

  14. 侵袭性牙周炎龈沟液中有机酸与牙龈卟啉单胞菌和齿垢密螺旋体的关系%Relationship between volatile fatty acids and Porphyromonas gingivalis and Treponema denticola in gingival crevicular fluids of patients with aggressive periodontitis

    Institute of Scientific and Technical Information of China (English)

    路瑞芳; 冯琳; 高学军; 孟焕新; 冯向辉

    2013-01-01

    Short chain fatty acids (SCFAs), such as succinic acid, acetic acid, propionic acid, butyric acid, etc. are metabolic product of putative periodontal pathogens, which play significant roles in periodontitis. The aim of this study was to analyze the relationship between Porphyromonas gingivalis (P. gingivalis) , Treponema denticola (T. denticola) , and the concentration of SCFAs in gingival crevicular fluid ( GCF) of patients with aggressive periodontitis ( AgP). Methods; GCF was sampled from 4 sites per individual in 20 patients with AgP and 14 healthy controls. Concentrations of SCFAs, including succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid in the supernant of GCF were analyzed by high performance capillary electrophoresis (HPCE), P. gingivalis and T. denticola in the deposit of the same GCF were detected by PCR with their electrophoretic band quantified. Results : The concentrations of succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid, the prevalence and PCR band quantity of P. gingivalis and T. denticola in GCF were all significantly higher in patients with AgP than that of healthy controls. In patients with AgP, butyric acid concentration was significantly higher in P. gingivalis positive sites than negative sites [2.87 (0.99, 4. 36) mmol/L vs. 0.33 (0.00, 1.44) mmol/L, P<0.05], the concentrations of succinic acid, acetic acid, propionic acid, butyric acid, and isovaleric acid were positively correlated with PCR band quantity of P. gingivalis (r value was 0. 334, 0. 548, 0.411, 0. 493, 0. 273, respectively, P < 0. 05); the concentrations of SCFAs were significantly higher in T. denticola positive sites than negative sites; succinic acid, 1. 67 (1.15, 2.11) mmol/L m. 0.80 (0.48, 1.06) mmol/L; acetic acid, 31.95 (23.77, 43.13) mmol/L vs. 12.51 (7.57, 15.69) mmol/L; propionic acid, 11.86 (6.55, 14.98) mmol/L vs. 2.82 (1.71, 7.03) mmol/L; butyric acid, 3.45 (2.41,4.78) mmol/L vs. 0.54 (0.00, 1.56) mmol

  15. Fluid mechanics

    CERN Document Server

    Kundu, Pijush K; Dowling, David R

    2011-01-01

    Fluid mechanics, the study of how fluids behave and interact under various forces and in various applied situations-whether in the liquid or gaseous state or both-is introduced and comprehensively covered in this widely adopted text. Revised and updated by Dr. David Dowling, Fluid Mechanics, 5e is suitable for both a first or second course in fluid mechanics at the graduate or advanced undergraduate level. Along with more than 100 new figures, the text has been reorganized and consolidated to provide a better flow and more cohesion of topics.Changes made to the

  16. Insight, psychosis and aggressive behaviour in mania

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

    2010-06-01

    Full Text Available Background and Objectives: Aggressiveness is a common component of manic symptoms. The aim of this study was to determine the clinical characteristics associated with aggressive behaviour in bipolar patients with acute manic episodes. Methods: A study was carried out with 173 patients who met the DSM-IV criteria for manic or mixed bipolar disorder. Clinical and demographic variables were evaluated using the Positive and Negative Symptoms Scale (PANSS, the Young Mania Rating Scale (YMRS, the Brief Psychiatric Rating Scale (BPRS, and the Hamilton Depression Rating Scale (HDRS. Significance and independence of relevant variables were tested with regression models. Results: Forty percent of patients displayed aggressive behaviour. Involuntary nature of admission, positive psychotic symptoms and lack of insight were predictors of aggressive behaviour in manic patients. Conclusions: Aggressive behaviour during acute manic episodes appears to be related with the severity of the psychopathology, and particularly positive psychotic symptoms, involuntary admissions and lack of insight.

  17. Are Aggressive Cartoons Really Funnier? A Replication

    Directory of Open Access Journals (Sweden)

    Stefan Stieger

    2014-10-01

    Full Text Available Research has found that more aggressive cartoons are perceived as funnier. The current study (N = 106; 16 cartoons examined this finding in more detail by additionally including painfulness and cleverness rankings of cartoons, and by examining possible moderating effects of different humor styles, self-esteem (explicit, implicit, and social desirability. Aggressive or painful cartoons were not perceived to be funnier, but were rated as having a cleverer punch line. Effects were only weakly correlated with participants’ humor styles, but were independent of self-esteem and social desirability. This suggests that aggressive cartoons are not in general perceived to be funnier than non-aggressive ones, and that there may be other moderators influencing this effect (e.g., the type of cartoons, definition of aggression and funniness, cultural aspects.

  18. Transdermal fluid loss in severely burned patients

    Directory of Open Access Journals (Sweden)

    Lange, Thomas

    2010-01-01

    Full Text Available Introduction: The skin protects against fluid and electrolyte loss. Burn injury does affect skin integrity and protection against fluid loss is lost. Thus, a systemic dehydration can be provoked by underestimation of fluid loss through burn wounds. Purpose: We wanted to quantify transdermal fluid loss in burn wounds. Method: Retrospective study. 40 patients admitted to a specialized burn unit were analyzed and separated in two groups without (Group A or with (Group B hypernatremia. Means of daily infusion-diuresis-ratio (IDR and the relationship to totally burned surface area (TBSA were analyzed. Results: In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean abbreviated burned severity index (ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Statistical analysis of the period from day 3 to day 6 showed a significant higher daily IDR-amount in Group A (Group A vs. Group B: 786±1029 ml vs. –181±1021 ml; p<0.001 and for daily IDR-TBSA-ratio (Group A vs. Group B: 40±41 ml/% vs. –4±36 ml/%; p<0.001. Conclusions: There is a systemic relevant transdermal fluid loss in burn wounds after severe burn injury. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy to avoid water and electrolyte imbalances.

  19. Psychometric Properties of the Situation and Aggressive Behavior Inventory and the Motives for Aggression Inventory

    Directory of Open Access Journals (Sweden)

    Maribel Montejo Hernández

    2008-05-01

    Full Text Available Psychometric properties of the Situation and Aggressive Behavior Inventory and the Motives for Aggression Inventory were examined in a sample of 373 students of Medicine and Psychology in the city of Tunja in Colombia. In the Situation and Aggressive Behavior Inventory, most common aggressive behaviors were verbal aggression and attitudes or rage gestures, with physical aggression, verbal aggression and threatening showing the highest correlations; most common situation were study problems, family and interpersonalrelations, and familiar or personal economy, no high correlationswere found among situations or situations with behaviors. In the Motives for Aggression Inventory, most common motives were rage, emotional discomfort, self-defense and defending values. A ronbach´s Alpha of 0.91 was obtained. Both of the questionnaires showed a single dimension (construct validity and satisfactory divergent validity, with the Psychopathy subscale of the Clinical Analysis Questionnaire by Krug (1987, and convergent validity, with the Aggression Questionnaire by Buss and Perry (1992. Homogeneity coefficients were appropriated. Motives in the IMA, specially the pleasure of being aggressive, getting what you want, somethingmakes you feel bad, and valuing aggressive persons, were predictors of the behaviors in the ISCA.

  20. The relationships among perceived peer acceptance of sexual aggression, punishment certainty, and sexually aggressive behavior.

    Science.gov (United States)

    Strang, Emily; Peterson, Zoë D

    2013-12-01

    Researching the correlates of men's sexually aggressive behavior (i.e., verbal coercion and rape) is critical to both understanding and preventing sexual aggression. This study examined 120 men who completed an anonymous online questionnaire. The study aimed to determine the relative importance of two potential correlates of men's self-reported use of sexual aggression: (a) perceptions that male peers use and support sexual aggression and (b) perceptions of punishment likelihood associated with sexual aggression. Results revealed that perceptions of male friends' acceptance of sexual aggression were strongly associated with individual men's reports of using verbal coercion and rape. Perceptions of punishment likelihood were negatively correlated with verbal coercion but not with rape through intoxication and force. Implications for sexual aggression prevention are discussed. PMID:24014542

  1. Aggression on inpatient units: Clinical characteristics and consequences.

    Science.gov (United States)

    Renwick, Laoise; Stewart, Duncan; Richardson, Michelle; Lavelle, Mary; James, Karen; Hardy, Claire; Price, Owen; Bowers, Len

    2016-08-01

    Aggression and violence are widespread in UK Mental Health Trusts, and are accompanied by negative psychological and physiological consequences for both staff and other patients. Patients who are younger, male, and have a history of substance use and psychosis diagnoses are more likely to display aggression; however, patient factors are not solely responsible for violence, and there are complex circumstances that lead to aggression. Indeed, patient-staff interactions lead to a sizeable portion of aggression and violence on inpatient units, thus they cannot be viewed without considering other forms of conflict and containment that occur before, during, and after the aggressive incident. For this reason, we examined sequences of aggressive incidents in conjunction with other conflict and containment methods used to explore whether there were particular profiles to aggressive incidents. In the present study, 522 adult psychiatric inpatients from 84 acute wards were recruited, and there were 1422 incidents of aggression (verbal, physical against objects, and physical). Cluster analysis revealed that aggressive incident sequences could be classified into four separate groups: solo aggression, aggression-rule breaking, aggression-medication, and aggression-containment. Contrary to our expectations, we did not find physical aggression dominant in the aggression-containment cluster, and while verbal aggression occurred primarily in solo aggression, physical aggression also occurred here. This indicates that the management of aggression is variable, and although some patient factors are linked with different clusters, these do not entirely explain the variation. PMID:26892149

  2. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E

    2010-03-01

    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  3. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia : Dutch nationwide retrospective cohort study

    NARCIS (Netherlands)

    Kieboom, J. K.; Verkade, H. J.; Burgerhof, J. G.; Bierens, J. J.; van Rheenen, P. F.; Kneyber, M. C.; Albers, M. J.

