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PubMed2006

Fluid resuscitation with hemoglobin-vesicle solution does not increase hypoxia or inflammatory responses in moderate hemorrhagic shock.

The aim of the present study was to compare the hypoxic and inflammatory effects of transfusing hemoglobin-vesicles (HbV) or lactated Ringer's (LR) solution on several organs in a hemorrhagic shock model. Hemorrhagic shock was induced in 48 anesthetized rats by withdrawing 28 mL/kg blood. The animals were resuscitated by replacing the blood with an equal volume of HbV solution or three times the volume of LR solution. The heart, lung, liver, kidney and spleen were extracted at different time points following resuscitation, and mRNA expression levels of hypoxia-induced factor 1-alpha (HIF-1alpha) and tumor necrosis factor-alpha (TNF-alpha) were determined. Blood lactate concentrations in the HbV group rapidly returned to baseline levels, whereas elevated lactate concentrations in the LR group were prolonged. There were no significant differences between the two resuscitation groups in terms of HIF-1alpha and TNF-alpha expression in the organs examined. HIF-1alpha and TNF-alpha expression in the lungs was significantly greater than in other organs. Our results suggest that resuscitation from hemorrhagic shock with HbV did not increase hypoxic or inflammatory effects in major organs, compared with resuscitation using LR solution, despite prolonged elevation of blood lactate.

Animals↗
PubMed2005

[Controversies about the resuscitation of extremely preterm infants in the delivery room].

OBJECTIVE: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in the delivery room. SOURCES OF DATA: Systematic review including articles from MEDLINE, SciELO and Cochrane Library, and abstracts published in national and international proceedings, using the keywords resuscitation, asphyxia, and newborn infant. SUMMARY OF THE FINDINGS: The main controversies concern the oxygenation and ventilation of extremely low birth weight infants. The effects of oxygen concentrations between 21 and 100% need to be addressed. Appropriate inspiratory pressure, lung volume, and positive end-expiratory pressure parameters also need to be established in order to decrease barotrauma and volutrauma. The benefits of nasal continuous positive airway pressure may be determined through randomized clinical trials. On top of that, manual resuscitation devices have to be developed in order to optimize these ventilatory parameters and to reduce lung injury. So far, clinical trials on the administration of epinephrine, volume expanders, and sodium bicarbonate to extremely low birth weight infants have not been published. In addition, the main ethical dilemma concerns the decision of health professionals and parents not to initiate resuscitation procedures at very low gestational ages. CONCLUSIONS: In the future, guidelines may be modified based on the results of randomized and controlled clinical trials, as well as neurodevelopmental follow-up studies, involving extremely low birth weight infants submitted to resuscitation procedures in the delivery room.

Delivery Rooms↗
PubMedDate not supplied

Resuscitation with diaspirin crosslinked hemoglobin increases cerebral and renal blood perfusion in hemorrhaged rats.

Diaspirin crosslinked hemoglobin (DCLHb Baxter Healthcare Corp., Round Lake, IL, USA), a hemoglobin-based blood substitute has been found to be an effective resuscitative agent following hemorrhage in animals. The present study was undertaken to determine the effect of DCLHb on microvascular perfusion in the brain and kidney following hemorrhage in anaesthetized, male Sprague Dawley rats using laser Doppler flowmetry. Hemorrhage was induced by withdrawal of arterial blood at a rate of 0.5 to 1.0 ml/min until blood pressure of 35-40 mmHg was achieved. This was maintained for up to 30 min. The arterial blood pH, pO2, pCO2 and total hemoglobin (THb) were monitored. Hemorrhage significantly decreased pH, pCO2 and THb and increased pO. Hemorrhage significantly decreased (26%) brain blood perfusion due to a decrease (17%) in the concentration of moving red blood cells (CMBC). In the kidney there was a greater decrease (65%) in blood perfusion due to a significant decrease in both CMBC (28%) and red blood cell velocity (49%). Resuscitation with vehicle (Ringer's lactate, 4 ml/kg, i.v.) did not produce any improvement in cerebral and renal blood perfusion. Resuscitation with DCLHb (400 mg/kg, i.v.) improved perfusion in the brain (112%) due to an increase in the CMBC (69%) and the velocity of red blood cells (33%). Similarly, in the kidney, DCLHb increased perfusion (178%) by increasing CMBC (55%) and red blood cell velocity (89%) of hemorrhaged rats. The increase in renal blood perfusion was more marked (p < 0.001) than the changes in cerebral blood perfusion following resuscitation with DCLHb in hemorrhaged rats. It is concluded that DCLHb can significantly increase cerebral and renal blood perfusion of hemorrhaged rats and this effect may contribute to its efficacy as a resuscitative solution.

