Impedance Threshold Device
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Impedance Threshold Device
An inspiratory impedance threshold device is a valve used in cardiopulmonary resuscitation (CPR) to decrease intrathoracic pressure and improve venous return to the heart. The valve is a part of a mask or other breathing device such as an endotracheal tube, and may open at high or low pressures (called "cracking pressures.") ITDs are still in the early phases of clinical use, but preliminary investigational studies have suggested a potential benefit in achieving return of spontaneous circulation (ROSC) and early improvement after cardiopulmonary arrest in humans. More recently, the Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation Impedance Valve and Early Versus Delayed Analysis (PRIMED) study (n=8718) failed to demonstrate improved outcomes with the use of an impedance threshold device (ITD) as an adjunct to conventional CPR when compared with use of a sham device. Quality of cardiopulmonary resuscitation (CPR) was a deciding factor, with ITD increasing survival w ...
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Cardiopulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. CPR involves chest compressions for adults between and deep and at a rate of at least 100 to 120 per minute. The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose (mouth-to-mouth resuscitation) or using a device that pushes air into the subject's lungs (mechanical ventilation). Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers. Wit ...
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Intrathoracic
The thoracic cavity (or chest cavity) is the chamber of the body of vertebrates that is protected by the thoracic wall (rib cage and associated skin, muscle, and fascia). The central compartment of the thoracic cavity is the mediastinum. There are two openings of the thoracic cavity, a superior thoracic aperture known as the thoracic inlet and a lower inferior thoracic aperture known as the thoracic outlet. The thoracic cavity includes the tendons as well as the cardiovascular system which could be damaged from injury to the back, spine or the neck. Structure Structures within the thoracic cavity include: * structures of the cardiovascular system, including the heart and great vessels, which include the thoracic aorta, the pulmonary artery and all its branches, the superior and inferior vena cava, the pulmonary veins, and the azygos vein * structures of the respiratory system, including the diaphragm, trachea, bronchi and lungs * structures of the digestive system, including ...
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Endotracheal Tube
A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. Many different types of tracheal tubes are available, suited for different specific applications: * An endotracheal tube is a specific type of tracheal tube that is nearly always inserted through the mouth (orotracheal) or nose (nasotracheal). * A tracheostomy tube is another type of tracheal tube; this curved metal or plastic tube may be inserted into a tracheostomy stoma (following a tracheotomy) to maintain a patent lumen. * A tracheal button is a rigid plastic cannula about 1 inch in length that can be placed into the tracheostomy after removal of a tracheostomy tube to maintain patency of the lumen. History Portex Medical (England and France) produced the first cuff-less plastic 'Ivory' endotracheal tubes. Ivan Magill later added a cuff (these were glued on by hand to mak ...
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Return Of Spontaneous Circulation
Return of spontaneous circulation (ROSC) is the resumption of a sustained heart rhythm that perfuses the body after cardiac arrest. It is commonly associated with significant respiratory effort. Signs of return of spontaneous circulation include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure. Someone is considered to have sustained return of spontaneous circulation when circulation persists and cardiopulmonary resuscitation has ceased for at least 20 consecutive minutes. Predictors of ROSC There are multiple factors during cardiopulmonary resuscitation (CPR) and defibrillation that are associated with success of achieving return of spontaneous circulation. One of the factors in CPR is the chest compression fraction, which is a measure of how much time during cardiac arrest are chest compressions performed. A study measured the effects of chest compression fraction on return of spontaneous circulation in out-of-hospital cardiac arrest patients w ...
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Cardiopulmonary Arrest
Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possibly defibrillation are needed until further treatment can be provided. Cardiac arrest results in a rapid loss of consciousness, and breathing may be abnormal or absent. While cardiac arrest may be caused by heart attack or heart failure, these are not the same, and in 15 to 25% of cases, there is a non-cardiac cause. Some individuals may experience chest pain, shortness of breath, nausea, an elevated heart rate, and a light-headed feeling immediately before entering cardiac arrest. The most common cause of cardiac arrest is an underlying heart problem like coronary artery disease that decreases the amount of oxygenated blood supplying the heart muscle. This, in turn, damages the structure of the muscle, which can alter its function. The ...
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Resuscitation (journal)
''Resuscitation'' is a monthly peer-reviewed medical journal covering research on cardiac arrest and cardiopulmonary resuscitation. It is an official journal of the European Resuscitation Council and is published by Elsevier. The editor-in-chief is Jerry Nolan (University of Southampton). Editorial introductions. ''Current Opinion in Critical Care'', 2013, Wolters Kluwer Health/Lippincott Williams & Wilkins The journal is abstracted and idexed in Current Contents, Index Medicus/MEDLINE/PubMed, Embase, Scopus, and the Science Citation Index Expanded. According to the ''Journal Citation Reports'', the journal has a 2018 impact factor of 4.572. See also * List of medical journals * European Resuscitation Council The European Resuscitation Council (ERC) is the European Interdisciplinary Council for Resuscitation Medicine and Emergency Medical Care Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring i ... References Ext ...
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American Heart Association
The American Heart Association (AHA) is a nonprofit organization in the United States that funds cardiovascular medical research, educates consumers on healthy living and fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. Originally formed in New York City in 1924, it is currently headquartered in Dallas, Texas. The American Heart Association is a national voluntary health agency. They are known for publishinguidelineson cardiovascular disease and prevention, standards on basic life support, advanced cardiac life support (ACLS), and pediatric advanced life support (PALS), and in 2014 issued its first guidelines for preventing strokes in women. They are known also for operating a number of highly visible public service campaigns starting in the 1970s, and also operate a number of fundraising events. In 1994, the ''Chronicle of Philanthropy'', an industry publication, released a study that showed the American H ...
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Critical Care Medicine (journal)
''Critical Care Medicine'' is a peer-reviewed monthly medical journal in the field of intensive care medicine. The journal was established in 1973 with William C. Shoemaker as the founding editor. It is the official publication of the Society of Critical Care Medicine and is published by Lippincott Williams & Wilkins. The journal's editor-in-chief is Timothy G. Buchman. Abstracting and indexing The journal is abstracted and indexed in: According to the ''Journal Citation Reports'', the journal has a 2020 impact factor The impact factor (IF) or journal impact factor (JIF) of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly mean number of citations of articles published in the last two years in a given journal, as ... of 7.598, ranking it 5th out of 82 journals in the category "‘Critical Care and Intensive Care Medicine". Editors * William C. Shoemaker, 1972-1991 * Bart Chernow, 1991-1997 * Joseph E. Parrillo, 1997-2014 * T ...
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