    2015-01-01

    OBJECTIVES To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. DESIGN Nationwide retrospective cohort study. S

  4. [Prehospital cardiac resuscitation in Queretaro, Mexico. Report of 3 cases. Importance of an integral emergency medical care system].

    Science.gov (United States)

    Fraga-Sastrías, Juan Manuel; Aguilera-Campos, Andrea; Barinagarrementería-Aldatz, Fernando; Ortíz-Mondragón, Claudio; Asensio-Lafuente, Enrique

    2014-01-01

    In Mexico, out-of-hospital cardiac arrest is a health problem that represents 33,000 to 150,000 or more deaths per year. The few existent reports show mortality as high as 100% in contrast to some international reports that show higher survival rates. In Queretaro, during the last 5 years there were no successful resuscitation cases. However, in 2012 some patients were reported to have return of spontaneous circulation. We report in this article 3 cases with return of spontaneous circulation and pulse at arrival to the hospital. Two of the patients were discharged alive, one of them with poor cerebral performance category. Community cardiopulmonary resuscitation, early defibrillation and better emergency medical system response times, are related with survival. This poorly explored health problem in Queretaro could be increased with quality and good public education, bystander assisted cardiopulmonary resuscitation, police involvement in cardiopulmonary resuscitation and defibrillation, public access defibrillation programs and measurement of indicators and feedback for better results.

  5. Structured Communication: Teaching Delivery of Difficult News with Simulated Resuscitations in an Emergency Medicine Clerkship

    Directory of Open Access Journals (Sweden)

    Lamba, Sangeeta

    2015-03-01

    Full Text Available Introduction: The objective is to describe the implementation and outcomes of a structured communication module used to supplement case-based simulated resuscitation training in an emergency medicine (EM clerkship. Methods: We supplemented two case-based simulated resuscitation scenarios (cardiac arrest and blunt trauma with role-play in order to teach medical students how to deliver news of death and poor prognosis to family of the critically ill or injured simulated patient. Quantitative outcomes were assessed with pre and post-clerkship surveys. Secondarily, students completed a written self-reflection (things that went well and why; things that did not go well and why to further explore learner experiences with communication around resuscitation. Qualitative analysis identified themes from written self-reflections. Results: A total of 120 medical students completed the pre and post-clerkship surveys. Majority of respondents reported that they had witnessed or role-played the delivery of difficult news, but only few had real-life experience of delivering news of death (20/120, 17% and poor prognosis (34/120, 29%. This communication module led to statistically significant increased scores for comfort, confidence, and knowledge with communicating difficult news of death and poor prognosis. Pre-post scores increased for those agreeing with statements (somewhat/very much for delivery of news of poor prognosis: comfort 69% to 81%, confidence 66% to 81% and knowledge 76% to 90% as well as for statements regarding delivery of news of death: comfort 52% to 68%, confidence 57% to 76% and knowledge 76% to 90%. Respondents report that patient resuscitations (simulated and/or real generated a variety of strong emotional responses such as anxiety, stress, grief and feelings of loss and failure. Conclusion: A structured communication module supplements simulated resuscitation training in an EM clerkship and leads to a self-reported increase in knowledge

  6. Changes of Tumor Necrosis Factor-α and the Effects of Ulinastatin Injection during Cardiopulmonary Cerebral Resuscitation

    Institute of Scientific and Technical Information of China (English)

    王卫; 黄唯佳; 陈寿权; 李章平; 王万铁; 王明山

    2004-01-01

    Summary: The changes of tumor necrosis factor-α (TNF-α) and brain ultrastructure during cardiopulmonary resuscitation and the effects of ulinastation injection were observed, and the mechanism was investigated. Twenty-four adult healthy Sprague-Dawley rats were randomly divided into.control group (8 rats), resuscitation group (8 rats) and ulinastatin (UTI) group (8 rats). Rats in control group underwent tracheotomy without clipping the trachea to induce circulatory and respiratory standstill. Rats in resuscitation and ulinastatin group were subjected to the procedure of establishing the model of cardiopulmonary cerebral resuscitation (CPCR). Rats in ulinastatin group were given with UTI 104 U/kg once after CPCR. In the control group, the plasma was collected immediate,30 min, 2 h, 4 h, and 6 h after tracheotomy. In resuscitation group and UTI group, plasma was collected immediate after tracheotomy, 30 min, 2 h, 4 h and 6 h after successful resuscitation. The plasma levels of TNF-α were determined by radioimmunoassay (RIA). At the end of the experi-ment, 2 rats were randomly selected from each group and were decapitated. The cortex of the brain was taken out immediately to observe the ultrastructure changes. In control group, there were nosignificant differences in the level of TNF-α among different time points (P>0.05). In resuscitation group, the level of TNF-α was increased obviously after resuscitation (P<0.01) and reached its peak 2 h later after resuscitation. An increasing trend of TNF-α showed in UTI group. There were no differences in TNF-α among each sample taken after successful resuscitation and that after tracheotomy. The utrastructure of brains showed the injury in UTI group was ameliorated as compared with that in resuscitation group. In early period of CPCR, TNF-α was expressed rapidly and kept increasing. It indicated that TNF-α might take part in the tissue injury after CPCR. The administration of UTI during CACR could depress TNF

  7. Effect of a Neonatal Resuscitation Course on Healthcare Providers' Performances Assessed by Video Recording in a Low-Resource Setting.

    Directory of Open Access Journals (Sweden)

    Daniele Trevisanuto

    Full Text Available We assessed the effect of an adapted neonatal resuscitation program (NRP course on healthcare providers' performances in a low-resource setting through the use of video recording.A video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course were collected and assessed based on a previously published score.All 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV and chest compressions (CC, respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for "initial steps", the score increased from 33% (IQR 28-39 to 44% (IQR 39-56, p<0.0001; for BMV, from 20% (20-40 to 40% (40-60, p = 0.001; and for CC, from 0% (0-10 to 20% (0-50, p = 0.01. Times of resuscitative interventions after the course were improved in comparison to those obtained before the course, but remained non-compliant with the recommended algorithm.Although resuscitations remained below the recommended standards in terms of quality and time of execution, clinical practice of healthcare providers improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting.

  8. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. PMID:27015887

  9. Combination of Epinephrine with Esmolol Attenuates Post-Resuscitation Myocardial Dysfunction in a Porcine Model of Cardiac Arrest

    OpenAIRE

    Qian Zhang; Chunsheng Li

    2013-01-01

    BACKGROUND: Recent experimental and clinical studies have indicated that the β-adrenergic effect of epinephrine significantly increases the severity of post resuscitation myocardial dysfunction. The aim of the study was to investigate whether the short-acting β₁-selective adrenergic blocking agent, esmolol, would attenuate post resuscitation myocardial dysfunction in a porcine model of cardiac arrest. METHODS AND RESULTS: After 8 min of untreated ventricular fibrillation and 2 min of basic li...

  10. Effect of a Neonatal Resuscitation Course on Healthcare Providers’ Performances Assessed by Video Recording in a Low-Resource Setting

    Science.gov (United States)

    Trevisanuto, Daniele; Bertuola, Federica; Lanzoni, Paolo; Cavallin, Francesco; Matediana, Eduardo; Manzungu, Olivier Wingi; Gomez, Ermelinda; Da Dalt, Liviana; Putoto, Giovanni

    2015-01-01

    Background We assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers’ performances in a low-resource setting through the use of video recording. Methods A video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course) were collected and assessed based on a previously published score. Results All 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV) and chest compressions (CC), respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for “initial steps”, the score increased from 33% (IQR 28–39) to 44% (IQR 39–56), p<0.0001; for BMV, from 20% (20–40) to 40% (40–60), p = 0.001; and for CC, from 0% (0–10) to 20% (0–50), p = 0.01. Times of resuscitative interventions after the course were improved in comparison to those obtained before the course, but remained non-compliant with the recommended algorithm. Conclusions Although resuscitations remained below the recommended standards in terms of quality and time of execution, clinical practice of healthcare providers improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting. PMID:26659661

  11. Advanced Cardiac Resuscitation Evaluation (ACRE: A randomised single-blind controlled trial of peer-led vs. expert-led advanced resuscitation training

    Directory of Open Access Journals (Sweden)

