Abstract:
STUDY OBJECTIVE:The purpose of this study was to observe, measure, and describe the changes in central venous oxygen saturation during CPR and immediately after return of spontaneous circulation. It also was to examine the clinical utility of continuous central venous oxygen saturation monitoring as a indicator of return of spontaneous circulation during CPR in human beings. DESIGN AND SETTING:Eight-month, prospective, non-outcome, observational, nonrandomized case series in the ED of a large urban hospital. TYPES OF PATIENTS: Adult normothermic, nontraumatic, out-of-hospital cardiopulmonary arrests. INTERVENTIONS:All patients were managed according to advanced cardiac life support guidelines. A proximal aortic and double-lumen central venous catheter was placed. Central venous oxygen saturation was measured continuously spectrophotometrically with a fiberoptic catheter in the central venous location. MEASUREMENTS:Aortic blood pressure and central venous oxygen saturation were simultaneously measured throughout each resuscitation. Return of spontaneous circulation was defined as a systolic blood pressure of more than 60 mm Hg for more than five minutes. RESULTS:One hundred patients who experienced 68 episodes of cardiac arrest were studied. Patients with return of spontaneous circulation had a higher initial and statistically higher mean and maximal central venous oxygen saturation than those without return of spontaneous circulation (P = .23, .0001, and .0001, respectively; P less than .05 is significant). No patient attained return of spontaneous circulation without reaching a central venous oxygen saturation of at least 30%. Only one of 68 episodes of return of spontaneous circulation was attained without reaching a central venous oxygen saturation of at least 40%. A central venous oxygen saturation of greater than 72% was 100% predictive of return of spontaneous circulation. CONCLUSION:Continuous central venous oxygen saturation monitoring can serve as a reliable indicator of return of spontaneous circulation during CPR in human beings.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Rivers EP,Martin GB,Smithline H,Rady MY,Schultz CH,Goetting MG,Appleton TJ,Nowak RMdoi
10.1016/s0196-0644(05)80650-xsubject
Has Abstractpub_date
1992-09-01 00:00:00pages
1094-101issue
9eissn
0196-0644issn
1097-6760pii
S0196-0644(05)80650-Xjournal_volume
21pub_type
杂志文章abstract::Although most clinical trials comparing therapies are analyzed using classical hypothesis testing and P values, such methods do not yield the information most useful to the clinician, that is, the probability that one treatment is more efficacious than another. Bayesian inference can yield this probability but only if...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80119-2
更新日期:1993-08-01 00:00:00
abstract::The last 3 to 5 years have witnessed a tremendous change in direction for the academic health center. The major trends in this regard are increased importance of managed care, cost consciousness, development of a clinical system, pressure to downsize graduate medical education, and increased competition. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70045-3
更新日期:1997-12-01 00:00:00
abstract::Drinking increases motor vehicle crash likelihood starting at blood alcohol levels as low as .02 mmol/L. Clinical experience tells us that drunken drivers "cycle through" the system many times, presenting opportunities for intervention. We describe the drunken driver's risk of occurrence at each juncture in the cycle ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(95)70148-6
更新日期:1995-08-01 00:00:00
abstract:STUDY OBJECTIVES:To survey faculty attrition in emergency medicine and compare it with faculty attrition in the specialties of orthopedic surgery and cardiology. DESIGN:Chairmen of the three departments were surveyed regarding faculty attrition, work hours, and motivation for leaving. Those emergency physicians having...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81110-2
更新日期:1991-01-01 00:00:00
abstract::There is general agreement that physical examination alone is inadequate for abdominal evaluation in the multiply injured blunt trauma patient; but controversy exists regarding the preferred method of detecting intraabdominal injuries requiring celiotomy. Both peritoneal lavage and the newer computed tomography imagin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80269-0
更新日期:1989-12-01 00:00:00
abstract::Sodium dichloroacetate (DCA) has been shown to lower elevated serum lactate levels produced by hypoxia, exercise, and phenformin. We conducted a study to investigate the effect of DCA treatment on lactic acidosis following resuscitation from asphyxial cardiac arrest. Conditioned dogs were anesthetized with pentobarbit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80239-7
更新日期:1988-05-01 00:00:00
abstract::This clinical policy focuses on critical issues in the evaluation and management of adult patients with seizures. The medical literature was reviewed for articles that pertained to the critical questions posed. Subcommittee members and expert peer reviewers also supplied articles with direct bearing on this policy. Th...
journal_title:Annals of emergency medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1016/S019606440400068X
更新日期:2004-05-01 00:00:00
abstract::OxyContin (oxycodone hydrochloride controlled release) is a long-acting preparation of oxycodone that is used as an opioid analgesic to treat chronic pain conditions. We report a patient who ingested a massive quantity of OxyContin and had altered mental status, noncardiogenic pulmonary edema, and hypoventilation that...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.128143
更新日期:2002-10-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to determine whether working 5 serial night shifts in the emergency department results in a decline in physician performance as measured with an intelligence test. METHODS:This study compared the cognitive functioning of emergency physicians who worked the day shift (7 AM to 5 pm) with those ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.116024
更新日期:2001-08-01 00:00:00
abstract::A profoundly hypothermic 5-hour-old infant in cardiac arrest was brought to the emergency department by paramedics. The infant was found wrapped in a garbage bag inside a freezer. She had been in the freezer for approximately four hours. Her initial rectal temperature was 16.2 degrees C. Active external and core warmi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70369-8
更新日期:1994-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if hypertonic saline/dextran (HSD) is effective in treating hemorrhage in the presence of dehydration. DESIGN:After surgical preparation, swine were euhydrated or dehydrated for 24 or 48 hours. Animals were bled 25 mL/kg over 60 minutes and treated with HSD. SETTING:Laboratory. PARTICIPA...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80143-x
更新日期:1992-02-01 00:00:00
abstract:STUDY OBJECTIVE:Lumbar puncture is a commonly performed procedure, although previous studies have documented low rates of successful completion in infants. Ultrasonography can visualize the anatomic landmarks for lumbar puncture and has been shown in some studies to reduce the failure rate of lumbar puncture in adults....
