Current American Heart Association guidelines recommend standardized interval administration of epinephrine for patients in cardiac arrest. The objective of this study was to compare short-term survival using a hemodynamic directed resuscitation strategy versus chest compression depth-directed cardiopulmonary resuscitation in a porcine model of cardiac arrest. Design: Randomized interventional study.
Setting: Preclinical animal laboratory. Subjects: Twenty-four 3-month-old female swine. MK-1775 ic50 Interventions: After 7 minutes of ventricular fibrillation, pigs were randomized to receive one of three resuscitation strategies: 1) Hemodynamic directed care (coronary perfusion pressure-20): chest compressions with depth titrated to a target systolic blood pressure of 100 mm Hg and titration of vasopressors to maintain coronary perfusion pressure greater than 20 mm Hg; 2) Depth 33 mm: target chest compression depth of 33 mm with standard American Heart Association epinephrine dosing; or 3) Depth 51 mm: target chest compression depth of 51 mm with standard American Heart Association epinephrine dosing. All animals received manual cardiopulmonary resuscitation guided by audiovisual feedback for 10 minutes before first shock. Measurements and Main Results: Forty-five-minute survival was higher in the coronary perfusion
pressure-20 VX 809 group (8 of 8) compared to depth 33 mm (1 of 8) or depth 51 mm (3 of 8) groups; p equals to 0.002. Coronary perfusion pressures were higher in the coronary perfusion pressure-20 group compared to depth 33 p53 inhibitor mm (p = 0.004) and depth 51 mm (p = 0.006) and in survivors compared to nonsurvivors (p smaller than 0.01). Total epinephrine dosing and defibrillation attempts were not different. Conclusions: Hemodynamic directed resuscitation targeting coronary perfusion pressures greater
than 20 mm Hg during 10 minutes of cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest improves short-term survival, when compared to resuscitation with depth of compressions guided to 33 mm or 51 mm and standard American Heart Association vasopressor dosing.”
“Background: This study aims to review our surgical results of elastofibroma dorsi. Methods: Between January 2005 and December 2012, a total of 42 patients (33 females, 9 males; mean age 59.7 years; range 31 to 77 years) who were operated in our clinic were included. All patients were admitted with complaints of pain, swelling or limited range of motions of the shoulder range except two cases who underwent thoracotomy for other reasons. Twenty three patients (55%) had bilateral tumors. All patients were operated. Results: Postoperative complications were seroma in six patients, pneumothorax in one and local recurrence in one at eight months.