Acid-Base Equilibrium↗
PubMed1993

Traumatic brain injury, hemorrhagic shock, and fluid resuscitation: effects on intracranial pressure and brain compliance.

Intracranial hypertension following traumatic brain injury is associated with considerable morbidity and mortality. Hemorrhagic hypovolemia commonly coexists with head injury in this population of patients. Therapy directed at correcting hypovolemic shock includes vigorous volume expansion with crystalloid solutions. It is hypothesized that, following traumatic brain injury, cerebrovascular dysfunction results in rapid loss of brain compliance, resulting in increased sensitivity to cerebrovascular venous pressure. Increased central venous pressure (CVP) occurring with vigorous crystalloid resuscitation may therefore contribute to the loss of brain compliance and the development of intracranial hypertension. The authors tested this hypothesis in miniature swine subjected to traumatic brain injury, hemorrhage, and resuscitation. Elevated CVP following resuscitation from hemorrhage to a high CVP significantly worsened intracranial hypertension in animals with concurrent traumatic brain injury, as compared to animals subjected to traumatic brain injury alone (mean +/- standard error of the mean: 33.0 +/- 2.0 vs. 20.0 +/- 2.0 mm Hg, p < 0.05) or to animals subjected to the combination of traumatic brain injury, hemorrhage, and resuscitation to a low CVP (33.0 +/- 2.0 vs. 24.0 +/- 2.0 mm Hg, p < 0.05). These data support the hypothesis that reduction in brain compliance can occur secondary to elevation of CVP following resuscitation from hemorrhagic shock. This may worsen intracranial hypertension in patients with traumatic brain injury and hemorrhagic shock.

Animals↗
PubMed1996

Factors associated with do-not-resuscitate orders: patients' preferences, prognoses, and physicians' judgments. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.

BACKGROUND: Medical treatment decisions should be based on the preferences of informed patients or their proxies and on the expected outcomes of treatment. Because seriously ill patients are at risk for cardiac arrest, examination of do-not-resuscitate (DNR) practices affecting them provides useful insights into the associations between various factors and medical decision making. OBJECTIVE: To examine the association between patients' preferences for resuscitation (along with other patient and physician characteristics) and the frequency and timing of DNR orders. DESIGN: Prospective cohort study. SETTING: 5 teaching hospitals. PATIENTS: 6802 seriously ill hospitalized patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) between 1989 and 1994. MEASUREMENTS: Patients and their surrogates were interviewed about patients' cardiopulmonary resuscitation preferences, medical records were reviewed to determine disease severity, and a multivariable regression model was constructed to predict the time to the first DNR order. RESULTS: The patients' preference for cardiopulmonary resuscitation was the most important predictor of the timing of DNR orders, but only 52% of patients who preferred not to be resuscitated actually had DNR orders written. The probability of surviving for 2 months was the next most important predictor of the timing of DNR orders. Although DNR orders were not linearly related to the probability of surviving for 2 months, they were written earlier and more frequently for patients with a 50% or lower probability of surviving for 2 months. Orders were written more quickly for patients older than 75 years of age, regardless of prognosis. After adjustment for these and other influential patient characteristics, the use and timing of DNR orders varied significantly among physician specialties and among hospitals. CONCLUSIONS: Patients' preferences and short-term prognoses are associated with the timing of DNR orders. However, the substantial variation seen among hospital sites and among physician specialties suggests that there is room for improvement. In this study, DNR orders were written earlier for patients older than 75 years of age, regardless of prognosis. This finding suggests that physicians may be using age in a way that is inconsistent with the reported association between age and survival. The process for making decisions about DNR orders needs to be improved if such orders are to routinely and accurately reflect patients' preferences and probable outcomes.

