ABSTRACT
Corona virus disease 2019 (COVID-19) pandemic has posed significant risk for health care workers. Various steps of cardiopulmonary resuscitation involve aerosol-generating procedures and have significant risk of spread of corona virus. Indian Academy of Pediatrics Advanced Life Support Basic Life Support (IAP ALS BLS) group had constituted a guideline update team to suggest modifications in existing resuscitation guidelines in view of COVID-19 pandemic. The GRADE approach was used to develop recommendations on shortlisted clinical practice questions on resuscitation during COVID pandemic as modifications.
Subject(s)
COVID-19 , Cardiopulmonary Resuscitation , Amyotrophic Lateral Sclerosis , Child , Humans , Pandemics , SARS-CoV-2ABSTRACT
During the past decade, guidelines for cardiopulmonary resuscitation have focused on the importance of high quality CPR. The purpose is to temporarily maintain a circulation to vital organs until specialized treatment is available. In, essence, it has been a revolution in pediatric resuscitation in terms of coming full circle to the 1960s when basic CPR was first developed. A fifth component to the pediatric chain of survival has been added with emphasis on integrated post cardiac arrest care. With mounting scientific evidences, American Heart Association published new Pediatric Advanced life support 2010 guidelines in accordance with the established five yearly cycle of guideline changes.
Subject(s)
Cardiopulmonary Resuscitation/standards , Heart Arrest/therapy , Pediatrics/standards , Child , Humans , Practice Guidelines as TopicSubject(s)
Body Weight , Dopamine/administration & dosage , Child , Humans , Infusions, Intravenous/methodsSubject(s)
Dapsone/poisoning , Exchange Transfusion, Whole Blood , Child, Preschool , Cyanosis/therapy , Humans , Hypoxia/therapy , MaleABSTRACT
An attempt has been made to formulate a stable, aqueous injection of nifedipine (1) using the technique of hydrotropic solubilization. Sodium benzoate (2; 30% w/v) and sodium salicylate (3; 30% w/v) have been employed as the vehicle to prepare the injection of 1 in 1 mg/5 ml and 1 mg/2 ml concentration in either case. An accelerated stability study for 4 weeks at 8 degrees C, room temperature, 40 and 50 degrees C indicates maximum stability at 8 degrees C, suggesting the need of storage with refrigeration. Light stability study in the specially designed chamber indicates that covering the ampoules with black chart paper affords adequate stability to the 1 injection. The injections are also stable to autoclaving. Preliminary in vivo study in rats shows that the injection is effective.
Subject(s)
Nifedipine/administration & dosage , Animals , Blood Pressure/drug effects , Chemical Phenomena , Chemistry, Physical , Drug Stability , Evaluation Studies as Topic , Female , Light , Nifedipine/pharmacology , Pharmaceutical Vehicles , Rats , Solubility , Sterilization , TemperatureABSTRACT
Nifedipine (1), a drug practically insoluble in water, has been solubilized employing sodium benzoate (2) and sodium salicylate (3) as hydrotropes. In 30% w/v 2 solution the solubility of 1 increased 85 and 76 fold at 25 +/- 1 degree C and at 37 +/- 1 degree C respectively. The corresponding increase in solubility of 1 in 30% w/v 3 solution was 135 and 107 fold respectively. To study the mechanism of hydrotropic solubilization of 1, the solution properties of 2 and 3 over a concentration range of 1 to 30% w/v were undertaken. The probable mechanism involves a complexation type of interaction at a low concentration of hydrotrope, aggregation of the hydrotropic molecules and inclusion of 1 in these aggregates at high concentration; and structural changes in water caused by hydrotropes.
