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Pediatric cardiac arrest hypothermia

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https://www.readbyqxmd.com/read/29580960/prediction-of-survival-in-accidental-hypothermia-requiring-extracorporeal-life-support-an-individual-patient-data-meta-analysis
#1
Richard S Saczkowski, Doug J A Brown, Riyad B Abu-Laban, Guy Fradet, Costas J Schulze, Nick D Kuzak
BACKGROUND: Extra-corporeal life support (ECLS) is a life-saving intervention for patients with hypothermia induced cardiac arrest or severe cardiovascular instability. However, its application is highly variable due to a paucity of data in the literature to guide practice. Current guidelines and recommendations are based on expert opinion, single case reports, and small case series. Combining all of the published data in a patient-level analysis can provide a robust assessment of the influence of patient characteristics on survival with ECLS...
March 23, 2018: Resuscitation
https://www.readbyqxmd.com/read/29528976/survival-and-long-term-functional-outcomes-for-children-with-cardiac-arrest-treated-with-extracorporeal-cardiopulmonary-resuscitation
#2
Francesc Torres-Andres, Ericka L Fink, Michael J Bell, Mahesh S Sharma, Eric J Yablonsky, Joan Sanchez-de-Toledo
OBJECTIVES: To identify patient- and disease-related factors related to survival and favorable outcomes for children who underwent extracorporeal cardiopulmonary resuscitation after a refractory cardiac arrest. DESIGN: Retrospective observational study with prospective assessment of long-term functional outcome. PATIENTS: Fifty-six consecutive children undergoing extracorporeal cardiopulmonary resuscitation at our institution from 2007 to 2015...
May 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29476891/post-arrest-therapeutic-hypothermia-in-pediatric-patients-with-congenital-heart-disease
#3
Henry H Cheng, Satish K Rajagopal, Arnold J Sansevere, Erica McDavitt, Daniel Wigmore, Jessica Mecklosky, Kristofer Andren, Kathryn A Williams, Amy Danehy, Janet S Soul
BACKGROUND: While therapeutic hypothermia (TH) is an effective neuroprotective therapy for neonatal hypoxic-ischemic encephalopathy, TH has not been demonstrated to improve outcome in other pediatric populations. Patients with acquired or congenital heart disease (CHD) are at high risk of both cardiac arrest and neurodevelopmental impairments, and therapies are needed to improve neurologic outcome. The primary goal of our study was to compare safety/efficacy outcomes in post-arrest CHD patients treated with TH versus controls not treated with TH...
May 2018: Resuscitation
https://www.readbyqxmd.com/read/29454009/24-vs-72-hours-of-hypothermia-for-pediatric-cardiac-arrest-a-pilot-randomized-controlled-trial
#4
Ericka L Fink, Robert S B Clark, Rachel P Berger, Anthony Fabio, Derek C Angus, R Scott Watson, John J Gianakas, Ashok Panigrahy, Clifton W Callaway, Michael J Bell, Patrick M Kochanek
AIM: Children surviving cardiac arrest (CA) lack proven neuroprotective therapies. The role of biomarkers in assessing response to interventions is unknown. We hypothesized that 72 versus 24 h of hypothermia (HT) would produce more favorable biomarker profiles after pediatric CA. METHODS: This single center pilot randomized trial tested HT (33 ± 1 °C) for 24 vs. 72 h in 34 children with CA. Children comatose after return of circulation aged 1 week to 17 years and treated with HT by their physician were eligible...
May 2018: Resuscitation
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#5
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29406474/childhood-drowning-review-of-patients-presenting-to-the-emergency-departments-of-2-large-tertiary-care-pediatric-hospitals-near-and-distant-from-the-sea-coast
#6
Neta Cohen, Dennis Scolnik, Ayelet Rimon, Uri Balla, Miguel Glatstein
OBJECTIVE: Drowning is a leading cause of death among infants and toddlers. Unique physiological and behavioral factors contribute to high mortality rates. Drowning incidents predominantly occur during warmer months and holidays. The aim of this study was to describe the characteristics of pediatric drowning victims who attended 2 different emergency departments (EDs), 1 near and 1 distant from the sea coast, to recognize risk factors, complications, causes of death, and the educational needs of families and caregivers...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#7
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
February 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#8
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28687308/deep-hypothermia-therapy-attenuates-lps-induced-microglia-neuroinflammation-via-the-stat3-pathway
#9
G Tong, A Krauss, J Mochner, S Wollersheim, P Soltani, F Berger, K R L Schmitt
Deep hypothermia therapy (HT) is a standard method for neuroprotection during complex pediatric cardiac surgery involving extracorporeal circulation and deep hypothermic cardiac arrest. The procedure, however, can provoke systemic inflammatory response syndrome (SIRS), one of the most severe side effects associated with pediatric cardiac surgery. To date, the cellular inflammatory mechanisms induced by deep HT remain to be elucidated. Therefore, we investigated the effects of deep HT (17°C) and rewarming on the inflammatory response in lipopolysaccharide (LPS) stimulated BV-2 murine microglia...