Aged↗
PubMed1995

Neonatal Resuscitation Program and Pediatric Advanced Life Support.

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 Support course focuses on early recognition and treatment of respiratory failure and shock. The possibility of improving outcome with properly trained prehospital providers is a topic of interest. Intubation in the field can be successful and may contribute to a reduction in mortality, although complications of field intubation need to be reduced.

Cardiopulmonary Resuscitation↗
PubMed1999

[The teaching of basic pediatric cardiopulmonary resuscitation in the degree course in medicine and surgery].

OBJECTIVE: The aim of this study was to analyze the effectiveness of pediatric cardiopulmonary resuscitation training of medical students in pediatric basic life support (PBLS) courses. PATIENTS AND METHODS: Between 1995 and 1998, four theoretical and practical PBLS courses were given to 304 fifth and sixth-year medical students. The theoretical classes provided conceptual information about cardiorespiratory arrest and prevention, basic cardiopulmonary resuscitation maneuvers and practice sessions in basic cardiopulmonary resuscitation of infants and older children to groups of 6 to 8 students. At the beginning of the course, students took a theoretical test that consisted of 10 or 20 multiple-choice questions. At the end of the course, the theoretical test was repeated and a practical test of basic cardiopulmonary resuscitation skills for infants and children was given. Students evaluated the course by completion of an anonymous written questionnaire. RESULTS: The mean initial score (out of a maximum of 10) was 6.4 and the mean score on the final theoretical test was 9.6 (p < 0.001). The practical evaluation showed that 95% of the students mastered the skills of the basic pediatric cardiopulmonary resuscitation maneuvers. The student evaluation of the course yielded scores (on a scale of 5 points) of 4.4 for the theoretical classes, 4.4 for presentation, 4.7 for practical classes and 4.8 for professors' teaching skills. CONCLUSIONS: The pediatric basic life support courses were a useful method for providing theoretical-practical training to students of medicine and should be an essential part of the pediatric curricula in medical studies.

Cardiopulmonary Resuscitation↗
PubMed1999

History of neonatal resuscitation. Tales of heroism and desperation.

Although the history of neonatal resuscitation is as old as medicine itself, today's standards of practice evolved over the past 40 years. Most ancient physicians and midwives did know that stimulation and expansion of lungs was needed to revive the "apparently dead" newborn, but the means of providing these 'therapies' varied from brutal shaking, hitting, swinging, electrocuting, hanging upside-down to applying gentle pressures or squeezing of the chest. It would take centuries of development in physiological concepts and technology for the evolution of a rational approach in resuscitating the newborn infant. Even after great advances in medical science in the 19th century, cardiopulmonary resuscitation techniques remained primitive until the mid-1950s. In this article the author has traced some elements of cardiopulmonary resuscitation techniques and developed an outline of the history of neonatal resuscitation.

Fetal Death↗
PubMed2000

Current status of burn resuscitation.

Rapid assessment and management of airway and breathing problems are required in the patient with severe burns complicated by significant facial burns and inhalation injury. A policy that results in intubation of all patients at potential risk for airway compromise can be both foolish and dangerous. At the same time, it is recognized that intubation of patients who are likely to develop unstable airways is necessary if transport times to burn centers are long and if i.v. resuscitation is initiated during transport. The ideal burn resuscitation formula does not exist. Whichever formula is used, patients must be monitored closely and the fluid resuscitation individualized according to their responses. Patients with delay in resuscitation, associated trauma, inhalation injury, or alcohol abuse may require fluid resuscitations greater than those predicted. The goal is to maintain urine outputs in the range of 0.5 to 1 mL/kg/hr for adults and 1 to 1.5 mL/kg/hr in children. In patients with fluid requirements greater than 150% of that predicted by formula, the addition of colloid at 12 hours can reduce total fluid requirements and burn edema. Early placement of pulmonary artery catheters can be useful in patients with known myocardial dysfunction, age greater than 65 years, severe inhalation injury, or fluid requirements greater than 150% of that predicted by formula.