    Hughes Thomas C

    2010-01-01

    Full Text Available Abstract Background Advanced resuscitation skills training is an important and enjoyable part of medical training, but requires small group instruction to ensure active participation of all students. Increases in student numbers have made this increasingly difficult to achieve. Methods A single-blind randomised controlled trial of peer-led vs. expert-led resuscitation training was performed using a group of sixth-year medical students as peer instructors. The expert instructors were a senior and a middle grade doctor, and a nurse who is an Advanced Life Support (ALS Instructor. A power calculation showed that the trial would have a greater than 90% chance of rejecting the null hypothesis (that expert-led groups performed 20% better than peer-led groups if that were the true situation. Secondary outcome measures were the proportion of High Pass grades in each groups and safety incidents. The peer instructors designed and delivered their own course material. To ensure safety, the peer-led groups used modified defibrillators that could deliver only low-energy shocks. Blinded assessment was conducted using an Objective Structured Clinical Examination (OSCE. The checklist items were based on International Liaison Committee on Resuscitation (ILCOR guidelines using Ebel standard-setting methods that emphasised patient and staff safety and clinical effectiveness. The results were analysed using Exact methods, chi-squared and t-test. Results A total of 132 students were randomised: 58 into the expert-led group, 74 into the peer-led group. 57/58 (98% of students from the expert-led group achieved a Pass compared to 72/74 (97% from the peer-led group: Exact statistics confirmed that it was very unlikely (p = 0.0001 that the expert-led group was 20% better than the peer-led group. There were no safety incidents, and High Pass grades were achieved by 64 (49% of students: 33/58 (57% from the expert-led group, 31/74 (42% from the peer-led group. Exact

  12. Fluid Dynamics

    DEFF Research Database (Denmark)

    Brorsen, Michael

    These lecture notes are intended mainly for the 7th semester course "Fluid Dynamics" offered by the Study Committee on Civil Engineering, Aalborg University.......These lecture notes are intended mainly for the 7th semester course "Fluid Dynamics" offered by the Study Committee on Civil Engineering, Aalborg University....

  13. Reactive and proactive aggression and suicide attempts among criminal offenders

    OpenAIRE

    Swogger, Marc T.; Walsh, Zach; Maisto, Stephen A.; Conner, Kenneth R.

    2013-01-01

    Outwardly-directed aggression is associated with suicide attempts, but aggression is a heterogeneous construct. Increased specificity in our understanding of the link between aggression and suicide attempts can be attained by examining subtypes of aggression. We studied the relationships of reactive and proactive aggression to history of a suicide attempt among 96 criminal offenders in a pretrial supervision program. Consistent with prior findings in non-offender samples, reactive aggression ...

  14. Verbal versus Physical Aggression in Intermittent Explosive Disorder

    OpenAIRE

    Look, Amy E.; McCloskey, Michael S.; Coccaro, Emil F.

    2014-01-01

    Intermittent Explosive Disorder (IED) is the only adult psychiatric diagnosis for which pathological aggression is primary. DSM-IV criteria focused on physical aggression, but DSM-5 allows for an IED diagnosis in the presence of frequent verbal aggression with or without concurrent physical aggression. It remains unclear how individuals with verbal aggression differ from those with physical aggression with respect to cognitive-affective deficits and psychosocial functioning. The current study...

  15. Neonatal resuscitation 1: a model to measure inspired and expired tidal volumes and assess leakage at the face mask

    Science.gov (United States)

    O'Donnell, C; Kamlin, C; Davis, P; Morley, C

    2005-01-01

    Background: Neonatal resuscitation is a common and important intervention, and adequate ventilation is the key to success. In the delivery room, positive pressure ventilation is given with manual ventilation devices using face masks. Mannequins are widely used to teach and practise this technique. During both simulated and real neonatal resuscitation, chest excursion is used to assess tidal volume delivery, and leakage from the mask is not measured. Objective: To describe a system that allows measurement of mask leakage and estimation of tidal volume delivery. Methods: Respiratory function monitors, a modified resuscitation mannequin, and a computer were used to measure leakage from the mask and to assess tidal volume delivery in a model of neonatal resuscitation. Results: The volume of gas passing through a flow sensor was measured at the face mask. This was a good estimate of the tidal volume entering and leaving the lung in this model. Gas leakage between the mask and mannequin was also measured. This occurred principally during inflation, although gas leakage during deflation was seen when the total leakage was large. A volume of gas that distended the mask but did not enter the lung was also measured. Conclusion: This system can be used to assess the effectiveness of positive pressure ventilation given using a face mask during simulated neonatal resuscitation. It could be useful for teaching neonatal resuscitation and assessing ventilation through a face mask. PMID:15871990

  16. Affective Dependence and Aggression: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Filippo Petruccelli

    2014-01-01

    Full Text Available Introduction. Emotionally dependent subjects may engage in controlling, restrictive, and aggressive behaviours, which limit their partner’s autonomy. The underlying causes of such behaviours are not solely based on levels of aggression, but act as a mean of maintaining the subject’s own sense of self-worth, identity, and general functioning. Objective. The aim of the paper is to explore the correlation between affective dependency and reactive/proactive aggression and to evaluate individual differences as predisposing factors for aggressive behaviour and emotional dependency. Methods. The Spouse-Specific Dependency Scale (SSDS and the Reactive Proactive Questionnaire (RPQ were administered to a sample of 3375 subjects. Results. In the whole sample, a positive correlation between emotional dependency and proactive aggression was identified. Differences with regard to sex, age group, and geographical distribution were evidenced for the scores of the different scales. Conclusion. A fundamental distinction between reactive and proactive aggression was observed, anchoring proactive aggression more strictly to emotional dependency. Sociocultural and demographical variables, together with the previous structuring of attachment styles, help to determine the scope, frequency, and intensity of the demands made to the partner, as well as to feed the fears of loss, abandonment, or betrayal.

  17. Assessment of aggression in inpatient settings.

    Science.gov (United States)

    McDermott, Barbara E; Holoyda, Brian J

    2014-10-01

    The threat of violence is a major concern for all individuals working or receiving treatment in an inpatient psychiatric setting. One major focus in forensic psychology and psychiatry over the past several decades has been the development of risk assessments to aid in the identification of those individuals most at risk of exhibiting violent behavior. So-called second- and third-generation risk assessments were developed to improve the accuracy of decision making. While these instruments were developed for use in the community, many have proven to be effective in identifying patients more likely to exhibit institutional aggression. Because the purpose of risk assessment is the reduction of violence, dynamic factors were included in third-generation risk instruments to provide opportunities for intervention and methods for measuring change. Research with these instruments indicates that both static factors (second-generation) and dynamic factors (third-generation) are important in identifying those patients most likely to engage in institutional aggression, especially when the aggression is categorized by type (impulsive/reactive, organized/predatory/instrumental, psychotic). Recent research has indicated that developing a typology of aggressive incidents may provide insight both into precipitants to assaults as well as appropriate interventions to reduce such aggression. The extant literature suggests that both static and dynamic risk factors are important, but may be differentially related to the type of aggression exhibited and the characteristics of the individuals exhibiting the aggression. PMID:25296966

  18. Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

    Directory of Open Access Journals (Sweden)

    Zheng-gang WANG

    2012-02-01

    Full Text Available Objective  To observe the effect of vacuum sealing drainage (VSD assisted intra-abdominal volume increment (IAVI technique on the liver in the treatment of intra-abdominal hypertension (IAH following hemorrhagic shock resuscitation in pigs. Methods  Twelve healthy mini-pigs (Bama, Guangxi were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h, and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT group (n=4 and sham operation control (SC group (n=4. Vesical pressure (VP and inferior vena cava pressure (IVCP were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST and alanine aminotransferase (ALT were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results  The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions  The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.

  19. 每搏输出量变异度在脓毒症休克液体复苏治疗中的指导作用%Value of Stroke Volume Variation in Guiding Resuscitation of Septic Shock

    Institute of Scientific and Technical Information of China (English)

    李权; 陈琦; 郭俊; 李鲲; 王夜明

    2012-01-01

    Objective: To review the recent research on the application of stroke volume variation in re-suscitation of septic shock. Methods: The characteristics, mechanism, advances, application, limitations, etc. , were reviewed in this paper about stroke volume variation. Results: Early fluid resuscitation is an important procedure in anti-septic shock therapy, while during this process, hemodynamics and blood volume changes should be monitored. As an effective and real-time technique, stroke volume variation is a superior indicator to central venous pressure (CVP) in reflecting the changes of circulation during resuscitation. Conclusion; Stroke volume variation has better guiding value and application prospect in the early fluid resuscitation in septic shock therapy%目的:探讨每搏输出量变异度在脓毒症休克液体复苏治疗中的指导作用.方法:对每搏输出量变异度的特点、机理、研究进展、应用范围、局限性等方面进行综述.结果:早期液体复苏在脓毒症休克治疗中占据重要的地位,可维持最佳前负荷,改善容量管理,防止由于低血容量导致的低灌注和过度复苏,可能进一步防止发生多器官功能障碍.因而治疗中监测血流动力学和容量的变化极为重要.脉搏波指示连续心排血量技术是新近出现的一种简便、有效的临床实时监测手段,测定每搏输出量变异度比传统的测定中心静脉压更准确地指导快速液体复苏.结论:每搏输出量变异对预测脓毒症体克早期液体复苏的效果具有良好的指导意义和应用前景.

