Arizona researchers have added another piece to the mounting body of evidence that suggests during resuscitation efforts to treat patients in cardiac arrest, "passive ventilation" significantly increases survival rates, compared to the widely practiced "assisted ventilation."
The study, published in an online edition of Annals of Emergency Medicine, compared the numbers of patients who had suffered a cardiac arrest outside a hospital setting and were resuscitated in the field by Emergency Medical Services personnel. Rescuers used either bag-valve-mask ventilation, which forces air into the patient's lungs, or facemasks with a continuous flow of oxygen, which work in a similar fashion to those carried on airplanes in case the cabin pressure drops.
Among the 1,019 adult out-of-hospital cardiac arrest patients in the analysis, 459 received passive ventilation and 560 received bag-valve-mask ventilation. Neurologically normal survival after witnessed cardiac arrest with a shockable heart rhythm was higher for the passive oxygen flow method (38.2 percent) than bag-valve-mask ventilation (25.8 percent).
"These results are strikingly similar to earlier observations from Wisconsin, where survival rates went up from 15 percent to 38 percent after paramedics abandoned the official guidelines for the modified protocol that we developed," says Gordon A. Ewy, MD, a co-author of the study and director of the Sarver Heart Center at The University of Arizona College of Medicine. The Sarver Heart Center's Resuscitation Research Group developed a modified protocol for treating out-of-hospital cardiac arrest called Cardiocerebral Resuscitation, as opposed to Cardiopulmonary Resuscitation, which should be reserved for respiratory arrest (such as near-drowning or drug overdose).
Under the new concept, first tested in Wisconsin, EMS personnel no longer intubated the patient for ventilation. Instead, they applied a facemask delivering a continuous, low-pressure flow of oxygen.
"Our findings provide compelling evidence that positive pressure ventilation is not optimal in the initial management of out-of-hospital cardiac arrest," says lead author Bentley Bobrow, MD, emergency physician at Maricopa Medical Center in Phoenix and associate professor of emergency medicine at the UA College of Medicine. "The work from our EMS providers in Arizona further questions the longstanding dogma of tracheal intubation and ventilation for cardiac arrest.
"We are most pleased that while we are helping to advance the science of resuscitation, we are saving more victims of cardiac arrest in Arizona than ever before," adds Dr. Bobrow, who also is the medical director for the Arizona Department of Health Services Bureau of Emergency Medical Services.
"This study reinforces our belief that survival of out-of-hospital cardiac arrest has more to do with circulating the blood through quality and uninterrupted chest compressions than with ventilation," Dr. Ewy adds.
Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin
Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....
Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....
An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.
We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.
Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...
An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...
24.05.2017 | Event News
23.05.2017 | Event News
22.05.2017 | Event News
26.05.2017 | Life Sciences
26.05.2017 | Life Sciences
26.05.2017 | Physics and Astronomy