Adult↗
PubMed2000

Use of nursing resources and comfort of cancer patients with and without do-not-resuscitate orders in the intensive care unit.

BACKGROUND: Little is known about the level of comfort experienced by cancer patients with do-not-resuscitate orders and how use of nursing resources affects their comfort. OBJECTIVE: To explore the relationship between use of nursing resources and comfort in cancer patients with and without do-not-resuscitate orders in the intensive care unit. METHODS: The sample consisted of 30 adult patients who had do-not-resuscitate orders and 30 randomly selected patients who did not. Pairs consisting of 1 patient from each group were admitted to the study simultaneously and were evaluated during the same observation period. Level of comfort was assessed by using the PACU Behavioral Pain Rating Scale. Data on use of nursing resources, determined with the Therapeutic Intervention Scoring System, and on demographics and severity of illness were abstracted from the medical records. RESULTS: Chi-square analyses revealed no significant relationship between comfort and use of nursing resources. Differences between the 2 types of patients in comfort and in use of resources were not significant. Evaluation of the multivariate relationship between comfort and use of resources, with do-not-resuscitate status added as a further predictor variable, revealed no significant relationships. Severity of illness and a patient's number of visitors were predictors of use of nursing resources. CONCLUSIONS: Despite high use of nursing resources, nurses continue to focus on comfort as an outcome of care irrespective of patients' do-not-resuscitate status.

Adolescent↗
PubMed2000

[Resuscitation of newborn infants with room air or oxygen].

In this article we present results from the Resair 2 study in which we tested whether room air is more efficient than 100% oxygen in newborn resuscitation. Eleven participating centres in Egypt, Estonia, India, Norway, Philippines, and Spain recruited 609 infants who needed resuscitation at birth; of these, 288 were resuscitated with room air and 321 with 100% oxygen. There were no differences between the two groups with regard to outcome. One minute Apgar scores were significantly lower in the oxygen group than in the room air group. Median time to first breath was significantly delayed with 24 seconds in the oxygen group compared with the room air group. It seems that 100% oxygen depresses ventilation in newborn infants. Room air is as safe and efficient as 100% oxygen at least in most cases of newborn resuscitation. Further studies confirming these results are needed before new resuscitation routines are implemented.

Acid-Base Equilibrium↗
PubMed2001

Noncompliance of health care workers with universal precautions during trauma resuscitations.

BACKGROUND: Universal precautions during resuscitations are mandated by hospital regulations. We documented adherence to universal precautions during trauma resuscitations at our level I trauma center. METHODS: During trauma resuscitations, a medical student using an elevated viewing platform observed health care workers (HCWs) for the use of barrier precautions (BPs): gloves, masks, gowns, and eyewear. Only HCWs having direct patient contact were included. The purpose of the observation was not disclosed to those being observed. RESULTS: In 12 resuscitations involving 104 HCWs, none had 100% compliance with BPs. Compliance rates for individual BPs were gloves, 98%; eyewear (any type), 52%; gowns, 38%; masks, 10%; and eyewear (with side protectors), 9%. Resuscitations in which bleeding was observed involved 59 HCWs with 38% compliance; only 2 used full BPs. No difference in compliance rates occurred during the study period. CONCLUSIONS: Experienced trauma care HCWs are cavalier regarding blood-borne disease exposure risks. Measures to encourage (or force) compliance are needed.