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2016.09.014
更新日期:2017-05-01 00:00:00
abstract:STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70238-1
更新日期:1994-12-01 00:00:00
abstract::Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80296-6
更新日期:1984-08-01 00:00:00
abstract::Although ingestions of button batteries can have serious complications, the majority of these ingestions will be benign. Button batteries that lodge in the esophagus should be removed immediately by endoscopy. Other ingestions can be managed with observation at home unless symptoms develop. Weekly radiographic examina...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(89)80417-2
更新日期:1989-03-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time. METHODS:We randomized emergency department patients older than 18 years who need...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2018.11.016
更新日期:2019-05-01 00:00:00
abstract::Right ventricular infarction due to ischemic heart disease can be diagnosed by a right precordial electrogram or by first-pass radionuclide angiography (FPRNA). Prior FPRNA studies have shown that cardiac dysfunction after blunt chest trauma (myocardial contusion) is most often due to right ventricular dysfunction. We...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80665-6
更新日期:1988-09-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of this study is to derive a clinical decision instrument with a sensitivity of at least 95% (with upper and lower bounds of the 95% confidence intervals [CIs] within a 5% range) to identify adult emergency department patients with mild traumatic intracranial hemorrhage who are at low risk...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.11.003
更新日期:2014-04-01 00:00:00
abstract::The prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in 232 sexual assault victims who presented for examinations between August 1, 1987, and July 31, 1988, was determined. Results are reported for cervical, rectal, and oropharyngeal NG cultures and for cervical and rectal CT smears. Results fro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82197-3
更新日期:1990-05-01 00:00:00
abstract:STUDY OBJECTIVE:Training physicians in new skills through classroom-based teaching has inherent cost and time constraints. We seek to evaluate whether Web-based didactics result in similar knowledge improvement and retention of basic ultrasonographic principles and the Extended Focused Assessment with Sonography for Tr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2010.04.019
更新日期:2010-12-01 00:00:00
abstract::Reported are two cases of metallic constricting devices presenting to our emergency department. A 40-year-old man was unable to remove a steel ring from his engorged penile shaft after autostimulation, and a 22-year-old man riveted a metallic nut onto his right index finger proximal to his distal interphalangeal joint...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80368-5
更新日期:1982-07-01 00:00:00
abstract::The goal of thrombolytic treatment in acute myocardial infarction is to reestablish permanent blood flow, salvage ischemic myocardium, and reduce mortality. If patency is achieved sufficiently early and is maintained, left ventricular function is preserved and mortality decreases. The recent experience with tissue pla...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80063-5
更新日期:1988-11-01 00:00:00
abstract:STUDY OBJECTIVE:The literature suggests that the d -dimer is useful in patients suspected of having pulmonary embolism and who have a low pretest probability of disease. A previously defined clinical decision rule, the Wells Criteria, may provide a reliable and reproducible means of determining this pretest probability...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.04.002
更新日期:2004-11-01 00:00:00
abstract::This study was undertaken to determine the clinical circumstances of femoral fractures in children. The study was a retrospective investigation of 117 consecutive patients with femoral fractures admitted to The Children's Mercy Hospital, Kansas City, Missouri, from December 1975 to September 1979. Of the 117 patients....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80492-7
更新日期:1982-04-01 00:00:00
abstract:STUDY OBJECTIVE:We seek to examine the effectiveness of the graduated driver licensing system in Utah by determining whether crash rates of 16-year-old drivers decreased after graduated driver licensing implementation. METHODS:We studied 16-year-old-driver crashes using statewide motor vehicle crash data probabilistic...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.10.007
更新日期:2005-02-01 00:00:00
abstract::When the abdomen is compressed manually in counterpoint to the rhythm of chest compression, in the performance of interposed abdominal compression-CPR, artificial circulation is approximately doubled in animal experiments and in electronic models of the circulatory system. These studies suggest that external manual co...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80245-8
更新日期:1993-01-01 00:00:00
abstract::In May 1993, the appearance of critically ill patients with unexplained respiratory distress was noted in the Four Corners area formed by New Mexico, Arizona, and Colorado. This epidemic was ultimately linked to a hantavirus, an emerging pathogen. The impact on the emergency department of a new infectious disease with...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70179-2
更新日期:1994-09-01 00:00:00
abstract:STUDY OBJECTIVE:Prediction rules for pulmonary embolism use variables explicitly shown to estimate the probability of pulmonary embolism. However, clinicians often use variables that have not been similarly validated, yet are implicitly believed to modify probability of pulmonary embolism. The objective of this study i...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2009.11.010
更新日期:2010-04-01 00:00:00
abstract::While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown re...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80067-0
更新日期:1984-11-01 00:00:00
abstract:STUDY OBJECTIVE:The Centers for Medicare & Medicaid Services (CMS) recently published emergency department (ED) timeliness measures. These data show substantial variation in hospital performance and suggest the need for process improvement initiatives. However, the CMS measures are not risk adjusted and may provide mis...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.05.029
更新日期:2016-04-01 00:00:00