Abstract Background Mechanical cardiopulmonary resuscitation (CPR) devices are currently recommended when high-quality CPR could not be provided and only if used by trained rescuers. Guidelines are against their routinely use since clinical trials results are controversial, and solid evidence of improved survival are missing. Moreover, many studies compared these devices to very high-quality manual CPR, hardly replicable in a pre-hospital emergency setting. Nowadays, different machines are available but literature is poor in direct comparison studies. Purpose To assess whether the type of mechanical chest compressor could affect the probability of return of spontaneous circulation (ROSC) and of 30-days mortality after an out-of-hospital cardiac arrest (OHCA) as compared to manual standard CPR. Methods Data were prospectively collected from our Utstein-based cardiac arrest registry. We considered all OHCAs from January 1, 2015 to December 31, 2022 from 7 provinces covered by the same regional emergency system (population covered 4.2mln. inhabitants) but equipped with three different types of mechanical compressor: Autopulse®; LUCAS® and Easy Pulse®. Patients treated with mechanical CPR and manual CPR were randomly matched via a multivariable logistic regression propensity score considering age, gender, witnessed OHCA, presence of bystander CPR, first rhythm recorded, EMS arrival time and lay defibrillation before EMS arrival. Logistic regression and COX regression models were performed and adjusted for resuscitation duration to investigate the association between the type of CPR and the probability of ROSC and of 30-day mortality. Results Among 13,203 OHCAs with attempted CPR, 10,497 (79.5%) received manual CPR and in 2,405 (18.2%) mechanical CPR [Easy Pulse® in 1,102(45.8%), Autopulse® in 776 (32.3%) and LUCAS® in 521 (21.7%)]. ROSC before hospital admission was obtained in 1,712 patients (13.0%) and 762 (5.8%) were alive after 30 days. After propensity score matching two homogeneous groups of 1,946 patients each (manual and mechanical CRP) were identified. The rate of ROSC and of 30-day survival were lower in the mechanical CPR group (ROSC: 14.7% vs 24.1%; p<0.001; 30-day survival 6% vs 14%; p<0.001). The three devices showed an independent association with the probability of ROSC as compared to manual CPR [Autopulse®: OR 1.76, 95% CI (1.36-2.28) p<0.001; LUCAS®:OR 1.55, 95% CI (1.13-2.13), p=0.006 and Easy Pulse®:OR 0.49; 95% CI (0.37-0.65), p<0.001] (Figure 1A). Only Autopulse® was independently associated with 30-day mortality [AutoPulse HR 0.87, 95%CI (0.79-0.97), p=0.01; LUCAS®: HR 1.00, 95%CI (0.88-1.14), p=0.97) and Easy Pulse®: HR: 1.06, 95%CI (0.97-1.16), p=0.19] (Figure 1B). Conclusions This is the first study comparing the performance of three devices for mechanical chest compressions revealing that they differently affect the probability of ROSC and of 30-day survival.
A new methanofullerene derivative with a pyridine residue at the methano bridge (PC60) has been synthesized. Its electrochemical and photophysical properties have been investigated in toluene solution along with those of the analogous fullerene mono-malonate adduct RC60, which does not contain the pyridyl moiety. PC60 and RC60 display almost identical steady state absorption and luminescence properties and transient absorption spectra, as shown by means of nano- and picosecond laser flash photolysis. Their markedly different spectroscopic features with respect to plain C60 are discussed, with the aid of semi-empirical calculations. PC60 binds zinc(II) meso-tetraphenylporphyrin (ZnTPP) through coordination of the pyridyl moiety to the zinc ion giving, to the best of our knowledge, the first non-covalent assembly of a porphyrin–fullerene diad. The association constant of the 1:1 complex between PC60 and ZnTPP has been determined at 300 K by 1H NMR (Ka=3600±150 L mol-1, C6D6 solution) and fluorescence titrations (Ka=3000±400 L mol-1, toluene solution). Mixtures of RC60 and ZnTPP have also been investigated, giving no evidence of association. Extremely fast ZnTPP luminescence quenching in the PC60–ZnTPP complex was observed by time-resolved luminescence spectroscopy (k>5×1010 s-1), tentatively attributed to an energy transfer mechanism. The bimolecular quenching constant of the lowest triplet excited state of ZnTPP by PC60 was determined via a Stern–Volmer analysis (kq=6.7×109 s-1).
