Nevertheless the first-year students consider high income as one of the most important factors. They appear more conscious and more ambitious regarding their future speciality choice. The Hungarian health care system and medical education must be prepared for the presence of students that are aware of the high market value of a medical diploma, selleck screening library have excellent language skills, and consider migration as one main factor in their motivation when choosing a medical profession.”
“Purpose: To compare cerebral and hemodynamic consequences
of different volumes of cold acetated Ringer’s solution or cold hypertonic saline dextran administered in order to achieve mild hypothermia after cardiac arrest (CA) in a pig model of experimental cardiopulmonary resuscitation (CPR).
Methods: Using an experimental pig model of 12 min CA (followed by 8 min CPR or no resuscitation) we compared four groups of piglets: a control group, a normothermic group and two groups with different solutions administered for induction of Selleck IPI-549 hypothermia. The control group of 5 piglets underwent 12
min CA without subsequent CPR, after which the brain of the animals was removed immediately. After restoration of spontaneous circulation (ROSC) the resuscitated piglets were randomized into a normothermic group (NT group = 10), and two hypothermic groups that received cold infusions of either 30 mL/kg acetated Ringer’s solution (Much fluid group, M, n = 10) or 3 mL/kg hypertonic saline dextran solution (Less fluid group, L, n = 10), respectively, administered during 30 min. Additional external cooling with ice packs was used in hypothermic groups. Sixty or 180 min after ROSC the experiment was terminated. Immediately after arrest the brain was removed for histological analyses.
Results: The median time to reach the target core temperature of 34 degrees C after ROSC was 51.5 +/- 7.8 min in L group and 48.8 +/- 8.6 min in M group. Less cerebral tissue content of water (p < 0.001), sodium (p < 0.0001), potassium (p < 0.0001) and less central venous pressure (CVP) MLN0128 concentration at 5 and 15 min after ROSC were demonstrated
in L group. Increased brain damage was demonstrated over time in NT group (p < 0.001). Less neurologic damage and BBB disruptions (albumin leakage) was observed at 180 min in M group in comparison with both NT and L groups (p < 0.001).
Conclusion: No statistical differences were observed between the hypothermic groups in the time to achieve mild hypothermia. Although inclusion of cold hypertonic crystalloid-colloidal solutions in the early resuscitation after ROSC may be more effective than cold crystalloids in reducing brain edema, this study demonstrates that mild hypothermia induced with small volumes of cold hypertonic crystalloid-colloids is less as effective as crystalloid’s induced hypothermia in mitigating brain injury after cardiac arrest.