BACKGROUNDTherapeutic hypothermia has been recommended for the treatment of cardiac arrest patients who remain comatose after the return of spontaneous circulation. The aim of this study was to evaluate the effectiveness and safety of mild hypothermia on patients with cardiac arrest by conducting a meta-analysis.

METHODSThe relevant trials were searched in Cochrane Library, PubMed, Web of Science, Embase, CNKI and Wan Fang Data from the date of their establishment to October 2014. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria. Data were extracted, and the quality of the included studies was evaluated. A meta-analysis was conducted using the Cochrane Collaboration Review Manager 5.2 software.

RESULTSSix randomized controlled trials involving 531 cases were included, among which 273 cases were assigned to the treatment group and the other 258 cases to the control group. The meta-analysis indicated that mild hypothermia therapy after cardiac arrest produced significant differences in survival rate (relative risk [RR] =1.23, 95% confidence interval [CI]: 1.02-1.48, P = 0.03) and neurological function (RR = 1.33, 95% CI: 1.08-1.65, P = 0.007) after 6 months compared with normothermia therapy. However, no significant differences were observed in the survival to the hospital discharge (RR = 1.35, 95% CI: 0.87-2.10, P = 0.18), favorable neurological outcome at hospital discharge (RR = 1.53, 95% CI: 0.95-2.45, P = 0.08) and adverse events.

CONCLUSIONSThe meta-analysis demonstrated that mild hypothermia can improve the survival rate and neurological function of patients with cardiac arrest after 6 months. On the other hand, regarding the survival to hospital discharge, favorable neurological outcome at hospital discharge, and adverse events, our meta-analysis produced nonsignificant results.

PURPOSE: This study compared the effectiveness and ease of operation of two different training methods, response sequence based training (RBST) and chest compression first training (CCFT), for cardiopulmonary resuscitation (CPR). METHODS: Eighty-five railroad workers were divided into two groups: those who applied the usual CPR training method (response sequence based training, 44 people) and those who applied our CPR training method (chest compression first training, 41 people). The objective skill performances were evaluated by using a mannequin (JAMY-IV RECO, Kyotokagaku, Japan). RESULTS: There was no statistical difference in CPR performance and artificial ventilation success rate between the RSBT group and the CCFT group. However, the artificial compression success rate and compression depth of the CCFT group compared to the RSBT group was statistically higher (p=0.006, 0.001). In addition, the wrong-hand-position rate of the RSBT group compared to the CCFT group was statistically higher (p=0.000). Furthermore, instructor satisfaction with practical training operations in the CCFT group compared to the RSBT group was statistically higher (p=0.001) and instructors reported that students were focused and easily capable of performing the CCFT training method. CONCLUSION: The chest compression first training method is easy to perform and not too complex to operate, making it effective in student performance and instruction. More effective CPR training is expected based on this method.
Cardiopulmonary Resuscitation* ; Education ; Humans ; Manikins ; Methods* ; Railroads ; Teaching ; Thorax ; Ventilation

PURPOSE: The purpose of this study was to examine the effects of an infant cardiopulmonary resuscitation (CPR) training program that applied the 5-step method on the knowledge, attitudes, and performance ability of nursing students in terms of enhancement and sustainability. METHODS: Sixty-one nursing students (28 in the experimental group and 33 in the control group) from D city participated in this study. Data were collected from April 25 to December 15, 2016. The experimental group and control group received infant CPR education using the 5-step method and the traditional method, respectively. The outcome variables were measured 3 times (pretest and posttest at 1 week and 6 months after training). RESULTS: There were significant differences in attitude (t=2.68, p=.009) and performance ability (t=4.56, p < .001) between the groups at 1 week after training, as well as in sustained performance ability at 6 months after training (F=6.76, p=.012). CONCLUSION: The 5-step method of infant CPR training was effective for improving performance ability in a sustained manner and promoting a positive attitude. Therefore, it is recommended that nursing students, as infant CPR novices, receive training using this effective method.
Cardiopulmonary Resuscitation* ; Education ; Humans ; Infant* ; Methods* ; Nursing* ; Students, Nursing