  20. Adolescent Aggression: The Role of Peer Group Status Motives, Peer Aggression, and Group Characteristics.

    Science.gov (United States)

    Faris, Robert; Ennett, Susan

    2012-10-01

    Recent studies of youth aggression have emphasized the role of network-based peer influence processes. Other scholars have suggested that aggression is often motivated by status concerns. We integrate these two veins of research by considering the effects of peer status motivations on subsequent adolescent aggression, net of their own status motivations, prior aggression, and peer behavior. We also explore different levels at which peer effects may occur, considering the effects of reciprocated and unreciprocated friendships as well as larger, meso-level peer groups. We anticipate that peer group effects are magnified by both size and boundedness as measured by Freeman's (1972) Segregation Index. We find that, net of the adolescent's aggression at time 1, both the aggressive behaviors and the status valuations of friends independently increase the likelihood of aggression at time 2, six months later. The aggressive behavior of friends who do not reciprocate the adolescent's friendship nomination has particular impact. The average status valuation of peer groups increases their members' likelihood of aggression, even after controlling for their own attitudes about status, their friends' attitudes, and their friends' aggressive behavior. This effect is magnified in large groups and groups with high Freeman segregation scores. PMID:25152562

  1. [Role of an anesthesiologist-resuscitation specialist in organ donation for transplantation].

    Science.gov (United States)

    Iaroshetskiĭ, A I; Protsenko, D N; Gel'fand, B R

    2010-01-01

    There is an annual reduction in the number of donors worldwide. An anesthesiologist-resuscitation specialist is a key figure in the whole system of organ donation. The so-called transplantation, i.e., the organization of the whole process of interaction between a healthy care facility, a local organ donation center, and ancillary laboratory and diagnostic services is one of his/her primary roles in organ donation. The organizational, legal, and ethic issues of organ donation for transplantation are discussed from the viewpoint of an anesthesiologist-resuscitation specialist. There is a parallel between the treatment of a patient with multiple organ dysfunction and the management of a donor with brain death. PMID:20737699

  2. Retrospective Study of the Survival of Patients who Underwent Cardiopulmonary Resuscitation in an Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moreira Daniel Martins

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical and evolutive characteristics of patients admitted in an intensive care unit after cardiopulmonary resuscitation, identifying prognostic survival factors.METHODS: A retrospective study of 136 patients admitted between 1995 and 1999 to an intensive care unit, evaluating clinical conditions, mechanisms and causes of cardiopulmonary arrest, and their relation to hospital mortality.RESULTS: A 76% mortality rate independent of age and sex was observed. Asystole was the most frequent mechanism of death, and seen in isolation pulmonary arrest was the least frequent. Cardiac failure, need for mechanical ventilation, cirrhosis and previous stroke were clinically significant (p<0.01 death factors.CONCLUSION: Prognostic factors supplement the doctor's decision as to whether or not a patient will benefit from cardiopulmonary resuscitation.

  3. Clinical audit on documentation of anticipatory "Not for Resuscitation" orders in a tertiary australian teaching hospital

    Directory of Open Access Journals (Sweden)

    Naveen Sulakshan Salins

    2011-01-01

    Full Text Available Aim: The purpose of this clinical audit was to determine how accurately documentation of anticipatory Not for Resuscitation (NFR orders takes place in a major metropolitan teaching hospital of Australia. Materials and Methods: Retrospective hospital-based study. Independent case reviewers using a questionnaire designed to study NFR documentation reviewed documentation of NFR in 88 case records. Results: Prognosis was documented in only 40% of cases and palliative care was offered to two-third of patients with documented NFR. There was no documentation of the cardiopulmonary resuscitation (CPR process or outcomes of CPR in most of the cases. Only in less than 50% of cases studied there was documented evidence to suggest that the reason for NFR documentation was consistent with patient′s choices. Conclusion: Good discussion, unambiguous documentation and clinical supervision of NFR order ensure dignified and quality care to the dying.

  4. Are the current guideline recommendations for neonatal cardiopulmonary resuscitation safe and effective?

    Science.gov (United States)

    Rottenberg, Eric M

    2016-08-01

    A recently published review of approaches to optimize chest compressions in the resuscitation of asphyxiated newborns discussed the current recommendations and explored potential determinants of effective neonatal cardiopulmonary resuscitation (CPR). However, not all potential determinants of effective neonatal CPR were explored. Chest compression shallower than the current guideline recommendation of approximately 33% of the anterior-posterior (AP) chest diameter may be safer and more effective. From a physiological standpoint, high-velocity brief duration shallower compression may be more effective than current recommendations. The application of a 1- or 2-finger method of high-impulse CPR, which would depend on the size of the subject, may be more effective than using a 2-thumb (TT) encircling hands method of CPR. Adrenaline should not be used in the treatment of asphyxiated neonates and when necessary titrated vasopressin should be used. PMID:27220864

  5. Laypersons may learn basic life support in 24min using a personal resuscitation manikin

    DEFF Research Database (Denmark)

    Isbye, Dan Lou; Rasmussen, Lars Simon; Lippert, Freddy Knudsen;

    2006-01-01

    BACKGROUND: Bystander basic life support (BLS) is an important part of cardiopulmonary resuscitation (CPR) and improves outcome after out-of-hospital cardiac arrest. However, the general population has poor BLS skills. Several training initiatives could be used to improve this situation and the c......BACKGROUND: Bystander basic life support (BLS) is an important part of cardiopulmonary resuscitation (CPR) and improves outcome after out-of-hospital cardiac arrest. However, the general population has poor BLS skills. Several training initiatives could be used to improve this situation...... assessed after 3 months, a 24 min DVD-based instruction plus subsequent self-training in BLS appears equally effective compared to a 6h BLS course and hence is more efficient. Udgivelsesdato: 2006-Jun...

  6. Initial resuscitation and stabilization of the periviable neonate: the Golden-Hour approach.

    Science.gov (United States)

    Wyckoff, Myra H

    2014-02-01

    There is a paucity of data to support recommendations for stabilization and resuscitation of the periviable neonate in the delivery room. The importance of delivery at a tertiary center with adequate experience, resuscitation team composition, and training for a periviable birth is reviewed. Evidence for delayed cord clamping, delivery room temperature stabilization, strategies to establish functional residual capacity, and adequate ventilation as well as oxygen use in the delivery room is generally based on expert consensus, physiologic plausibility, as well as data from slightly more mature extremely low gestational-age neonates. Little is known about optimal care in the delivery room of these most fragile infants, and thus the need for research remains critical.

  7. The significance of clinical experience on learning outcome from resuscitation training-a randomised controlled study

    DEFF Research Database (Denmark)

    Jensen, Morten Lind; Lippert, Freddy; Hesselfeldt, Rasmus;

    2008-01-01

    CONTEXT: The impact of clinical experience on learning outcome from a resuscitation course has not been systematically investigated. AIM: To determine whether half a year of clinical experience before participation in an Advanced Life Support (ALS) course increases the immediate learning outcome ...... but statistically significant impact on the retention of learning, but not on the immediate learning outcome Udgivelsesdato: 2008/12/4......CONTEXT: The impact of clinical experience on learning outcome from a resuscitation course has not been systematically investigated. AIM: To determine whether half a year of clinical experience before participation in an Advanced Life Support (ALS) course increases the immediate learning outcome...... and retention of learning. MATERIALS AND METHODS: This was a prospective single blinded randomised controlled study of the learning outcome from a standard ALS course on a volunteer sample of the entire cohort of newly graduated doctors from Copenhagen University. The outcome measurement was ALS...

  8. Invasive strategy in patients with resuscitated cardiac arrest and ST elevation myocardial infarction.

    Science.gov (United States)

    Gorjup, Vojka; Noc, Marko; Radsel, Peter

    2014-06-26

    Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion ("ACS" lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and safe but highly effective and there is evidence of improved survival with good neurological outcome. PCI of the culprit lesion is the primary goal while PCI of stable obstructive lesions may be postponed unless post-resuscitation cardiogenic shock is present.

  9. Reanimación neonatal: actualización Neonatal resuscitation: up-date

    Directory of Open Access Journals (Sweden)

    E. Burón Martínez

    2009-01-01

    Full Text Available Las últimas recomendaciones en reanimación neonatal fueron publicadas en el año 2005 por el ERC (European Resuscitation Council, el grupo ILCOR (International Liaison Committee on Resuscitation y la AHA (American Heart Association. En nuestro país estas normas fueron difundidas por el grupo de RCP Neonatal de la Sociedad Española de Neonatología, introduciendo algunas adaptaciones y ampliando algunos capítulos como la reanimación del recién nacido de muy bajo peso (RNMBP. En la figura 1 se recoge el algoritmo de reanimación neonatal en sala de partos y en la figura 2 el algoritmo de reestabilización inicial y manejo respiratorio en sala de partos del prematuro de < 32 semanas realizados por el grupo RCP neonatal-SEN y consensuados por el Consejo Español de RCP y el ERC...

  10. Rhythm recognition is accountable for the majority of hands-off time during cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Hansen, Lars Koch; Brabrand, Mikkel

    2014-01-01

    Cardiopulmonary resuscitation guidelines are constantly optimized to increase survival. Keeping hands-off time brief is vital. Our hypothesis is that rhythm recognition is time-consuming during cardiopulmonary resuscitation. A Laerdal Sim-Man simulated three shockable and four nonshockable rhythms....... Rhythms were presented to physicians who identified whether they were shockable and whether they would defibrillate. We measured time to stated decision. Thirty-five doctors participated, 32 had completed advanced life support training. The mean time to make a decision on whether to defibrillate...... or not was 3.4 s [95% confidence interval (CI): 2.8-3.9] for shockable and 4.4 s (95% CI: 3.6-5.3) for nonshockable rhythms (Pcompared with 88.6 % of nonshockable rhythms...