September 1, 2017: Neuroscience
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#10
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28486266/pediatric-drowning-a-standard-operating-procedure-to-aid-the-prehospital-management-of-pediatric-cardiac-arrest-resulting-from-submersion
#11
Rebecca R Best, Benjamin H L Harris, Jason L Walsh, Timothy Manfield
OBJECTIVES: Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. METHODS: A literature review on the management of pediatric drowning was conducted...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28481829/a-population-pharmacokinetic-analysis-to-study-the-effect-of-therapeutic-hypothermia-on-vancomycin-disposition-in-children-resuscitated-from-cardiac-arrest
#12
Nicole R Zane, Michael D Reedy, Marc R Gastonguay, Adam S Himebauch, Evan Z Ramsey, Alexis A Topjian, Athena F Zuppa
OBJECTIVES: Limited data exist on the effects of therapeutic hypothermia on renal function and pharmacokinetics in pediatric patients after cardiac arrest. The objective was to describe the differences in vancomycin disposition in pediatric patients following cardiac arrest treated with either therapeutic hypothermia or normothermia using population pharmacokinetic modeling. DESIGN: Single-center, retrospective cohort study. SETTING: A tertiary care hospital pediatric and cardiac ICU...
July 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#13
REVIEW
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28274812/pediatric-cardiac-arrest-due-to-drowning-and-other-respiratory-etiologies-neurobehavioral-outcomes-in-initially-comatose-children
#14
RANDOMIZED CONTROLLED TRIAL
Beth S Slomine, Vinay M Nadkarni, James R Christensen, Faye S Silverstein, Russell Telford, Alexis Topjian, Joshua D Koch, Jill Sweney, Ericka L Fink, Mudit Mathur, Richard Holubkov, J Michael Dean, Frank W Moler
AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#15
REVIEW
Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28150290/a-review-of-the-utility-of-a-hypothermia-protocol-in-cardiac-arrests-due-to-non-shockable-rhythms
#16
Brin Freund, Peter W Kaplan
BACKGROUND: Therapeutic hypothermia and targeted temperature management are considered standard of care in the management of patients following out-of-hospital cardiac arrests due to shockable rhythms to improve neurological outcomes. In those presenting out-of-hospital cardiac arrests associated with non-shockable rhythms, the benefit of hypothermia is less clear. In this review we try to clarify the utility of implementing a hypothermia protocol after cardiac arrests due to non-shockable rhythms...
2017: Cardiology Journal
https://www.readbyqxmd.com/read/27849689/9-therapeutic-hypothermia-after-pediatric-cardiac-arrest-in-hospital-trial
#17
Frank Moler, J Michael Dean
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#18
RANDOMIZED CONTROLLED TRIAL
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27509385/functional-outcome-trajectories-after-out-of-hospital-pediatric-cardiac-arrest
#19
Faye S Silverstein, Beth S Slomine, James Christensen, Richard Holubkov, Kent Page, J Michael Dean, Frank W Moler
OBJECTIVES: To analyze functional performance measures collected prospectively during the conduct of a clinical trial that enrolled children (up to age 18 yr old), resuscitated after out-of-hospital cardiac arrest, who were at high risk of poor outcomes. DESIGN: Children with Glasgow Motor Scale score less than 5, within 6 hours of resuscitation, were enrolled in a clinical trial that compared two targeted temperature management interventions (THAPCA-OH, NCT00878644)...
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27403966/asian-targeted-temperature-management-task-panel-report
#20
Mayuki Aibiki, Ming-Chou Chiang, Sombat Muengtaweepongsa, Sohil Pothiawala, Chien-Hua Huang
In the fields of emergency and critical care, targeted temperature management has become a critical issue and particularly popular in clinical practices throughout Asia. As more research is carried out, evidence and concepts about targeted temperature management continue to evolve. Areas of interest include new 2015 resuscitation guidelines, temperature management in pediatrics, and integrated care and neurological monitoring for cardiac arrest patients. The Asian Targeted Temperature Management task panel includes colleagues from various Asian countries and allows them to exchange experiences in a professional environment...
March 2017: Therapeutic Hypothermia and Temperature Management
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