Podcast appearances and mentions of James E Manning

Today’s episode will be conducted in English, as it will feature the lecture of Doctor and Professor James E. Manning, from the University of North Carolina at Chapel Hill, School of medicine.  He will be talking about several of the exciting studies he’s conducted on:  Selective Aortic Arch Perfusion SAAP,  Intra Aorta adrenalin injection, as means of treatment during medical and traumatic cardiac arrests. Resuscitive Endovascular Ballon Occlusion of the Aorta REBOA Extracorporeal Membrane Oxygenation ECMO These procedures are very advanced, but the effectiveness of them are controversial within the medical community. In Norway, a prehospital study on the REBOA procedure during cardiac arrests, is already ongoing in the city of Trondheim.  A huge Thank You to Doctor and Professor James E. Manning and Per Olav Berve at the Air Ambulance Department at Oslo University Hospital for letting me record and share this lecture on my podcast.   Vil du være med å støtte podkasten økonomisk kan du bidra her: https://www.patreon.com/Dupusterforfort Mvh Ole Kristian.  

The use of adrenaline in cardiac arrest resuscitation has been advocated since the 1960s. Laboratory studies and anecdotal experience showed improved rates of return of spontaneous circulation (ROSC) with the use of adrenaline at a dosage of approximately 0.01 mg/kg. This led to the widespread adoption of adrenaline administration during cardiac arrest into every resuscitation guideline for decades to come. Extensive laboratory studies characterized the beneficial physiological effects of adrenaline during cardiac arrest and closed-chest cardiopulmonary resuscitation (CC-CPR). Adrenaline administered during CC-CPR results in peripheral arterial vasoconstriction that raises the aortic pressure, particularly during the relaxation phase of CC-CPR. This increase in aortic pressure results in an increased aortic to right atrial pressure gradient that drives blood flow to the myocardium during CC-CPR. This pressure gradient is known as the coronary perfusion pressure (CPP) and has been shown to correlate with ROSC in both laboratory investigations and clinical studies. During the 1990s, the use of “high-dose” adrenaline showed increased rates of ROSC compared to “standard-dose” adrenaline. However, it was subsequently recognized that larger doses of adrenaline did not result in improved survival. Furthermore, questions have been raised as to whether or not “standard-dose” adrenaline improves survival from cardiac arrest. Recent meta-analyses have raised serious questions about the value of adrenaline, showing a benefit for achieving ROSC but no clear evidence of improved long-term survival. Controlled clinical trials to address this question are now underway. However, there is another important issue that needs to be addressed: the “route” of administration. With the growing interest in endovascular resuscitation, the use of intra-aortic adrenaline titration offers a means of rapidly and effectively delivering adrenaline to peripheral arterial effector sites while providing arterial pressure and CPP monitoring to guide titration of adrenaline doses to achieve an optimal hemodynamic effects while avoiding excessive adrenaline doses.

Join hosts Cliff Perotti and Jonathan Nicholas as they talk real estate values and the challenges of the appraisal system in the U.S. with guest James E. Manning, author of Public Trust Betrayed: The Truth Behind the Real Estate Appraisal Industry. Manning's new book emphasizes that there must be transparency and objectivity in the mortgage and evaluation process if we are to solve the current credit crisis and what we must change in the financial industry to prevent another economic meltdown. As a result of fraud, conflicts of interest, over-valuations, and lax underwriting standards, the entire lending industry must be examined and changed if any meaningful housing recovery is to be accomplished.