Circulation. 2007;116:1337
doi: 10.1161/CIRCULATIONAHA.107.185631
(Circulation. 2007;116:1337.)
© 2007 American Heart Association, Inc.
Issue Highlights
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CARDIAC ARREST IN SCHOOLS, by Lotfi et al and DISSEMINATING CARDIOPULMONARY RESUSCITATION TRAINING BY DISTRIBUTING 35 000 PERSONAL MANIKINS AMONG SCHOOL CHILDREN, by Isbye et al.
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Sudden cardiac death in the young is an uncommon but often devastating
problem. Teaching children how to perform cardiopulmonary resuscitation
(CPR) and making automatic external defibrillators available
at schools may both be beneficial programs for reducing adverse
outcomes of cardiac arrests among students and adults. In this
issue of
Circulation, 2 separate manuscripts, by Lotfi and colleagues
and Isbye and colleagues, address these important topics. Lotfi
and colleagues report on the frequency of nontraumatic cardiac
arrests on school premises, reported to cardiac arrest registries
over a 16-year period, and determine the number of arrests among
students, faculty, and other adults. They find that 2.6% of
all public cardiac arrests occur at schools and also estimate
the annual incidence of cardiac arrests in these populations
at different school levels from preschool through college and
university. Faculty and other adults have accounted for the
majority of arrests on school premises. These data may be important
for determining appropriate resource use, particularly when
disseminating automatic external defibrillators. Isbye and colleagues
describe their results with widespread training of school-age
children in CPR using a personal resuscitation manikin. They
distributed CPR manikins to 35 000 students ages 12 to 14 years,
along with an instructional DVD and encouragement to train their
friends and family members. This public health project was facilitated
by a teacher and reported successful training of pupils. Approximately
20% of students returned a questionnaire after CPR training;
their answers indicated that each student trained an average
of 2.5 individuals, leading to over 17 000 additional CPR-trained
people in the immediate community. However, the authors did
not identify a significant increase in the use of bystander
CPR following this project. See pp 1374 and 1380 (editorial
p
1341).
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TRANSIENT LIMB ISCHEMIA INDUCES REMOTE PRECONDITIONING AND REMOTE POSTCONDITIONNING IN HUMANS BY A KATP CHANNEL–DEPENDENT MECHANISM, by Loukogeorgakis et al.
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It is well known that in experimental animals a prolonged ischemic
insult has protective effects against ischemia reperfusion injury
at remote sites. This protective effect could have important
clinical utility in patients with coronary artery or cerebrovascular
disease, in particular, if its mechanisms of action could be
known and could be used pharmacologically. The endothelium may
be a crucial target of ischemia reperfusion injury. In this
study, Loukogeorgakis et al demonstrate in normal subjects,
as well as in patients with atherosclerosis, that 20 minutes
of ischemia followed by reperfusion is associated with marked
impairment of endothelial function as assessed by flow-mediated
vasodilation and that this effect was prevented by remote ischemia
reperfusion. Because the K
ATP channel blocker glibenclamide
prevented this protective effect of remote ischemia reperfusion,
it is likely that, at sites of ischemia and reperfusion, a mediator,
or mediators, is released that activates these channels. Hence,
activation of K
ATP channels may provide a future target for
preventing reperfusion injury in patients. See p
1386.
Visit http://circ.ahajournals.org
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Images in Cardiovascular Medicine
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Cryptogenic Ventricular Arrhythmias and Sudden Death by Fabry
Disease: Prominent Infiltration of Cardiac Conduction Tissue.
See p
e350.
Subacute Massive Pulmonary Embolism Diagnosed by Transesophageal Echocardiography. See p e352.
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Correspondence
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See p
e354.
Related Articles:
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Prediction and Prevention of Sudden Cardiac Arrest: Lessons Learned in Schools
- N.A. Mark Estes, III
Circulation 2007 116: 1341-1343.
[Full Text]
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Cryptogenic Ventricular Arrhythmias and Sudden Death by Fabry Disease: Prominent Infiltration of Cardiac Conduction Tissue
- Andrea Frustaci and Cristina Chimenti
Circulation 2007 116: e350-e351.
[Full Text]
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Subacute Massive Pulmonary Embolism Diagnosed by Transesophageal Echocardiography
- Rajinder S. Bilku, Peter E. Glennon, and Martin Been
Circulation 2007 116: e352-e353.
[Full Text]
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Letter by Gaibazzi Regarding Article, "Usefulness of 64-Slice Cardiac Computed Tomographic Angiography for Diagnosing Acute Coronary Syndromes and Predicting Clinical Outcome in Emergency Department Patients With Chest Pain of Uncertain Origin"
- Nicola Gaibazzi
Circulation 2007 116: e354.
[Full Text]
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Transient Limb Ischemia Induces Remote Preconditioning and Remote Postconditioning in Humans by a KATP Channel–Dependent Mechanism
- Stavros P. Loukogeorgakis, Rupert Williams, Anna T. Panagiotidou, Shyamsunder K. Kolvekar, Ann Donald, Tim J. Cole, Derek M. Yellon, John E. Deanfield, and Raymond J. MacAllister
Circulation 2007 116: 1386-1395.
[Abstract]
[Full Text]
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CARDIAC ARREST IN SCHOOLS,...
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