关键词： 心脏停搏   心肺复苏术   高压氧   蛋白质C  

摘要： 目的探讨高压氧预处理对窒息性心脏停搏复苏大鼠血浆蛋白质C活化的影响。方法清洁级健康成年雄性SD大鼠105只，70～90日龄，体重260～320g，采用随机数字表法分为3组：心脏停搏组（CA组，n=5）、心脏停搏复苏组（CA／R组，n=50）和高压氧预处理组（H组，n=50）。采用呼气末夹闭气管窒息法建立大鼠心脏停搏复苏模型。H组给予连续3d高压氧预处理（纯氧舱压力2个绝对大气压力，稳压吸氧45min，控制氧浓度〉95％后，20min匀速降压至常压，1次／d）后制备心脏停搏复苏模型。CA组不进行复苏。CA／R组和H组于自主循环恢复后3、6、12和24h时随机取5只大鼠，CA组于心脏停搏30min时，经腹主动脉取血标本5ml，采用ELISA法测定血浆活化的蛋白质C（APC）浓度，记录窒息至心脏停搏时间、自主心率恢复时间和复苏成功情况。结果与CA组比较，CA／R组和H组自主循环恢复后各时点血浆APC浓度降低（P〈0．05）；与CA／R组比较，H组窒息至心脏停搏时间延长，自主心率恢复时间缩短，复苏成功率升高，自主循环恢复后各时点血浆APC浓度升高（P〈0．05）。结论高压氧预处理可促进窒息性心脏停搏大鼠复苏后血浆PC活化，有助于改善高凝状态。

关键词： 老龄化   死振   外部刺激   心脏复苏  

摘要： 本文引入外部扰动对副交感神经系统分泌乙酰胆碱的影响,利用计算机模拟考察了外部扰动对窦房结组织动作电位积极的调控作用.可以观察到,在老龄化心脏体系中,由于窦房结组织中钠电流的降低或活性细胞数量的减少,会引起心脏起搏活动的变慢甚至出现死振.不过该死振现象可以通过引入外部低频信号来减轻或消除.再者,体系内外环境噪声也有类似的作用效果.上述现象表明,在控制心脏的起搏活动过程中,外部扰动有着重要的调节作用.

关键词： electrocardiogram   fibrinolytics   myocardial infarction   ST-segment elevation   unstable angina   ACUTE MYOCARDIAL-INFARCTION   ST-SEGMENT-ELEVATION   HOSPITAL CARDIAC-ARREST   PREHOSPITAL 12-LEAD ELECTROCARDIOGRAM   RANDOMIZED OPEN-LABEL   ON-SITE THROMBOLYSIS   TO-BALLOON TIMES   PRIMARY ANGIOPLASTY   THERAPEUTIC HYPOTHERMIA   IMMEDIATE THROMBOLYSIS  

摘要： The article discusses the diagnosis of acute coronary syndromes in patients having cardiac arrest. Information about the extensive evidence review process for recommendations of cardiopulmonary resuscitation (CPR) and emergency cardiovascular care based on the 2015 guidelines from U.S. nonprofit organization American Heart Association, is given. Also mentioned is the significant role of emergency departments (EDs), care providers and paramedics in handling patients with cardiac arrest.

关键词： cardiac arrest   cardiopulmonary resuscitation   emergency   resuscitation   HOSPITAL CARDIAC-ARREST   ACUTE ISCHEMIC-STROKE   INTERNATIONAL CONSENSUS   EARLY MANAGEMENT   PROFESSIONALS   SURVIVAL   SCIENCE  

摘要： The 2015 AHA Guidelines Update for CPR and ECC incorporated the evidence from the systematic reviews completed as part of the 2015 International Consensus on CPR and ECC Science With Treatment Recommendations. This 2015 Guidelines Update marks the transition from periodic review and publication of new science-based recommendations to a more continuous process of evidence evaluation and guideline optimization designed to more rapidly translate new science into resuscitation practice that will save more lives. The Appendix to this Part contains a list of all recommendations published in the 2015 Guidelines Update and, in addition, lists the recommendations from the 2010 Guidelines. The 2015 recommendations were made consistent with the new AHA Classification System for describing the risk-benefit ratio for each Class and the Levels of Evidence supporting them. (Please see Figure 1 in "Part 2: Evidence Evaluation and Management of Conflicts of Interest.") Survival from both IHCA and OHCA has increased over the past decade, but there is still tremendous potential for improvement. It is clear that successful resuscitation depends on coordinated systems of care that start with prompt rescuer actions, require delivery of high-quality CPR, and continue through optimized ACLS and post-cardiac arrest care. Systems that monitor and report qualityof-care metrics and patient-centered outcomes will have the greatest opportunity through quality improvement to save the most lives. © 2015 American Heart Association, Inc., and The American National Red Cross.