Emergency Medicine↗
PubMed2001

Thoughts, feelings, and motivations of bystanders who attempt to resuscitate a stranger: a pilot study.

BACKGROUND: Rates of bystander cardiopulmonary resuscitation remain low nationwide. Possibly, low rates can be explained by examining the reactions of laypersons who attempt to resuscitate a stranger. OBJECTIVE: To examine the thoughts, feelings, and motivations of laypersons who have attempted to resuscitate a stranger. METHOD: Survey methods were used to do a qualitative study of 12 laypersons who had provided bystander resuscitation. A 36-item questionnaire of predominately open-ended questions was used to elicit retrospective information about the laypersons' thoughts, feelings, and motivations during several stages of the resuscitation event. Data were analyzed by using content analysis. RESULTS: Thoughts about the event included curiosity, questioning of personal capability, and recognition of differences between classroom training and real-life events. Feelings included hope, euphoria, pride, relief, satisfaction, hopelessness, doubt, agitation, anger, sadness, and fear. Primary motivations were duty and responsibility, guilt and social pressure, and altruism. All participants reported that they had excellent recall of the event. CONCLUSION: These results provide insight into a population that acts on behalf of the medical community.

Adult↗
PubMed2002

Hypertonic saline solution resuscitation in hemorrhagic shock dogs.

OBJECTIVE: 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.

Animals↗
PubMed2002

Analysis of factors associated with successful cardiopulmonary resuscitation in non-traumatic dead-on-arrival patients in emergency department.

Out-of-hospital cardiopulmonary arrest has a dismal prognosis. Successful resuscitation of these patients depends on the "chain of survival". In Taiwan, the emergency medical services (EMS) system is under development and the links of "chain of survival" are weak and frequently broken. A 2-year retrospective study was conducted from January, 1999, to December, 2000 to evaluate the factors of successful cardiopulmonary resuscitation (CPR) in non-traumatic DOA patients in ED. Of 175 studied patients, 51 patients (29.1%) were successfully resuscitated with return of spontaneous circulation (ROSC), but only 7 patients (4%) survived to hospital discharge. Most successfully resuscitated patients (84.3%) regained their vital signs within 30 minutes. There were no significant differences in age, sex, vehicle of transportation, administration of prehospital CPR or not, EMS response interval, on-scene duration, and scene-to-hospital interval between patients with ROSC and without ROSC. Compared with asystole cardiac rhythm, patients with pulseless electrical activity (PEA) had a higher successful resuscitation rate (p = 0.001), but no significant differences existed between patients with ventricular fibrillation/ventricular tachycardia (VF/VT) and PEA or VF/VT and asystole. However, there were no significant differences in the survival discharge rate among patients with different initial cardiac rhythms in ED.

Adult↗
PubMed2002

Predictors of survival following in-hospital adult cardiopulmonary resuscitation.