To realize the measurement of the chest compression depth during the administration of manual cardiopulmonary resuscitation, two 3-axis digital accelerometers were applied for chest compression acceleration and environment acceleration acquisition, with one placed in the chest compression sensor pad, and the other placed in the back sensor pad. Then double integration was made for the acceleration-to-depth conversion with both of the accelerations after preprocessing. The method further included integration reset mechanism based on compression force, with the force point of a pre-determined threshold and the maximum force point as the starting point and the ending point of the integration, respectively. Moreover, a software compensation algorithm was implemented to further increase the accuracy of the depth estimation and reliability of the acceleration. The final performance of the compression depth estimation is within +/- 0.6 cm with 95% confidence of a total of 283 compressions. Accurate and real-time estimation of chest compression depth greatly facilitates the control of compression depth for the lifesaver during manual cardiopulmonary resuscitation.
Acceleration ; Cardiopulmonary Resuscitation ; instrumentation ; methods ; Heart Arrest ; therapy ; Heart Massage ; methods ; standards ; Humans ; Pressure ; Thorax

Targeted temperature management (TTM) has been partially applied in patients with restoration of spontaneous circulation (ROSC) after cardiac arrest (CA). In the 2020 American Heart Association (AHA) cardiopulmonary resuscitation (CPR) guidelines, TTM is used as advanced life support after ROSC for the treatment of patients with CPR. TTM has a protective effect on cardiac function after CA, but the specific mechanism of its protective effect on cardiac function remains unclear. In this paper, the basic experimental progress, clinical trial progress and development prospect of TTM on the protective mechanism of cardiac function after CA are reviewed.
United States ; Humans ; Cardiopulmonary Resuscitation/methods* ; Temperature ; Heart Arrest/therapy* ; Hypothermia, Induced/methods* ; Body Temperature

PURPOSE: The purpose of this study was to develop a first aid coaching program (FACP) and to investigate its effects on the first aid knowledge, confidence, and performance of childcare teachers. METHODS: A Delphi survey that included 16 experts was used to develop the FACP. A total of 60 participants were included to test the effectiveness of the program. The FACP developed using the survey results focused on improving first aid knowledge, confidence, and performance using a coaching-based method. First aid and cardiopulmonary resuscitation (CPR) performance was assessed using 39 items from the program content. RESULTS: Using a 3-round Delphi survey, 6 areas and 42 detailed topics for group and individual coaching programs were developed. The knowledge scores were significantly higher in the experimental group than in the control group (t=4.24, p=.001). The confidence scores were significantly higher in the experimental group than in the control group (F=3.89, p < .001). The performance scores were significantly higher in the experimental group than in the control group (t=12.40, p < .001). CONCLUSION: Continuous application of the FACP among child care teachers is expected to minimize the harm caused by minor accidents at child care facilities. This program should be formally implemented on a consistent basis.
Cardiopulmonary Resuscitation ; Child ; Child Care* ; Child* ; Delphi Technique ; First Aid* ; Health Education ; Humans ; Methods

BACKGROUND: In breast surgery, regional anesthesia rather than primary anesthesia has been mainly used for postoperative analgesia. Serratus anterior plane block is a new method for ultrasound-guided thoracic wall block. It is less invasive and relatively safer than conventional regional anesthetic techniques. CASE: We report a case of breast surgery under serratus anterior plane block as primary anesthesia with monitored anesthesia for a 78-year-old patient with a medical history of cardiopulmonary resuscitation due to stress-induced cardiomyopathy caused by pneumonia. CONCLUSIONS: Serratus anterior plane block might be simple and effective technique for breast surgery when a lesion is located on lateral side.
Aged ; Analgesia ; Anesthesia ; Anesthesia, Conduction ; Breast ; Cardiomyopathies ; Cardiopulmonary Resuscitation ; Humans ; Methods ; Pneumonia ; Thoracic Wall

OBJECTIVETo establish a good recoverable rat model of cardiopulmonary bypass (CPB) to lay the foundation for studying the pathophysiology of CPB.