关键词： cardiopulmonary resuscitation   BASIC LIFE-SUPPORT   HIGH-FIDELITY SIMULATION   HOSPITAL CARDIAC-ARREST   AUTOMATED EXTERNAL DEFIBRILLATORS   TECHNOLOGY-ENHANCED SIMULATION   VOICE ADVISORY MANNEQUIN   VIDEO SELF-INSTRUCTION   CHEST COMPRESSION RATES   HIGH-RISK   DELIBERATE PRACTICE  

摘要： The article examines the disparities in survival rates for both out-of-hospital and in-hospital cardiac arrest based on the 2015 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care from U.S. nonprofit organization American Heart Association (AHA). Information about the development of resuscitation education such as implementation of the science of resuscitation in cardiac arrest patients, is also provided.

关键词： cardiopulmonary resuscitation   RANDOMIZED-CONTROLLED-TRIAL   LOW-BIRTH-WEIGHT   SKIN-TO-SKIN   HYPOXIC-ISCHEMIC ENCEPHALOPATHY   MECONIUM ASPIRATION SYNDROME   RESPIRATORY-DISTRESS-SYNDROME   DELIVERY ROOM MANAGEMENT   ASPHYXIAL CARDIAC-ARREST   SUSTAINED LUNG-INFLATION   STAINED AMNIOTIC-FLUID  

摘要： The article discusses guidelines for neonatal resuscitation application based on the 2015 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care from U.S. nonprofit organization American Heart Association (AHA). Topics include the assessment of perinatal risk to assure effective teamwork and communication, beneficial effect of delayed cord clamping (DCC) and significance of normal temperature monitoring in the delivery room.

关键词： cardiac arrest   drug   imaging   moderate hypothermia   NEURON-SPECIFIC ENOLASE   PERCUTANEOUS CORONARY INTERVENTION   HOSPITAL VENTRICULAR-FIBRILLATION   SOMATOSENSORY-EVOKED-POTENTIALS   PREHOSPITAL THERAPEUTIC HYPOTHERMIA   BRAIN COMPUTED-TOMOGRAPHY   RANDOMIZED CLINICAL-TRIAL   ADULT COMATOSE SURVIVORS   ARTERIAL CARBON-DIOXIDE   DIFFUSION-WEIGHTED MRI  

摘要： The article focuses on the post-cardiac arrest care in patients during cardiac arrest based on the 2015 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care from U.S. nonprofit organization American Heart Association (AHA). It highlights the use of AHA Class of Recommendation (COR) and Level of Evidence (LOE) system in systematic review for patient compliance. An overview on the recommended standardized methodological approach in cardiovascular care, is also given.

关键词： arrhythmia   cardiac arrest   drugs   ventricular arrhythmia   ventricular fibrillation   HOSPITAL CARDIAC-ARREST   TIDAL CARBON-DIOXIDE   RECURRENT VENTRICULAR-FIBRILLATION   ENDOTRACHEAL-TUBE PLACEMENT   HIGH-DOSE EPINEPHRINE   ACTIVE COMPRESSION-DECOMPRESSION   POSITIVE-PRESSURE VENTILATION   CORONARY PERFUSION-PRESSURE   ESOPHAGEAL DETECTOR DEVICE   ADVANCED AIRWAY MANAGEMENT  

摘要： The article examines the effectiveness of basic life support (BLS), advanced cardiovascular life support (ACLS), and post-cardiac arrest care in treatment of patients during cardiac arrest. Information about the administration of steroid for in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA), is given. It also highlights the use of standardized methodological approach in the evaluation of recommendations assessment.

关键词： cardiac arrest   cardiopulmonary resuscitation   emergency   resuscitation   HOSPITAL CARDIAC-ARREST   RAPID RESPONSE TEAM   INTERNATIONAL LIAISON COMMITTEE   PUBLIC-ACCESS DEFIBRILLATION   ADVANCED LIFE-SUPPORT   NEW-ZEALAND COUNCIL   EARLY WARNING SCORE   EUROPEAN-RESUSCITATION   STROKE-FOUNDATION   CHEST-COMPRESSION  

摘要： The article focuses on the distinct systems of care in patients with cardiac arrest inside and outside the hospital based on the 2015 guidelines from U.S. nonprofit organization American Heart Association. Information about the healthcare delivery structure including education, prospective registry data collection and patient safety, is highlighted. Also emphasized is the utilization of systems-of-care approach for continuous quality improvement (CQI) in patients to improve their outcomes.

关键词： cardiac arrest   defibrillation   emergency   INTRAVENOUS LIPID EMULSION   PERCUTANEOUS CORONARY INTERVENTION   INTRAAORTIC BALLOON COUNTERPULSATION   TISSUE-PLASMINOGEN ACTIVATOR   MASSIVE PULMONARY-EMBOLISM   ELEVATION MYOCARDIAL-INFARCTION   MECHANICAL CHEST COMPRESSIONS   PERIMORTEM CESAREAN DELIVERY   OPIOID OVERDOSE PREVENTION   NONFATAL HEROIN OVERDOSE  

摘要： The article examines the recommended resuscitation management in several critical situations including cardiac arrest associated with pregnancy, pulmonary embolism, and opioid-associated resuscitative emergencies, with or without cardiac arrest. Information about the intravenous lipid emulsion (ILE) therapy for cardiac arrest due to drug intoxication, is given. Also highlighted is the use of standardized methodological approach in evaluation of evidence review process.