  11. Effect of naloxone on food competition aggression in food-restricted high and low aggression pigeons (Columba livia)

    OpenAIRE

    Fachinelli C.; Torrecillas M.; Rodríguez Echandía E.L.

    2004-01-01

    We determined the effect of the opiate receptor antagonist naloxone on aggression, emotion, feeder control, and eating behavior in high and low aggression female pigeons maintained at 80% of their normal weight and exposed to food competition interactions. Pigeons were divided into pairs by previously ranked high aggression (total time spent in offensive aggression exceeding 60 s/5 min; N = 6 pairs) and low aggression females (time spent in offensive aggression less than 10 s/5 min; N = 6 pai...

  12. Aggressive posterior retinopathy of prematurity classification

    Directory of Open Access Journals (Sweden)

    A.V. Tereshchenko,

    2013-02-01

    Full Text Available ABSTRACT Based on dynamic monitoring of 133 premature infants (266 eyes with aggressive posterior retinopathy of prematurity (ROP, digital retinoscopy and computer morphometry the disease clinical and morphometric features were revealed and systematized, and their consecutive replacement was fixed. As a result the separate classification of aggressive posterior disease was worked up. In aggressive posterior ROP course the next consecutive stages were marked out: subclinical, early clinical appearances stage, manifestation stage, advanced, far-advanced and terminal stages. The peculiarity of early clinical appearances stage and manifestation stage is the presence of such course types: favorable and unfavorable.

  13. [Aggressive behavior: theoretical and biological aspects].

    Science.gov (United States)

    Giotakos, O

    2013-01-01

    The susceptibility to aggression may manifest differently depending on the psychological context in which it occurs. In the context of psychopathy, characterized by a lack of empathy, this may manifest in aggression with criminal acts, which is characteristic of antisocial personality disorder. When the susceptibility is associated with psychotic impairment, aggression may be manifested in highly deviant behavior, like murder or serial killing. While the great majority of persons with schizophrenia do not commit violent acts, clinicians suggest that some schizophrenics may pose a risk in the community, particularly those patients with co-occurring substance abuse diagnoses, those who are noncompliant with prescribed psychiatric treatment, and those with a history of frequent relapses resulting in hospitalization or arrest. Episodic violence and aggression often accompany dementia. When coupled with emotional dysregulation, impulsive aggression often occurs in an interpersonal context, as in borderline personality disorder. However, the most common comorbidity is the substance abuse disorder, which contributes to both the cognitive distortions and disinhibition associated with the substance use. According to the biological data, aggression seems to emerge when the drive of limbic-mediated affective prefrontal response to provocative producing stimuli is insufficiently constrained by inhibition. Thus, excessive reactivity in the amygdale, coupled with inadequate prefrontal regulation, increase the possibility of aggressive behavior. The PET/SPECT studies focusing on schizophrenia have shown reduced activity in fronto-temoral circuitry. The fMRI studies concord with the hypothesis that among violent persons with schizophrenia, those with sociopathetic features and/or substance abuse constitute a highly different subgroup, in which cognitive, neurological and behavioral patterns are more closely associated with the personality traits than schizophrenia. It is known

  14. Effects of flashlight guidance on chest compression performance in cardiopulmonary resuscitation in a noisy environment

    OpenAIRE

    You, Je Sung; Chung, Sung Phil; Chang, Chul Ho; Park, Incheol; Lee, Hye Sun; Kim, SeungHo; Lee, Hahn Shick

    2012-01-01

    Background In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether ‘flashlight’ guidance influences CPR performance in a simulated noisy setting. Materials and methods We recruited 30 senior medical students with...

  15. Cardiopulmonary Arrest and Resuscitation in Severe Sepsis and Septic Shock: A Research Model.

    Science.gov (United States)

    Chalkias, Athanasios; Spyropoulos, Vaios; Koutsovasilis, Anastasios; Papalois, Apostolos; Kouskouni, Evaggelia; Xanthos, Theodoros

    2015-03-01

    Cardiopulmonary resuscitation in patients with severe sepsis and septic shock is challenging and usually unsuccessful. The aim of the present study is to describe our swine model of cardiac arrest and resuscitation in severe sepsis and septic shock. In this prospective randomized animal study, 10 healthy female Landrace-Large White pigs with an average weight of 20 ± 1 kg (aged 19 - 21 weeks) were the study subjects. Septicemia was induced by an intravenous infusion of a bolus of 20-mL bacterial suspension in 2 min, followed by a continuous infusion during the rest of the experiment. After septic shock was confirmed, the animals were left untreated until cardiac arrest occurred. All animals developed pulseless electrical activity between the fifth and sixth hours of septicemia, whereas five (50%) of 10 animals were successfully resuscitated. Coronary perfusion pressure was statistically significantly different between surviving and nonsurviving animals. We found a statistically significant correlation between mean arterial pressure and unsuccessful resuscitation (P = 0.046), whereas there was no difference in end-tidal carbon dioxide (23.05 ± 1.73 vs. 23.56 ± 1.70; P = 0.735) between animals with return of spontaneous circulation and nonsurviving animals. During the 45-min postresuscitation monitoring, we noted a significant decrease in hemodynamic parameters, although oxygenation indices and lactate clearance were constantly increased (P = 0.001). This successful basic swine model was for the first time developed and may prove extremely useful in future studies on the periarrest period in severe sepsis and septic shock.

  16. Chest Compression Synchronized Ventilation versus Intermitted Positive Pressure Ventilation during Cardiopulmonary Resuscitation in a Pig Model

    OpenAIRE

    Kill, Clemens; Galbas, Monika; Neuhaus, Christian; Hahn, Oliver; Wallot, Pascal; Kesper, Karl; Wulf, Hinnerk; Dersch, Wolfgang

    2015-01-01

    Background Guidelines recommend mechanical ventilation with Intermitted Positive Pressure Ventilation (IPPV) during resuscitation. The influence of the novel ventilator mode Chest Compression Synchronized Ventilation (CCSV) on gas exchange and arterial blood pressure compared with IPPV was investigated in a pig model. Methods In 12 pigs (general anaesthesia/intubation) ventricular fibrillation was induced and continuous chest compressions were started after 3min. Pigs were mechanically ventil...

  17. Advances in the diagnosis of shock, its assessment and resuscitation during the Great War.

    Science.gov (United States)

    Bullingham, A G P

    2016-07-01

    The Great War of 1914-1918 ushered in a new era of technology on the battlefield resulting in casualties on an unprecedented scale. There had been progress in many related areas of medicine before the outbreak of hostilities but these had not been applied or fully developed in clinical practice. This is particularly true for the management of haemorrhagic shock and resuscitation. This article discusses the history and development of medical treatment of shock and trauma patients during the conflict.

  18. Successful Resuscitation from Ventricular Fibrillation during Jogging in a Young Patient with Hypertrophic Cardiomyopathy

    OpenAIRE

    Kose, Noriyuki; Fujiwara, Hideki; Honda, Yuzuru; Doi, Yoshiyuki; Toda, Genii; Yano, Katsusuke; Miyahara, Yoshiyuki; Kohno, Shigeru

    1999-01-01

    A 15-year-old girl, who was previously in good health, suddenly collapsed while jogging. Immediate cardiopulmonary resuscitation (CPR) was initiated, and she arrived at our hospital 13 minutes later. The ventricular fibrillation (VF) on admission was reverted to sinus rhythm 18 minutes after collapse by the second cardioversion. The echocardiogram revealed hypertrophic nonobstructed cardiomyopathy (HNOCM), although the 24hr ambulatory electrocardiographic, electrophysiologic and exercise stre...

  19. Use of instructional video to prepare parents for learning infant cardiopulmonary resuscitation

    OpenAIRE

    Brannon, Timothy S.; White, Lisa A.; Kilcrease, Julie N.; Richard, LaShawn D.; Spillers, Jana G.; Cynthia L. Phelps

    2009-01-01

    Parents of premature infants often receive infant cardiopulmonary resuscitation (CPR) training prior to discharge from the hospital, but one study showed that 27.5% of parents could not demonstrate adequate CPR skills after completing an instructor-led class. We hypothesized that parents who viewed an instructional video on infant CPR before attending the class would perform better on a standardized skills test than parents who attended the class with no preparation. Parents randomized to the...

  20. Minocycline Decreases Liver Injury after Hemorrhagic Shock and Resuscitation in Mice

    Directory of Open Access Journals (Sweden)

    Christoph Czerny

    2012-01-01

    Full Text Available Patients that survive hemorrhage and resuscitation (H/R may develop a systemic inflammatory response syndrome (SIRS that leads to dysfunction of vital organs (multiple organ dysfunction syndrome, MODS. SIRS and MODS may involve mitochondrial dysfunction. Under pentobarbital anesthesia, C57BL6 mice were hemorrhaged to 30 mm Hg for 3 h and then resuscitated with shed blood plus half the volume of lactated Ringer’s solution containing minocycline, tetracycline (both 10 mg/kg body weight or vehicle. Serum alanine aminotransferase (ALT, necrosis, apoptosis and oxidative stress were assessed 6 h after resuscitation. Mitochondrial polarization was assessed by intravital microscopy. After H/R with vehicle or tetracycline, ALT increased to 4538 U/L and 3999 U/L, respectively, which minocycline decreased to 1763 U/L (P<0.01. Necrosis and TUNEL also decreased from 24.5% and 17.7 cells/field, respectively, after vehicle to 8.3% and 8.7 cells/field after minocycline. Tetracycline failed to decrease necrosis (23.3% but decreased apoptosis to 9 cells/field (P<0.05. Minocycline and tetracycline also decreased caspase-3 activity in liver homogenates. Minocycline but not tetracycline decreased lipid peroxidation after resuscitation by 70% (P<0.05. Intravital microscopy showed that minocycline preserved mitochondrial polarization after H/R (P<0.05. In conclusion, minocycline decreases liver injury and oxidative stress after H/R by preventing mitochondrial dysfunction.

