Dataset Information

Successful Resuscitation in a Model of Asphyxia and Hemorrhage to Test Different Volume Resuscitation Strategies. A Study in Newborn Piglets After Transition.

ABSTRACT: Background: Evidence for recommendations on the use of volume expansion during cardiopulmonary resuscitation in newborn infants is limited. Objectives: To develop a newborn piglet model with asphyxia, hemorrhage, and cardiac arrest to test different volume resuscitation on return of spontaneous circulation (ROSC). We hypothesized that immediate red cell transfusion reduces time to ROSC as compared to the use of an isotonic crystalloid fluid. Methods: Forty-four anaesthetized and intubated newborn piglets [age 32 h (12-44 h), weight 1,220 g (1,060-1,495g), Median (IQR)] were exposed to hypoxia and blood loss until asystole occurred. At this point they were randomized into two groups: (1) Crystalloid group: receiving isotonic sodium chloride (n = 22). (2) Early transfusion group: receiving blood transfusion (n = 22). In all other ways the piglets were resuscitated according to ILCOR 2015 guidelines [including respiratory support, chest compressions (CC) and epinephrine use]. One hour after ROSC piglets from the crystalloid group were randomized in two sub-groups: late blood transfusion and infusion of isotonic sodium chloride to investigate the effects of a late transfusion on hemodynamic parameters. Results: All animals achieved ROSC. Comparing the crystalloid to early blood transfusion group blood loss was 30.7 ml/kg (22.3-39.6 ml/kg) vs. 34.6 ml/kg (25.2-44.7 ml/kg), Median (IQR). Eleven subjects did not receive volume expansion as ROSC occurred rapidly. Thirty-three animals received volume expansion (16 vs. 17 in the crystalloid vs. early transfusion group). 14.1% vs. 10.5% of previously extracted blood volume in the crystalloid vs. early transfusion group was infused before ROSC. There was no significant difference in time to ROSC between groups [crystalloid group: 164 s (129-198 s), early transfusion group: 163 s (162-199 s), Median (IQR)] with no difference in epinephrine use. Conclusions: Early blood transfusion compared to crystalloid did not reduce time to ROSC, although our model included only a moderate degree of hemorrhage and ROSC occurred early in 11 subjects before any volume resuscitation occurred.

SUBMITTER: Mendler MR

PROVIDER: S-EPMC6048263 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Successful Resuscitation in a Model of Asphyxia and Hemorrhage to Test Different Volume Resuscitation Strategies. A Study in Newborn Piglets After Transition.

Mendler Marc R MR Schwarz Stephan S Hechenrieder Lisbeth L Kurth Steven S Weber Birte B Höfler Severin S Kalbitz Miriam M Mayer Benjamin B Hummler Helmut D HD

Frontiers in pediatrics 20180710

Background: Evidence for recommendations on the use of volume expansion during cardiopulmonary resuscitation in newborn infants is limited. Objectives: To develop a newborn piglet model with asphyxia, hemorrhage, and cardiac arrest to test different volume resuscitation on return of spontaneous circulation (ROSC). We hypothesized that immediate red cell transfusion reduces time to ROSC as compared to the use of an isotonic crystalloid fluid. Methods: Forty-four anaesthetized ...[more]

PMID: 30042934

Similar Datasets

Project description:BackgroundMany health care professionals experience a process of transition when entering the workforce. Various barriers have been documented in the literature, including a lack of confidence, challenging interactions with patients and colleagues, workload, increased responsibility, and a fear of making mistakes. Strategies to overcome these barriers, such as orientation and support programs, have been proposed. However, evidence for the transition of students into successful hospital pharmacists is limited.ObjectivesTo identify key barriers to the transition from student to successful hospital pharmacist and to outline strategies to overcome these barriers.MethodsAn electronic survey was distributed to Lower Mainland Pharmacy Services (LMPS) pharmacists, and subsequent one-on-one interviews were completed with a subgroup of new pharmacists.ResultsA total of 137 LMPS pharmacists (about 32% of potential respondents) responded to the survey, and 3 of these also participated in an interview. A performance score (used to quantify the transition experience) was calculated for 113 respondents, and there was a correlation between performance score and role satisfaction (r = 0.550, p < 0.001). Performance score was also correlated with years spent working as a hospital pharmacist (r = 0.333, p < 0.001) and with highest level of pharmacy education (r = 0.210, p = 0.026). Work in a specialty area and presence of an orientation program were additional factors associated with higher average performance scores. The greatest need for transitional support was during the first year of work, with trainers and social supports being identified as the most helpful resources. Various perspectives were offered during the interviews, with multiple barriers and strategies proposed.ConclusionsAmong respondents to this survey, the key barriers faced during the transition from student to successful hospital pharmacist were limited time working as a hospital pharmacist, lack of additional pharmacy education, lack of knowledge, rotation among multiple areas, uncertainty about role identity, and limited university preparation. Given that successful transition is associated with subsequent job satisfaction, workplace strategies such as limiting the number of practice areas, developing an orientation program, and providing continued support during the first year of work should be encouraged.

Dataset Information

Successful Resuscitation in a Model of Asphyxia and Hemorrhage to Test Different Volume Resuscitation Strategies. A Study in Newborn Piglets After Transition.

Publications

Successful Resuscitation in a Model of Asphyxia and Hemorrhage to Test Different Volume Resuscitation Strategies. A Study in Newborn Piglets After Transition.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets