[Resuscitation efficacy of extracorporeal membrane oxygenation in non-postcardiotomy adult patients with cardiac arrest].

Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes. Patients were divided into non-survival group (18 cases) and survival group (7 cases) based on their in-hospital outcome and the clinical characteristics were compared. Related factors of survival to discharge were analyzed by Spearman correlation analysis. Results: Majority of patients (84.0%(21/25)) developed cardiac arrest in our hospital, mostly due to acute myocardial infarction (80.0%(20/25)). The mean duration of CCPR prior to ECMO support was 40.0 (27.5, 72.0) minutes. The mean duration of ECMO support was 72.0 (47.5, 128.3) hours and 9 patients (36.0%) were successfully weaned. Intensive care unit stay was significantly shorter (3.0(1.8-7.8)days vs.16.0(11.0-37.0) days, P<0.01), mean blood pressure at 24 and 48 hours after ECMO initiation was significantly lower ((73.2±20.1)mmHg(1 mmHg=0.133 kPa) vs. (91.1±20.4)mmHg, P<0.05; (63.0±16.7)mmHg vs. (86.6±18.0 mmHg), P<0.05, respectively) and platelet count at 72 hours after extracorporeal support was significantly lower ((57.0±30.1)×109/L vs. (97.3±31.5)×109/L, P<0.05) in the non-survivor group than in survival group. Spearman correlation analysis demonstrated that mean arterial pressure at 24 hours (r=0.427, P<0.05) and 48 hours(r=0.558, P<0.05), and platelet count at 72 hours after extracorporeal support (r=0.577, P<0.05) were significantly correlated with survival to discharge. Conclusion: ECMO can be used as an effective alternative for refractory cardiac arrest in non-postcardiotomy adult patients.

[Effect and related factors of extracorporeal cardiopulmonary resuscitation combined with emergent percutaneous coronary intervention on cardiac arrest patients due to acute myocardial infarction].

OBJECTIVE: To evaluate the effect of extracorporeal membrane oxygenation (ECMO) combined with primary percutaneous coronary intervention (PPCI) on cardiac arrest in patients with acute myocardial infarction (AMI). METHODS: We retrospectively analyzed the clinical data from twenty cardiac arrest patients due to AMI from January 2010 to January 2015, who received both ECMO and PPCI after failed conventional cardiopulmonary resuscitation (CCPR) procedure in our center. The mean age was (58.8±13.9) years old and seventeen cases were male. The patients were divided into weaned (8 cases) and non-weaned group (12 cases) according to the outcome of ECMO removal, or survivor (6 cases) and non-survivor group (14 cases) according to the in-hospital outcome. The risk factors that affected weaning from ECMO and survival to discharge were analyzed via Spearman rank correlation test. RESULTS: (1) The mean duration of CCPR and ECMO support was (46.7±22.2)min and (102.3±66.6)h, respectively. The rate of return of simultaneous beating was 100%(20/20). (2) CCPR duration was significantly shorter ((35.1±11.8)min vs. (54.4± 24.5) min, P<0.05) and cardiac care unit(CCU) stay time was significantly longer ((20.5±12.3)d vs. (4.3±4.0)d, P<0.05) in weaned group than in non-weaned group. Moreover, a significant difference was identified in culprit vessel distribution between the two groups (P<0.05). Culprit vessel distribution (left anterior descending artery r=-0.612, P<0.01; right coronary artery r=0.612, P<0.01) and length of cardiac care unit stay (r=0.784, P<0.01) were associated with weaned patients. (3) CCPR duration was significantly shorter ((29.2±4.9)min vs. (51.0±24.5)min, P<0.01). CCU stay time was significantly longer(16.0(9.5, 37.8)d vs. 3.0(2.0, 11.0) d, P<0.01). Weaning rate (6/6 vs. 2/14, P<0.01) and mean blood pressure ((87.9±19.4)mmHg(1 mmHg=0.133 kPa) vs. (63.7±18.6)mmHg, P<0.05) were significantly higher, while lactic acid level in arterial blood((1.74±0.85)mmol/L vs. (6.41±5.65) mmol/L, P<0.05) 48 hours after ECMO support was significantly lower in survivor group compared with non-survivor group. Culprit vessel of right coronary artery (r=0.491, P<0.05), length of CCU stay (r=0.609, P<0.01), successful weaning rate (r=0.802, P<0.01), and mean blood pressure at 48 hours after ECMO establishment (r=0.558, P<0.05) were positively associated with survival. CONCLUSION: ECMO combined with PPCI is an effective therapeutic option to rescue AMI patients complicating with cardiac arrest.

In-line fiber-optic etalon formed by hollow-core photonic crystal fiber.

A novel fiber-optic in-line etalon formed by splicing a section of hollow-core photonic crystal fiber (HCPCF) in between two single-mode fibers is proposed and demonstrated, for the first time to our knowledge. Such a HCPCF-based etalon acts as an excellent optical waveguide to form a Fabry-Perot interferometer and hence allows the cavity length to be as long as several centimeters with good visibility as the transmission loss of the HCPCF is much smaller than that of a hollow core fiber; this offers great potential to generate a practical dense fiber-optic sensor network with spatial frequency division-multiplexing. This novel etalon is demonstrated for strain measurement, and the experimental results show that a good visibility of 0.3 and a strain accuracy of better than +/- 5 microepsilon are achieved.

Comparison of prototype and rote instruction of English names for Chinese visual characters.

This study compared prototype and rote instruction of English names for Chinese visual characters. In the prototype condition, participants were taught the meaning of the prototype that served as the distinctive feature of multicomponent characters. In the rote condition, participants traced the character and wrote its translation. Participants learned more rapidly and maintained more words in the prototype condition.