  1. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest

    OpenAIRE

    Ya-hua LIU; Xiu-man LI; Li-xiang WANG

    2012-01-01

    Objective To observe the effects of four cardiopulmonary resuscitation (CPR) methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR), compression under the diaphragm CPR (D-CPR), abdominal compression CPR (A-CPR), and abdominal wall lifting and compression CPR (L-CPR). Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of s...

  2. Diffusion of Cardiopulmonary Resuscitation Training to Chinese Immigrants with Limited English Proficiency

    OpenAIRE

    Mei Po Yip; Brandon Ong; Shin Ping Tu; Devora Chavez; Brooke Ike; Ian Painter; Ida Lam; Bradley, Steven M.; Coronado, Gloria D.; Meischke, Hendrika W.

    2011-01-01

    Cardiopulmonary resuscitation (CPR) is an effective intervention for prehospital cardiac arrest. Despite all available training opportunities for CPR, disparities exist in participation in CPR training, CPR knowledge, and receipt of bystander CPR for certain ethnic groups. We conducted five focus groups with Chinese immigrants who self-reported limited English proficiency (LEP). A bilingual facilitator conducted all the sessions. All discussions were taped, recorded, translated, and trans...

  3. Knowledge and psychomotor skills of nursing students in North Cyprus in the area of cardiopulmonary resuscitation

    OpenAIRE

    Dal, Umran; Sarpkaya, Dilek

    2013-01-01

    Objective : The aim of the study was to determine the cardiopulmonary resuscitation (CPR) knowledge and skill levels of nursing students in North Cyprus. Methods : The study design was quasi-experimental and longitudinal. A questionnaire was applied to the students before the CPR lecture. Then the students were informed about adult CPR by the researchers and all of the students practiced CPR on a Resusci-Anne manikin. One and six months after this training the same questionnaire and skills ch...

  4. Willingness to Perform Chest Compression Only in Witnessed Cardiac Arrest Victims versus Cardiopulmonary Resuscitation in Iran

    OpenAIRE

    Nesreen Yaghmour; Mohammad Reza Movahed

    2015-01-01

    Background: Performing immediate bystander Cardio Pulmonary Resuscitation (CPR) is the most important factor that determines survival from cardiac arrest. Recommended mouth to mouth ventilation maneuver during CPR has led to lower rate of CPR performance in the population. Objectives: The present survey aimed to evaluate the willingness of nurses at Shiraz University of Medical Sciences for performing CPR versus chest-compression-only CPR. Patients and Methods: During a CPR course, we...

  5. A Prospective Study of Survival After In-Hospital Cardiopulmonary Resuscitation and its Related Factors

    OpenAIRE

    Miranzadeh, Sedigheh; Adib-Hajbaghery, Mohsen; Hosseinpour, Nadimeh

    2016-01-01

    Background Despite several studies, there is no agreement on factors that affect survival after in-hospital cardiopulmonary resuscitation (CPR). Objectives This study aimed to evaluate the survival rate of in-hospital CPR and its related factors at Shahid Beheshti hospital in Kashan, Iran, in 2014. Patients and Methods A descriptive study was conducted on all cases of CPR performed in Kashan Shahid Beheshti hospital during a 6-month period in 2014. Through a consecutive sampling method, 250 c...

  6. Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

    OpenAIRE

    Lakshmi Rajeswaran; Valerie J. Ehlers

    2013-01-01

    Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to ...

  7. Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

    OpenAIRE

    Hilberman, M.; Kutner, J; Parsons, D; Murphy, D. J.

    1997-01-01

    Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performi...

  8. Enhancing residents’ neonatal resuscitation competency through unannounced simulation-based training

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Surcouf

    2013-03-01

    Full Text Available Background: Almost half of pediatric third-year residents surveyed in 2000 had never led a resuscitation event. With increasing restrictions on residency work hours and a decline in patient volume in some hospitals, there is potential for fewer opportunities. Purpose: Our primary purpose was to test the hypothesis that an unannounced mock resuscitation in a high-fidelity in-situ simulation training program would improve both residents’ self-confidence and observed performance of adopted best practices in neonatal resuscitation. Methods: Each pediatric and medicine–pediatric resident in one pediatric residency program responded to an unannounced scenario that required resuscitation of the high fidelity infant simulator. Structured debriefing followed in the same setting, and a second cycle of scenario response and debriefing occurred before ending the 1-hour training experience. Measures included pre- and post-program confidence questionnaires and trained observer assessments of live and videotaped performances. Results: Statistically significant pre–post gains for self-confidence were observed for 8 of the 14 NRP critical behaviors (p=0.00–0.03 reflecting knowledge, technical, and non-technical (teamwork skills. The pre–post gain in overall confidence score was statistically significant (p=0.00. With a maximum possible assessment score of 41, the average pre–post gain was 8.28 and statistically significant (p<0.001. Results of the video-based assessments revealed statistically significant performance gains (p<0.0001. Correlation between live and video-based assessments were strong for pre–post training scenario performances (pre: r=0.64, p<0.0001; post: r=0.75, p<0.0001. Conclusions: Results revealed high receptivity to in-situ, simulation-based training and significant positive gains in confidence and observed competency-related abilities. Results support the potential for other applications in residency and continuing education.

  9. Resuscitation speed affects brain injury in a large animal model of traumatic brain injury and shock

    DEFF Research Database (Denmark)

    Sillesen, Martin; Jin, Guang; Johansson, Pär I;

    2014-01-01

    infusion speed increment NS (n¿=¿7). Hemodynamic variables over a 6-hour observation phase were recorded. Following euthanasia, brains were harvested and lesion size as well as brain swelling was measured.ResultsBolus FFP resuscitation resulted in greater brain swelling (22.36¿±¿1.03% vs. 15.58¿±¿2.52%, p...

  10. The ethics of cardiopulmonary resuscitation. II. Medical logistics and the potential for good response.

    OpenAIRE

    Davies, J M; Reynolds, B M

    1992-01-01

    Mismatches between provision of paediatric cardiopulmonary resuscitation (CPR) and potential to benefit are examined. Deficiencies are most likely to occur in peripheral maternity units but futile CPR is more common in emergency departments where the child is unknown. Decision making in individual cases is best retained by the medical profession for the sake of the child and family. American style intervention by the legislature is likely to dissipate scarce resources and perhaps harm infants...

  11. Vasopressin combined with epinephrine during cardiac resuscitation: a solution for the future?

    OpenAIRE

    Wenzel, Volker; Lindner, Karl H

    2006-01-01

    Epinephrine given during cardiopulmonary resuscitation (CPR) may cause beta-mimetic complications in the postresuscitation phase. Vasopressin may be an alternative vasopressor drug during CPR. A subgroup analysis of a large prospective CPR investigation and of retrospective CPR studies suggests that vasopressin may be especially beneficial when combined with epinephrine. Beneficial effects of adding vasopressin were observed in other catecholamine-refractory shock states as well, such as vaso...

  12. Investigating Resuscitation Code Assignment in the Intensive Care Unit using Structured and Unstructured Data

    OpenAIRE

    Lojun, Sharon L.; Sauper, Christina J.; Medow, Mitchell; Long, William J.; Mark, Roger G.; Barzilay, Regina

    2010-01-01

    This study investigates the feasibility of using structured data (age, gender, and medical condition), and unstructured medical notes on classification accuracy for resuscitation code status. Data was extracted from the MIMICII database. Natural language processing (NLP) was used to evaluate the social section of the nurses’ progress notes. BoosTexter was used to predict the code-status using notes, age, gender, and Simplified Acute Physiology Score (SAPS). The relative impact of features was...

  13. Assessment of the teaching-learning process in students of the health area: cardiopulmonary resuscitation maneuvers

    OpenAIRE

    Patrícia Moita Garcia Kawakame; Ana Maria Kazue Miyadahira

    2015-01-01

    OBJECTIVETo evaluate the skills and knowledge of undergraduate students in the health area on cardiopulmonary resuscitation maneuvers with the use of an automatic external defibrillator.METHODThe evaluation was performed in three different stages of the teaching-learning process. A theoretical and practical course was taught and the theoretical classes included demonstration. The evaluation was performed in three different stages of the teaching-learning process. Two instruments were applied ...

  14. Resuscitation-induced intestinal edema and related dysfunction: State of the science

    OpenAIRE

    Shah, Shinil K.; Uray, Karen S.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

    2009-01-01

    High volume resuscitation and damage control surgical methods, while responsible for significantly decreasing morbidity and mortality from traumatic injuries, are associated with pathophysiological derangements that lead to subsequent end organ edema and dysfunction. Alterations in hydrostatic and oncotic pressures frequently result in intestinal edema and subsequent dysfunction. The purpose of this review is to examine the principles involved in the development of intestinal edema, current a...