METHODSTwenty adult male Sprague-Dawley rats weighing 480 g+/-20 g were randomly divided into CPB group (n equal to 10) and Sham group (n equal to 10). All rats were anaesthetized, intubated and ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular vein and further transferred by a miniaturized roller pump to a hollow fiber oxgenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 6 ml of colloid. The surface of the hollow fiber oxgenator was 0.075 m(2). Rats were catheterized and brought in bypass for 120 min at a flow rate of 100-120 ml/kg/min. Oxygen flow/perfusion flow was 0.8 to 1.0, the mean arterial pressure (MAP) kept in 60-80 mmHg. Blood gas analysis, lactate dehydrogenase (LDH), and survival rate were examined subsequently.

RESULTSAll CPB rats recovered from the operative process without incident and remained uneventful within one week. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. MAP remained stable. The results of blood gas analysis at different time points were within a normal range. No significant haemolysis could be detected in the given time frame under bypass condition by using LDH.

CONCLUSIONSThe rat model of CPB can principally simulate the clinical setting of human CPB. The non-transthoracic model is easy to establish and is associated with excellent recovery. This well reproducible model may open the field for various studies on pathophysiological process of CPB and also of systemic ischemia-reperfusion injury in vivo.

PURPOSE: The delivery of optimal respiration rate (RR) and tidal volume (TV) is a challenging issue during cardiopulmonary resuscitation (CPR). Amflow is a newly designed feedback device to optimize ventilation. The aim of study is to verify the efficacy of this device for delivering the correct RR and TV during simulated CPR. METHODS: This prospective, random cross-over designed study included a total of 40 participants who were trained for ventilation method. Using the self-inflating bags with Amflow and without Amflow, participants delivered 5-min of ventilations to test the lungs connected to gas flow analyzers. The correct RR and TV were defined as 10 breaths/min and 500-600 mL, respectively. RESULTS: For RRs during CPR, the Amflow group showed significantly higher proportions of delivering the correct RR (99.0%, 198/200) than the control group (ventilation without Amflow) (12.0%, 24/200) (p<0001). For TVs, the mean TVs were higher in the control group (535.4±87.9) than in the Amflow group (505.4±39.1) (p<0.001). Proportions of delivering the correct TVs were higher in the Amflow group (56.9%, 1,137/1,999) than in the control group (46.4%, 929/2,003) (p<0.001). CONCLUSION: Amflow could be useful in delivering the correct RR and TV for ventilations using bag-mask bags during CPR.
Cardiopulmonary Resuscitation* ; Cross-Over Studies ; Lung ; Methods ; Prospective Studies ; Respiratory Rate ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical

PURPOSE: Dispatcher-assisted telephone instruction during cardiopulmonary resuscitation (CPR) improves the quality of CPR performed by laypersons. However, in Korea, CPR instruction guidelines for bystanders have not made. We therefore studied the effects of verbal instruction on the quality of chest compression. METHODS: Data from two randomized, double-blinded, controlled trials using identical methodology were combined to obtain 175 records for analysis. Subjects were randomized into either a "push as hard as you can and fast" (n=87) or "push down 5~6 cm, 100~120 rate/min" (n=88), verbal instructions in the 2011 Korea Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). Data were recorded via a Resusci(R) Anne SkillReporter(TM), Laerdal Medical mannequin. Primary outcome measures included chest compression depth and chest compression rate per minute. RESULTS: The average compression depth and speed of chest compressions did not significantly differ between the two verbal instructions. CONCLUSION: The verbal istructions provided by telephone based on the 2011 Korean Guidelines for CPR and ECC are not effective. The instructions for high quality CPR of layperson should therefore be studied.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart Massage ; Korea ; Manikins ; Methods ; Outcome Assessment (Health Care) ; Telephone* ; Thorax ; Verbal Learning