| 1. |
- Kjellström, Barbro, et al.
(författare)
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The science committee of the CCNAP : Eager to start
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:4, s. 195-196
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Tidskriftsartikel (refereegranskat)abstract
- In 2010, the Council of Cardiovascular Nursing and Allied Professions (CCNAP) initiated the forming of a Science Committee (SC) with the aim to take responsibility for activities related to research and the scientific foundation for cardiovascular nursing and allied professional practice within the European Society of Cardiology (ESC). The formation of such a council seems a logical step in further developments of the CCNAP and can contribute to optimization of cardiovascular patient care.
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| 2. |
- Hansson, Anders, et al.
(författare)
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Self-Treatment Techniques in Patients with Paroxysmal Atrial Fibrillation and the Probable Influence of the Autonomic Nervous System
- 2013
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Ingår i: International journal of cardiovascular research. - : OMICS Publishing Group. - 2324-8602. ; 02:02
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Tidskriftsartikel (refereegranskat)abstract
- Self-treatment techniques in patients with paroxysmal atrial fibrillation (PAF) have seldom been described. It has been suggested that PAF attacks might be initiated by changes in the tonus of the autonomic nervous system. Our aim was to study patients’ measures to terminate PAF attacks and to evaluate the possible influence of the autonomic nervous system on start and stop mechanisms.
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| 3. |
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| 4. |
- Wagner, Henrik, et al.
(författare)
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Cerebral Oximetry During Prolonged Cardiac Arrest and Percutaneous Coronary Intervention : A Report on Five Cases
- 2013
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Ingår i: ICU Director. - : SAGE Publications. - 1944-4516 .- 1944-4524. ; 4:1, s. 22-32
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objective. To evaluate the feasibility of cerebral oximetry (SctO2) with arterial blood pressure (ABP), central venous pressure (CVP), end tidal carbon dioxide (ETCO2), pulse oximetry (SpO2), and arterial blood gases during resuscitation in the coronary catheterization laboratory (cath-lab) setting. Design. We have implemented SctO2 in our cath-lab when cardiac arrest patients are in the need of prolonged resuscitation efforts with mechanical chest compressions (MCC) during simultaneous percutaneous coronary intervention (PCI). Setting. An academic coronary catheterization laboratory. Patients. Five cardiac arrest patients required prolonged resuscitation efforts with MCC in the cath-lab during simultaneous PCI. Results. During MCC, median SctO2 (n = 5) was 47%, median systolic ABP (n = 5) was 88 mm Hg, mean ABP (n = 5) was 58 mm Hg, coronary perfusion pressure (n = 3) was 19 mm Hg, SpO2 (n = 4) was 81%, and ETCO2 (n = 4) was 18.8 torr (2.5 kPa). Four patients had a successful PCI, including 1 patient with a pericardial drainage for cardiac tamponade during MCC. Mean treatment time of MCC in the cath-lab was 50.8 ± 28.3 minutes (median = 45 minutes, range = 12-90 minutes). Two patients obtained return of spontaneous circulation (ROSC). They died in the ICU due to impaired circulation and multiorgan failure, after 32 and 60 hours, respectively. Conclusion. Cerebral oximetry seems to be a feasible noninvasive parameter in assessing the perfusion and oxygenation of the brain in cardiac arrest patients receiving chest compressions during simultaneous PCI. Further studies are needed to evaluate its use in resuscitation situations to predict ROSC, quality of cardiopulmonary resuscitation, and neurologic outcome.
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| 5. |
- Wagner, Henrik, et al.
(författare)
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Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model
- 2011
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the coronary perfusion pressure (CPP). In this study our aim was to correlate average peak coronary flow velocity (APV) to CPP during mechanical CCs. Methods: In a closed chest porcine model, cardiac arrest was established through electrically induced ventricular fibrillation (VF) in eleven pigs. After one minute, mechanical chest compressions were initiated and then maintained for 10 minutes upon which the pigs were defibrillated. Measurements of coronary blood flow in the left anterior descending artery were made at baseline and during VF with a catheter based Doppler flow fire measuring APV. Furthermore measurements of central (thoracic) venous and arterial pressures were also made in order to calculate the theoretical CPP. Results: Average peak coronary flow velocity was significantly higher compared to baseline during mechanical chests compressions and this was observed during the entire period of mechanical chest compressions (12 - 39% above baseline). The APV slowly declined during the 10 min period of mechanical chest compressions, but was still higher than baseline at the end of mechanical chest compressions. CPP was simultaneously maintained at > 20 mmHg during the 10 minute episode of cardiac arrest. Conclusion: Our study showed good correlation between CPP and APV which was highly significant, during cardiac arrest with on-going mechanical CCs in a closed chest porcine model. In addition APV was even higher during mechanical CCs compared to baseline. Mechanical CCs can, at minimum, re-establish coronary blood flow in non-diseased coronary arteries during cardiac arrest.
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| 6. |
- Wagner, Henrik, et al.
(författare)
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Repeated epinephrine doses during prolonged cardiopulmonary resuscitation have limited effects on myocardial blood flow: a randomized porcine study
- 2014
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: In current guidelines, prolonged cardiopulmonary resuscitation (CPR) mandates administration of repeated intravenous epinephrine (EPI) doses. This porcine study simulating a prolonged CPR-situation in the coronary catheterisation laboratory, explores the effect of EPI-administrations on coronary perfusion pressure (CPP), continuous coronary artery flow average peak velocity (APV) and amplitude spectrum area (AMSA). Methods: Thirty-six pigs were randomized 1:1:1 to EPI 0.02 mg/kg/dose, EPI 0.03 mg/kg/dose or saline (control) in an experimental cardiac arrest (CA) model. During 15 minutes of mechanical chest compressions, four EPI/saline-injections were administered, and the effect on CPP, APV and AMSA were recorded. Comparisons were performed between the control and the two EPI-groups and a combination of the two EPI-groups, EPI-all. Result: Compared to the control group, maximum peak of CPP (P-max) after injection 1 and 2 was significantly increased in the EPI-all group (p = 0.022, p = 0.016), in EPI 0.02-group after injection 2 and 3 (p = 0.023, p = 0.027) and in EPI 0.03-group after injection 1 (p = 0.013). At P-max, APV increased only after first injection in both the EPI-all and the EPI 0.03-group compared with the control group (p = 0.011, p = 0.018). There was no statistical difference of AMSA at any P-max. Seven out of 12 animals (58%) in each EPI-group versus 10 out of 12 (83%) achieved spontaneous circulation after CA. Conclusion: In an experimental CA-CPR pig model repeated doses of intravenous EPI results in a significant increase in APV only after the first injection despite increments in CPP also during the following 2 injections indicating inappropriate changes in coronary vascular resistance during subsequent EPI administration.
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