Excitation at 350−355 nm of the dyads PAu−Ir, PH2−Ir and of the triads PH2−Ir−PAu and PZn−Ir−PAu where Ir, iridium(III) bis-terpyridine, is covalently linked to gold (III), free-base and zinc(II) tetraaryl-porphyrins (PAu, PH2, PZn), produces to a predominant extent the ligand centered triplet excited state of the iridium complex unit, 3Ir. The processes occurring in the arrays upon UV excitation have been characterized by steady state and time-resolved spectroscopic methods. Energy transfer to the porphyrin triplets dominates the deactivation of 3Ir in PAu−Ir, PH2−Ir, and PH2−Ir−PAu, with rates of 2.9 × 1010 s-1 (3Ir → 3PAu) and ca. 1011 s-1 (3Ir → 3PH2), in contrast to what has been shown to occur upon selective excitation of the PH2 unit, which yields electron transfer leading to charge separation. The different outcome is discussed on the basis of the overlap of the HOMO and LUMO orbitals involved in the electron-transfer reaction for the Ir acceptor unit and the PH2 donor unit, with the aid of semiempirical calculations. Remarkably, the PZn based array PZn−Ir−PAu displays efficient electron transfer with the formation of a charge separated state with unitary yield, irrespective of the component which is excited. A very high driving force, ΔG° = −1.1 eV, could explain the prevalence of the electron-transfer reaction in the latter case.
Abstract The photophysical properties of rufloxacin, 9‐fluoro‐2 r 3‐dihydro‐10‐(4‐methyl‐l‐pyrazinyl)‐7‐oxo‐7‐H‐pyri‐do[l,2,3‐ de ]‐l,4‐benzothiazin‐6‐carboxylic acid, a fluoroquinolone antibacterial drug exhibiting photosensitizing action toward biological substrates, were studied in aqueous solutions at neutral pH. The lowest excited electronic states of the zwitterion were characterized by both experimental techniques and theoretical methods. Steady‐state and time‐resolved emission, triplet‐state absorption and singlet oxygen production were investigated. The results indicate that the lowest excited singlet is a fluorescent, relatively long‐lived state (φ r = 0.075, T r ≅ 4.5 ns) with an efficient intersystem crossing to the triplet manifold (φ isc ≅ 0‐ 7 )‐ The lowest triplet is a long‐lived state ( T T ≅ 10 μs at 295 K in 0.01 M phosphate buffer), with properties that make it a good candidate for being the precursor of the photodecarboxylation of the drug. It is quenched by oxygen at a rate of 1.7 times 10 9 M ‐1 s‐ 1 and singlet oxygen is formed with a quantum yield of 0.32 in air‐saturated solutions.
An entry from the Cambridge Structural Database, the world’s repository for small molecule crystal structures. The entry contains experimental data from a crystal diffraction study. The deposited dataset for this entry is freely available from the CCDC and typically includes 3D coordinates, cell parameters, space group, experimental conditions and quality measures.
An entry from the Cambridge Structural Database, the world’s repository for small molecule crystal structures. The entry contains experimental data from a crystal diffraction study. The deposited dataset for this entry is freely available from the CCDC and typically includes 3D coordinates, cell parameters, space group, experimental conditions and quality measures.
An entry from the Cambridge Structural Database, the world’s repository for small molecule crystal structures. The entry contains experimental data from a crystal diffraction study. The deposited dataset for this entry is freely available from the CCDC and typically includes 3D coordinates, cell parameters, space group, experimental conditions and quality measures.
