Results: The model predictions matched the human CC data to within an average difference of less than 1.5% at CC rates of 60 cpm and 90 cpm, and 0.6% for the manikin data at a CC rate of 90 cpm. The model predictions also showed that the net sternum-to-spine compression
depth achieved during force guided CPR strongly depends on the patient’s thoracic this website stiffness.
Conclusions: Good quantitative agreement between the experimental data from the literature and the theoretical model suggests that the constant peak force CPR model developed by Boe and Babbs provides reasonable prediction of CC mechanics during CPR over a range of clinically relevant CC rates. The model predictions also suggest that the effectiveness of CC during force guided CPR is highly sensitive to the patient’s thoracic stiffness and insensitive to the back support stiffness. Patients having high thoracic
stiffness (>= 100 N cm(-1)) were found to require higher CC forces, which may exceed the force above which severe chest wall trauma and abdominal injury occurs, in order to achieve the ERC recommended CC depth range. selleck compound This suggests that the choice of maximum sternal force applied by clinicians during constant peak force CPR ought to be based on a general assessment of the patient’s thoracic stiffness. (c) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Proximal thoracic aortic reconstruction performed with or without hypothermic circulatory arrest (HCA) is an effective surgical strategy for aortic pathology. In this study, the clinical outcomes of patients undergoing reoperative proximal thoracic aortic surgery were evaluated. A retrospective review was performed for reoperative proximal aortic surgery from 2004 to date. Patient data were abstracted from the society of thoracic surgeons (STS) institutional database and patient charts. Univariate analysis was conducted on the HCA group in order to determine the impact of variables on in-hospital mortality. Kaplan-Meier survival estimates were calculated for long-term survival analysis. One hundred and twenty-two patients Selleckchem SB525334 were included in the analysis. Twenty-seven (22.1%) were female,
and the mean age was 53.8 years. Seventy-seven (63.1%) patients had an aortic root replacement, and 93 (76.2%) patients underwent aortic arch replacement. Circulatory arrest was performed in 92 (75.4%) patients. Operative mortality occurred in 14 patients (11.5%). Complications included re-exploration for haemorrhage (nine patients, 7.4%), stroke (four, 3.3%), renal failure (13, 10.7%) and major adverse events (18, 14.8%). Univariate and multivariate analyses of HCA patients showed cardiopulmonary bypass (CPB) time, preoperative renal failure and prior coronary revascularization as independent predictors of mortality. Reoperative proximal aortic surgery can be performed with acceptable morbidity and mortality. These data also suggest that HCA represents a safe operative strategy for this patient population.