  15. Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improves prehospital cardiac arrest survivial

    OpenAIRE

    Vukmir, R

    2004-01-01

    Methods: This prospective, randomised, double blinded clinical intervention trial enrolled 874 prehospital cardiopulmonary arrest patients encountered in a prehospital urban, suburban, and rural regional emergency medical service (EMS) area. This group underwent conventional advanced cardiac life support intervention followed by empiric early administration of sodium bicarbonate (1 mEq/l), monitoring conventional resuscitation parameters. Survival was measured as presence of vital signs on em...

  16. Invasive strategy in patients with resuscitated cardiac arrest and ST elevation myocardial infarction

    OpenAIRE

    Gorjup, Vojka; Noc, Marko; Radsel, Peter

    2014-01-01

    Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion (“ACS” lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and ...

  17. Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after study

    OpenAIRE

    Johansson, P I; Stensballe, J

    2008-01-01

    Background and Objectives Evidence supporting the use of platelets and plasma in resuscitation of massive bleedings is questionable. Current consensus guidelines recommend restrictive use. Our aim was to determine the effect of changing the transfusion practice on 30-day survival in massively bleeding patients. Materials and Methods Consecutive adult patients receiving more than 10 units of red blood cells (RBC) within 24 h 2 years prior to (2002–2003) and 2 years after (2005–2006) a change i...

  18. Friendship and Aggression in Elementary School. The friendships of aggressive children and the effects of having aggressive friends

    OpenAIRE

    Palmen, J.M.H.

    2009-01-01

    Research has demonstrated the importance of friendship for children’s adjustment (e.g., Ladd, 1990). However, some children may be less capable of maintaining satisfying relationships with their peers. Aggressive children have been found to experience peer relation difficulties (e.g., Dodge, Coie, Pettit, & Price, 1990). Most research on aggression and peer relations has focused on children’s status within the peer group (group interaction), rather than friendship (dyadic interaction). Group ...

  19. RHABDOMYOBLASTS IN CEREBROSPINAL FLUID

    Directory of Open Access Journals (Sweden)

    Deepak Nayak

    2013-01-01

    Full Text Available Rhabdomyosarcoma (RMS is an aggressive soft tissue malignancy, not uncommonly seen in adults. The location of this malignancy is quite ubiquitous. However, a parameningeal location is uncommon and accounts for about 16% of all rhabdomyosarcomas. We report an instance where rhabdomyoblasts were seen infiltrati ng the cerebrospinal fluid (CSF. A 35 year old female patient presented to our hospita l with the primary complaints of bilateral nose block and left sided headache since1 month. Clinically, a deviated nasal septum was diagnosed which needed a septal surgery. Since t he hematological parameters showed a pancytopenia, the surgery was postponed. The patient pr esented 3 weeks later with additional complaints of worsening headache and significant blu rring of vision in her left eye. The MRI scan revealed a midline, dural-based mass. A therape utic tap of the cerebrospinal fluid sent to the clinical laboratory for analysis which showed l arge abnormal cells (figure 1. The bone marrow also showed similar cells, with karyomegaly, dense chromatin, and coalescing vacuoles which were Periodic Acid Schiff (PAS negative. The biopsy from the mass was diagnosed as rhabdomyosarcoma (parameningeal type. Immunohistoc hemistry showed positivity for Myogenin and Myo-D1.

  20. Fluid juggling

    CERN Document Server

    Soto, Enrique

    2013-01-01

    This fluid dynamics video is an entry for the Gallery of Fluid Motion for the 66th Annual Meeting of the Fluid Dynamics Division of the American Physical Society. We show the curious behaviour of a light ball interacting with a liquid jet. For certain conditions, a ball can be suspended into a slightly inclined liquid jet. We studied this phenomenon using a high speed camera. The visualizations show that the object can be `juggled' for a variety of flow conditions. A simple calculation showed that the ball remains at a stable position due to a Bernoulli-like effect. The phenomenon is very stable and easy to reproduce.

  1. Fluid therapy for severe acute pancreatitis in acute response stage

    Institute of Scientific and Technical Information of China (English)

    MAO En-qiang; TANG Yao-qing; FEI Jian; QIN Shuai; WU Jun; LI Lei; MIN Dong; ZHANG Sheng-dao

    2009-01-01

    Background Fluid therapy for severe acute pancreatitis (SAP) should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group (Group I, n=36) and a controlled fluid expansion group (Group Ⅱ, n=40). Hemodynamic disorders were either quickly (fluid infusion rate was 10-15 ml·kg-1·h-1, Group Ⅰ) or gradually improved (fluid infusion rate was 5-10 ml·kg-1·h-1, Group Ⅱ) through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE Ⅱ scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome (ACS), sepsis, and survival rate were obtained. Results The two groups had statistically different (P 0.05). Total amount of fluid sequestration within 4 days was higher in Group Ⅰ ((5378±2751)ml) than in Group Ⅱ ((4215±1998)ml, P<0.05). APACHE Ⅱ scores were higher in Group Ⅰ on days 1,2, and 3 (P<0.05). Rate of mechanical ventilation was higher in group Ⅰ (94.4%) than in group Ⅱ (65%, P<0.05). The incidences of abdominal compartment syndrome (ACS) and sepsis were significantly lower in Group Ⅱ (P <0.05). Survival rate was remarkably lower in Group Ⅰ (69.4%) than in Group Ⅱ (90%, P <0.05). Conclusions Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset.

  2. Differential resuscitative effect of pyruvate and its analogues on VBNC (viable but non-culturable) Salmonella.

    Science.gov (United States)

    Morishige, Yuta; Fujimori, Ko; Amano, Fumio

    2013-01-01

    An environmental isolate of Salmonella Enteritidis (SE), grown to the logarithmic phase, rapidly lost culturability by the addition of 3 mM H2O2 to cultures grown in Luria-Bertani (LB) medium; however, some H2O2-treated bacteria regained their culturability in M9 minimal medium, if sodium pyruvate was present at at least 0.3 mM. In addition, most pyruvate analogues, such as bromopyruvate or phenylpyruvate, did not show restoration activity similar to that of pyruvate, except in the case of α-ketobutyrate. Further analysis of the mechanism underlying the resuscitation by pyruvate revealed that although many of the bacteria showed respiratory activity on CTC (5-cyano-2,3-di-(p-tolyl) tetrazolium chloride) reduction with or without pyruvate, the biosynthesis of DNA and protein synthesis were quite different in the presence or absence of pyruvate, i.e., pyruvate endowed the cells with the ability to incorporate much more radio-label into precursors during the resuscitation process. These results suggest that pyruvate is one of the key molecules working in the resuscitation process by taking bacteria from the non-culturable state to the growing and colony-forming state by triggering the synthesis of macromolecules such as DNA and protein. PMID:23595023

  3. Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice.

    Science.gov (United States)

    Brummell, Stephen P; Seymour, Jane; Higginbottom, Gina

    2016-05-01

    Despite media images to the contrary, cardiopulmonary resuscitation in emergency departments is often unsuccessful. The purpose of this ethnographic study was to explore how health care professionals working in two emergency departments in the UK, make decisions to commence, continue or stop resuscitation. Data collection involved participant observation of resuscitation attempts and in-depth interviews with nurses, medical staff and paramedics who had taken part in the attempts. Detailed case examples were constructed for comparative analysis. Findings show that emergency department staff use experience and acquired tacit knowledge to construct a typology of cardiac arrest categories that help them navigate decision making. Categorisation is based on 'less is more' heuristics which combine explicit and tacit knowledge to facilitate rapid decisions. Staff then work as a team to rapidly assimilate and interpret information drawn from observations of the patient's body and from technical, biomedical monitoring data. The meaning of technical data is negotiated during staff interaction. This analysis was informed by a theory of 'bodily' and 'technical' trajectory alignment that was first developed from an ethnography of death and dying in intensive care units. The categorisation of cardiac arrest situations and trajectory alignment are the means by which staff achieve consensus decisions and determine the point at which an attempt should be withdrawn. This enables them to construct an acceptable death in highly challenging circumstances. PMID:27017090

  4. Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice.

    Science.gov (United States)

    Brummell, Stephen P; Seymour, Jane; Higginbottom, Gina

    2016-05-01

    Despite media images to the contrary, cardiopulmonary resuscitation in emergency departments is often unsuccessful. The purpose of this ethnographic study was to explore how health care professionals working in two emergency departments in the UK, make decisions to commence, continue or stop resuscitation. Data collection involved participant observation of resuscitation attempts and in-depth interviews with nurses, medical staff and paramedics who had taken part in the attempts. Detailed case examples were constructed for comparative analysis. Findings show that emergency department staff use experience and acquired tacit knowledge to construct a typology of cardiac arrest categories that help them navigate decision making. Categorisation is based on 'less is more' heuristics which combine explicit and tacit knowledge to facilitate rapid decisions. Staff then work as a team to rapidly assimilate and interpret information drawn from observations of the patient's body and from technical, biomedical monitoring data. The meaning of technical data is negotiated during staff interaction. This analysis was informed by a theory of 'bodily' and 'technical' trajectory alignment that was first developed from an ethnography of death and dying in intensive care units. The categorisation of cardiac arrest situations and trajectory alignment are the means by which staff achieve consensus decisions and determine the point at which an attempt should be withdrawn. This enables them to construct an acceptable death in highly challenging circumstances.