BACKGROUND: This study was undertaken to provide up-to-date survival data for Canadian adult in-patients following attempted resuscitation from cardiac or respiratory arrest. We hope that objective data might encourage more meaningful dialogue between physicians, patients and their families regarding resuscitation wishes. METHODS: We reviewed all records of adult cardiopulmonary arrest that occurred between Jan. 1, 1997, and Jan. 31, 1999, at the 3 main teaching hospitals in Edmonton. We then abstracted data from the full inpatient medical records to describe patient characteristics, type of arrest and survival details. The family physicians of survivors were contacted to confirm the outcomes. We included only adults admitted to hospital but not to a critical care bed. RESULTS: There were 247 arrests during the study period; 143 (57.9%) were witnessed, and 104 (42.1%) were unwitnessed). Of the patients whose arrests were witnessed, 48.3% (95% confidence interval [CI] 39.8%-56.8%) were able to be resuscitated, 22.4% (95% CI 1 5.8%-30.1%) survived to hospital discharge, and 18.9% (95% CI 12.8%-26.3%) were able to return home. Survival was highest after primary respiratory arrest and lowest after pulseless electrical activity or asystole. Of the patients with unwitnessed arrests, 21.2% (95% CI 13.8%-30.3%) were able to be resuscitated, but only 1 patient (1.0% [95% CI 0.0%-5.2%]) survived to hospital discharge and was able to return home. This patient survived an unwitnessed respiratory arrest. No patient who had an unwitnessed cardiac arrest survived to discharge. Most of the respiratory arrests were witnessed (93.1%), and most of the pulseless electrical activity or asystole arrests were unwitnessed (54.6%). We did not find age or sex to be independent predictors of survival. However, the risk of not returning home was higher among patients whose arrest occurred between 2301 and 0700 than among those whose arrest was between 0701 and 1500 (adjusted OR 3.2, 95% CI 1.0-10.1). Survival was significantly decreased after pulseless ventricular tachycardia or ventricular fibrillation arrest (adjusted OR 4.2, 95% CI 1.4-12.5) and even more so after pulseless electrical activity or asystole arrest (adjusted OR 21.0, 95% CI 6.2-71.7) than after respiratory arrest. INTERPRETATION: Overall, survival following cardiopulmonary resuscitation in hospital does not appear to have changed markedly in 40 years. The type of arrest is highly predictive of survival, whereas age and sex are not.

Adult↗
PubMed2002

Rescue systemic thrombolysis during cardiopulmonary resuscitation.

The main goal of the cardiopulmonary resuscitation is good neurological outcome. The primary ischaemic insult initiates a multitude of coagulation and inflammatory cascades resulting in cytotoxic brain oedema, necrosis and apoptosis. Thrombolytic agents may have experimentally and clinically significant beneficial effects in non-traumatic cardiac arrest. Prospective clinical trials show that thrombolytic therapy combined with heparin is feasible, safe and effective during resuscitation. We demonstrate three cases of successful systemic thrombolysis during in hospital CPR in cancer patients. Two patients were successfully resuscitated from cardiac arrest with streptase bolus (500.000 IU) and infusion (100,000/hr). One patient with pulmonary embolism and gynecological bleeding were treated with bolus (10,000 IU) and infusion of heparin (1,000 IU/hr) and successfully resuscitated. We observed a very good neurological outcome in all 3 cases following rescue thrombolysis and standard CPR. Two patients were discharged from hospital in good neurological outcome. One patient died on ICU on 10th day due to myocardial re-infarction and biventricular failure. Systemic thrombolysis is safe and effective treatment modality during resuscitative efforts even in cancer patients. In oncological patients with dissemination and/or bleeding heparin therapy should be considered due to better clinical control. (Ref. 17.)

Aged↗
PubMed2003

Does the episode of cardiopulmonary resuscitation in cardiac donors increase the risk of heart transplantation?

BACKGROUND: The aim of this study is to evaluate the risk of accepting cardiac donors after an episode of cardiopulmonary resuscitation. MATERIALS AND METHODS: Since 1997, 13 resuscitated donor hearts (10 M, 3 F, age 15-54 years) after sudden cardiac arrest have been transplanted. The retrospective analysis was used. RESULTS: Allografts after resuscitation episode were implanted in 13 patients (6 M, 7 F, age 31-65 years). 11 patients were on the urgency list and two of them required periodically intravenous inotropic therapy. Two patients (P.A, B.J) died in the first 24 hours after procedure (cause of death: pulmonary embolism, extensive cardiac ischemia). During follow up (6-48 months, avg. 25.1 +/- 15.9 months) none of the 11 patients died. All patients are NYHA functional class I or I/II. Total time of cardiopulmonary resuscitation did not influence the time of reperfusion (p > 0.05). Analysis of cardiac index Cl (l/min/m2) at 2, 4, 6, 8, 12, 24, 72 hours after heart transplantation showed correct values during following days. Echocardiographic and invasive examinations (8 patients) do not show any abnormalities. CONCLUSION: These results suggest that acceptance of cardiac donors after cardiopulmonary resuscitation may not increase the risk of heart transplantation.

Adolescent↗