Numerical modeling of sediment transfers at the catchment scale with TELEMAC

Water Qualit

Trans-nasal cooling during CPR: a single-center experience

IntroductionTrans-nasal cooling started during cardiopulmonary resuscitation (CPR) has shown to improve the return to spontaneous circulation (ROSC) and survival rate in an experimental prolonged cardiac arrest model. A multicenter randomized trial (PRINCE) has also suggested an improved neurological outcome in patients receiving trans-nasal cooling during CPR in the prehospital setting when compared with those treated by conventional hypothermia on hospital arrival, provided a delay between collapse and CPR of less than 10 minutes. MethodsPatients with witnessed cardiac arrest and a downtime less than 20 minutes were randomized to prehospital intra-arrest cooling versus standard ACLS care. Trans-nasal cooling (RhinoChill, BeneChill Inc. CA, USA) was initiated using a mixture of volatile coolant fluid with oxygen delivered into the nasopharynx for rapid evaporative heat transfer. Cooling was continued during CPR and, for patients who achieved ROSC, until initiation of systemic cooling at hospital. Resuscitation was continued for at least 30 minutes. All patients were then cooled at the hospital. ResultsTwenty-four patients were included, but one in the treatment group was excluded from the per-protocol analysis because of DNR orders. Patients randomized to treatment group (n = 9) or standard care (n = 14) had similar demographics, initial rhythm, time from collapse to CPR and ALS arrival. Median time from collapse to cooling initiation was 19 minutes. In total, 6/9 (66%) treated and 6/14 (42%) control patients achieved ROSC. Three patients (33%) in the treatment group survived to hospital discharge with CPC 1 to 2, while only one (7%) of the control group patients had good neurological outcome. No serious adverse events occurred in treated patients. ConclusionsTrans-nasal cooling seems to be safe and feasible in a prehospital setting. These single-center data confirm that trans-nasal cooling may improve the ROSC rate as well as good neurological outcome if started in patients with a short delay between collapse and CPR.info:eu-repo/semantics/publishe

Micropollutant and sediment interaction models using WAQTEL-MICROPOL module

Hydrodynamic

A newly implemented upwind scheme and numerical benchmark for the resolution of the Exner equation in GAIA

Hydrodynamic

Determination of initial soil moisture for a small highly erodible mountain basin with TELEMAC

Hydrodynamic

Beta-lactam antibiotics in continuous infusion in critically ill patients

info:eu-repo/semantics/publishe

A Multi-class Frazil Ice Model for Shallow Water Flows

Hydrodynamic

Modelling runoff for extreme rainfall events on large catchments using TELEMAC-2D

Hydrodynamic

Brain monitoring after cardiac arrest

Purpose of reviewTo describe the available neuromonitoring tools in patients who are comatose after resuscitation from cardiac arrest because of hypoxic-ischemic brain injury (HIBI).Recent findingsElectroencephalogram (EEG) is useful for detecting seizures and guiding antiepileptic treatment. Moreover, specific EEG patterns accurately identify patients with irreversible HIBI. Cerebral blood flow (CBF) decreases in HIBI, and a greater decrease with no CBF recovery indicates poor outcome. The CBF autoregulation curve is narrowed and right-shifted in some HIBI patients, most of whom have poor outcome. Parameters derived from near-infrared spectroscopy (NIRS), intracranial pressure (ICP) and transcranial Doppler (TCD), together with brain tissue oxygenation, are under investigation as tools to optimize CBF in patients with HIBI and altered autoregulation. Blood levels of brain biomarkers and their trend over time are used to assess the severity of HIBI in both the research and clinical setting, and to predict the outcome of postcardiac arrest coma. Neuron-specific enolase (NSE) is recommended as a prognostic tool for HIBI in the current postresuscitation guidelines, but other potentially more accurate biomarkers, such as neurofilament light chain (NfL) are under investigation.Neuromonitoring provides essential information to detect complications, individualize treatment and predict prognosis in patients with HIBI.Peer reviewe