  5. Fast resuscitation and care of the burn patients by telemedicine: A review

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2014-01-01

    Full Text Available Background: In Iran, burns are the second most common cause of death, after traffic accidents in individuals under the age of 15 years. Many burned patients die or suffer injury due to lack of immediate care, so we need to use an alternative resuscitations to cure them immediately. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients′ health status and care. The aim of this study was to express the advantages of Telemedicine to resuscitate and care burn patients. Materials and Methods: This study was a narrative review. The literature was searched on fast resuscitation and care of the patients′ burn by telemedicine with the help of libraries, databases, and also searches engines available at Google, Google scholar, books and conference proceedings. In our searches, we employed the following keywords and their combinations: Telemedicine, Telecare, Burn, Burn patient, Air transport, Triage and Health Information Management in the searching areas of titles, keywords, abstracts and full texts. Results: In this study, more than 78 articles and reports were collected and 30 of them were selected based on their relevancy. Conclusion: Acute evaluation of burn patients can be performed by the telemedicine and it plays an important role in improving access to the required expertise, and raises physician confidence in treating burn patients. This can reduce under-triage or over-triage for air transport and finally lead to saving time and cost.

  6. Comparative Analysis of Personality Structures of the Perpetrators of Aggressive and Non-aggressive Offense

    Directory of Open Access Journals (Sweden)

    Kalashnikova A.S.,

    2014-11-01

    Full Text Available problem of the emergence of aggressive behavior is seen through the analysis of the relationship of proagressive and inhibiting aggression personality structures. The study involved 54 men serving sentences for criminal offenses, of which 24 were accused for violent offenses and 30 - for offenses without resorting to violence. We used questionnaires to study the proagressive and deterring aggression personality structures. Statistical analysis was performed to reveal significant differences between groups and to determine correlations. On this basis, the correlations were interpreted with the help of not only quantitative but also qualitative analysis. The results showed no significant differences in the level of expression of aggression and aggression inhibitors between treatment groups, but we identified qualitative differences in the structural analysis of data from individual psychological characteristics that are expected to distinguish aggressive offenders from the perpetrators without violence.

  7. Breast Cancers Between Mammograms Have Aggressive Features

    Science.gov (United States)

    Breast cancers that are discovered in the period between regular screening mammograms—known as interval cancers—are more likely to have features associated with aggressive behavior and a poor prognosis than cancers found via screening mammograms.

  8. Research: Television Violence and Aggressive Behavior.

    Science.gov (United States)

    Wurtzel, Alan

    1977-01-01

    Summarizes the major research findings on the relationship between television violence and aggressive behavior; concludes that, while there is no definitive proof that such a relationship exists, the evidence points strongly in that direction. (GT)

  9. Suicidality and aggression during antidepressant treatment

    DEFF Research Database (Denmark)

    Sharma, Tarang; Guski, Louise Schow; Freund, Nanna;

    2016-01-01

    OBJECTIVE: To study serious harms associated with selective serotonin and serotonin-norepinephrine reuptake inhibitors.Design Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Mortality and suicidality. Secondary outcomes were aggressive behaviour and akathisia. DATA SOURCES: Clinical s...

  10. Electronic Aggression: New Technology and Youth Violence

    Science.gov (United States)

    ... Resources Featured Topic: Opportunities for Action Featured Topic: Bullying Research Featured Topic: Prevent Gang Membership Featured Topic: School Violence Data & Statistics Risk & Protective Factors Prevention Prevention Tools & Resources Featured Topic: Electronic Aggression Funded ...

  11. Antibiotics in the management of aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Abinaya Prakasam

    2012-01-01

    Full Text Available Aggressive periodontitis, although not rare, is a fairly unknown condition. Little is known about its optimal management. While majority of patients with common forms of periodontal disease respond predictably well to conventional therapy (oral hygiene instructions (OHI, non-surgical debridement, surgery, and Supportive Periodontal therapy (SPT, patients diagnosed with aggressive form of periodontal disease often do not respond predictably/favorably to conventional therapy owing to its complex multi-factorial etiology. Protocols for treating aggressive periodontitis are largely empirical. There is compelling evidence that adjunctive antibiotic treatment frequently results in more favorable clinical response than conventional therapy alone. This article mainly focuses on the role of adjunct use of pharmacological agents in improving the prognosis and treatment outcome of aggressive periodontitis patients.

  12. Risperidone for Aggressive Behavior in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-05-01

    Full Text Available The effects of risperidone augmentation for treatment-resistant aggression in children with ADHD were evaluated in a placebo-controlled pilot study at the University of Miami Miller School of Medicine, FL.

  13. Fluid dynamics

    CERN Document Server

    Bernard, Peter S

    2015-01-01

    This book presents a focused, readable account of the principal physical and mathematical ideas at the heart of fluid dynamics. Graduate students in engineering, applied math, and physics who are taking their first graduate course in fluids will find this book invaluable in providing the background in physics and mathematics necessary to pursue advanced study. The book includes a detailed derivation of the Navier-Stokes and energy equations, followed by many examples of their use in studying the dynamics of fluid flows. Modern tensor analysis is used to simplify the mathematical derivations, thus allowing a clearer view of the physics. Peter Bernard also covers the motivation behind many fundamental concepts such as Bernoulli's equation and the stream function. Many exercises are designed with a view toward using MATLAB or its equivalent to simplify and extend the analysis of fluid motion including developing flow simulations based on techniques described in the book.

  14. Desensitization to Media Violence: Links With Habitual Media Violence Exposure, Aggressive Cognitions, and Aggressive Behavior

    OpenAIRE

    Krahé, Barbara; Möller, Ingrid; Huesmann, L. Rowell; Kirwil, Lucyna; Felber, Juliane; Berger, Anja

    2011-01-01

    This study examined the links between desensitization to violent media stimuli and habitual media violence exposure as a predictor and aggressive cognitions and behavior as outcome variables. Two weeks after completing measures of habitual media violence exposure, trait aggression, trait arousability, and normative beliefs about aggression, undergraduates (N = 303) saw a violent film clip and a sad or a funny comparison clip. Skin conductance level (SCL) was measured continuously, and ratings...

  15. The impact of classroom aggression on the development of aggressive behavior problems in children

    OpenAIRE

    Thomas, Duane E.; Bierman, Karen L.

    2006-01-01

    Prior research suggests that exposure to elementary classrooms characterized by high levels of student aggression may contribute to the development of child aggressive behavior problems. To explore this process in more detail, this study followed a longitudinal sample of 4,907 children and examined demographic factors associated with exposure to high-aggression classrooms, including school context factors (school size, student poverty levels, and rural vs. urban location) and child ethnicity ...

  16. Pigs’ aggressive temperament affects pre-slaughter mixing aggression, stress and meat quality

    OpenAIRE

    D'Eath, Rick B.; Turner, S.P.; Kurt, E.; Evans, G; Thölking, L.; Looft, H.; Wimmers, K.; Murani, E.; Klont, R.; Foury, Aline; Ison, S.H.; Lawrence, A.B.; Mormède, Pierre

    2010-01-01

    Pre-slaughter stress has a negative impact on animal welfare and on meat quality. Aggressive behaviour when pigs are mixed together for transportation to, or on arrival at, the abattoir is an important factor in pre-slaughter stress. Aggressiveness of pigs varies between individuals in the population, and this study investigated its effects on stress and meat quality at slaughter We mixed pigs at a young age to identify individuals of high (H) or low (L) aggressive temperament using the previ...

  17. Comparative Analysis of Personality Structures of the Perpetrators of Aggressive and Non-aggressive Offense

    OpenAIRE

    Kalashnikova A.S.,; Vasilenko T.G.

    2014-01-01

    problem of the emergence of aggressive behavior is seen through the analysis of the relationship of proagressive and inhibiting aggression personality structures. The study involved 54 men serving sentences for criminal offenses, of which 24 were accused for violent offenses and 30 - for offenses without resorting to violence. We used questionnaires to study the proagressive and deterring aggression personality structures. Statistical analysis was performed to reveal significant differences b...

  18. DECLARED AGGRESSION AND AGGRESSIVENESS IN HANDBALL PLAYERS IN COMPARISON WITH REFERENCE GROUPS

    OpenAIRE

    Jasiński, Tadeusz

    2007-01-01

    Aim of this study was comparison of declared aggression and aggressiveness in boys training handball, where aggressive reactions not provided for in regulations are condemned and punished, with their level in schoolchildren participating only in the physical education lessons. The study involved altogether 146 male participants, aged between 12 to 33 years. The participants were divided into three groups. The first (G1) was formed out of sports club Orlen handball players (40 competitors). Re...

  19. How Food Controls Aggression in Drosophila

    OpenAIRE

    Rod S Lim; Eyrún Eyjólfsdóttir; Euncheol Shin; Pietro Perona; Anderson, David J.

    2014-01-01

    How animals use sensory information to weigh the risks vs. benefits of behavioral decisions remains poorly understood. Inter-male aggression is triggered when animals perceive both the presence of an appetitive resource, such as food or females, and of competing conspecific males. How such signals are detected and integrated to control the decision to fight is not clear. For instance, it is unclear whether food increases aggression directly, or as a secondary consequence of increased social i...

  20. Hormones and aggression in childhood and adolescence

    OpenAIRE

    Ramirez, J. Martin

    2003-01-01

    This review is a survey on recent psychobiosocial studies on association between hormones and aggression/violence in children and adolescents, with a special focus on puberty, given the rapid changes in both hormones and behavior occurring during that developmental period. Since it cannot be assumed that all readers have much background knowledge, it inevitably begins with some comments about the concept and multifaceted nature of aggression, as well as with a brief reminding about hormone ca...