No description available.

Regensburg, Univ., Diss., 2009.

No description available.

国立情報学研究所で電子化したコンテンツを使用している。

国立情報学研究所で電子化したコンテンツを使用している。

Techn. Universiẗat, Diss., 2005--München.

Background-High catecholamine concentrations are cytotoxic to cardiac myocytes. We hypothesized that myocardial interstitial catecholamine levels are greatly elevated immediately after long-duration ventricular fibrillation (VF), defibrillation, and reperfusion and that the short-acting β-antagonist esmolol administered at reperfusion would protect against this catecholamine surge and improve survival. Methods and Results-In part 1 of this study, catecholamines from myocardial interstitial fluid (ISF) and aortic and coronary sinus plasma were quantified by use of 3H-labeled radioenzymatic assay in 8 open-chest, anesthetized pigs. Eight minutes of electrically induced VF was followed by internal defibrillation and reperfusion. By 4 minutes of VF, ISF norepinephrine increased significantly, from 1.3±0.3 to 7.4±2.4 ng/mL. Epinephrine increased significantly, from 0.4±0.2 to 1.5±0.7 ng/mL. ISF norepinephrine and epinephrine peaked at 219.2±92.1 and 63.7±25.1 ng/mL after defibrillation and reperfusion and decreased significantly to 12.2±3.5 and 6.7±3.1 ng/mL 23 minutes after defibrillation. Transcardiac catecholamine changes were similar. In part 2, 8 minutes of VF was followed by external defibrillation in anesthetized, closed-chest pigs. Animals received 1.0 mg/kg esmolol (n=8) or saline (n=8) intravenously at the start of cardiopulmonary resuscitation (CPR). Advanced cardiac life support, including CPR and epinephrine, was delivered to both groups. Esmolol before reperfusion improved return of spontaneous circulation and 4-hour survival (7/8 versus 3/8 survivors, χ2 P<0.05). Conclusions-Transcardiac and ISF norepinephrine and epinephrine levels are briefly massively elevated after 8 minutes of VF, defibrillation, and reperfusion. A short-acting β-antagonist administered immediately after defibrillation improves return of spontaneous circulation and 4-hour survival after this prolonged VF.

No description available.

No description available.

The time from onset of a cardiac arrest to defibrillation is crucial hence access to and use of a defibrillator by all nurses essential. The purpose of this study was to use an established theoretical framework to examine and describe the defibrillation practices and beliefs of rural registered nurses in the Australian state of Queensland. The Theory of Reasoned Action (TRA) and Theory of Planned Behaviour (TPB) guided the research processes for this two phase study. In the first phase, focus group (n = 13) discussions identified the salient beliefs of the population. By eliciting nurses' beliefs, the subsequent quantitative study (n = 434) was conducted to determine the influences of these beliefs on nurses' use or non-use of defibrillators. The results showed that: (1) less than half of the cohort of participants were permitted to defibrillate; (2) the defibrillation beliefs of those nurses permitted to defibrillate were significantly more positive than those not permitted to do so; (3) the direct measures of TPB and selected variables external to the model predicted a significant portion of the variance in the measure of nurse-initiated defibrillation intention; and, (4) subjective norm emerged as the strongest predictor of intention. In conclusion, Queensland rural hospital nurses and employers still have some distance to travel down the path of nurse-initiated defibrillation. The TPB is a viable framework on which to base interventions designed to promote defibrillation by rural nurses. Understanding the role of social norms is of central importance to ensure all nurses can initiate the chain of survival expeditiously whenever the need arises.