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Hypothermia cardiac arrest

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https://www.readbyqxmd.com/read/28934276/enhanced-pyruvate-dehydrogenase-activity-improves-cardiac-outcomes-in-a-murine-model-of-cardiac-arrest
#1
Lin Piao, Yong-Hu Fang, Manfred M Kubler, Michael W Donnino, Willard W Sharp
RATIONALE: Post-ischemic changes in cellular metabolism alter myocardial and neurological function. Pyruvate dehydrogenase (PDH), the limiting step in mitochondrial glucose oxidation, is inhibited by increased expression of PDH kinase (PDK) during ischemia/reperfusion injury. This results in decreased utilization of glucose to generate cellular ATP. Post-cardiac arrest (CA) hypothermia improves outcomes and alters metabolism, but its influence on PDH and PDK activity following CA are unknown...
2017: PloS One
https://www.readbyqxmd.com/read/28895060/cerebral-tissue-oxidative-ischemia-reperfusion-injury-in-connection-with-experimental-cardiac-arrest-and-cardiopulmonary-resuscitation-effect-of-mild-hypothermia-and-methylene-blue
#2
Lars Wiklund, Ranjana Patnaik, Aruna Sharma, Adriana Miclescu, Hari S Sharma
The present investigation is an expansion of previous studies which all share a basic experimental protocol of a porcine-induced cardiac arrest (CA) of 12 min followed by 8 min of cardiopulmonary resuscitation (CPR), different experimental treatments (immediate as well as postponed induced mild hypothermia and administration of much or less cool intravenous fluids), and a follow-up period of 3 h after which the animals were sacrificed. Another group of animals was studied according to the same protocol after 12-min CA and "standard CPR...
September 11, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28887927/cardiac-support-emphasis-on-venoarterial-ecmo
#3
REVIEW
Christopher S King, Aviral Roy, Liam Ryan, Ramesh Singh
Major advances have been made in mechanical circulatory support in recent years. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) provides both pulmonary and circulatory support for critically ill patients with hemodynamic compromise, serving as a bridge to recovery or definitive therapy in the form of transplant or a durable ventricular assist device. In the past, VA ECMO support was used in cases of cardiogenic shock or failure to wean from cardiopulmonary bypass; however, the technology is now being applied to an ever-expanding list of conditions, including massive pulmonary embolism, cardiac arrest, drug overdose, and hypothermia...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28874237/-drowning-induced-hyperfibrinolytic-disseminated-intravascular-coagulation
#4
Andreas Lund Hattesen, Henrik Karsten Berg, Lars Folkersen, Anne-Mette Hvas
This article summarizes the current knowledge of drowning-induced hyperfibrinolytic disseminated intravascular coagulation. Drowning induces respiratory failure with ensuing cardiac arrest, hypoxaemia and ischaemia. A coagulopathy is induced by ischaemia, acidosis and hypothermia, and clinically the patient develops uncontrolled bleeding due to hyperfibrinolysis. A rapid diagnostic approach is required to recognize this hyperfibrinolytic state, since initiation of treatment with antifibrinolytics and fibrinogen concentrate may bring this life-threatening condition to cessation...
August 28, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28873073/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients-erratum
#5
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28844933/early-detection-of-brain-death-using-the-bispectral-index-bis-in-patients-treated-by-extracorporeal-cardiopulmonary-resuscitation-e-cpr-for-refractory-cardiac-arrest
#6
Romain Jouffroy, Lionel Lamhaut, Alexandra Guyard, Pascal Philippe, Kim An, Christian Spaulding, Frédéric Baud, Pierre Carli, Benoît Vivien
BACKGROUND: Despite increasing use of extracorporeal cardiopulmonary resuscitation (E-CPR) for treatment of refractory cardiac arrest patients, prognosis remains dismal, often resulting in brain-death. However, clinical assessment of brain-death occurence is difficult in post-cardiac arrest patients, sedated, paralyzed, under mild therapeutic hypothermia (MTH). Our objective was to assess the usefulness of Bispectral-Index (BIS) monitoring at bedside for an early detection of brain-death occurrence in refractory cardiac arrest patients treated by E-CPR...
August 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28844545/the-risk-of-neurological-dysfunctions-after-deep-hypothermic-circulatory-arrest-with-retrograde-cerebral-perfusion
#7
Giuseppe Gatti, Bernardo Benussi, Placido Currò, Gabriella Forti, Elisabetta Rauber, Alessandro Minati, Marco Gabrielli, Umberto Tognolli, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. METHODS: For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia...
August 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28844504/unsuspected-critical-illness-among-emergency-department-patients-presenting-for-acute-alcohol-intoxication
#8
Lauren R Klein, Jon B Cole, Brian E Driver, Christopher Battista, Ryan Jelinek, Marc L Martel
STUDY OBJECTIVE: Emergency department (ED) visits for acute alcohol intoxication are common, but this population is at risk for decompensation and occult critical illness. The purpose of this study is to describe the incidence and predictors of unsuspected critical illness among patients with acute alcohol intoxication. METHODS: This was a retrospective observational study of ED patients from 2011 to 2016 with acute alcohol intoxication. The study cohort included patients presenting for alcohol intoxication, whose initial assessment was uncomplicated alcohol intoxication without any other active acute medical or traumatic complaints...
August 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28842732/-preclinical-use-of-mild-therapeutic-hypothermia-after-cardiac-arrest-by-the-emergency-services-in-baden-w%C3%A3-rttemberg-germany
#9
R Fantin, B Schmid, C Busche, H Fritz, K Fink, H-J Busch
BACKGROUND: During the last decade target temperature management has become an integral part of postresuscitation care. Within recent years there was a strong debate about the optimal target temperature, which might have effects on the preclinical induction of hypothermia. The present investigation focuses on the use of mild therapeutic hypothermia by emergency services in the state of Baden-Württemberg (Germany) and compares it to results of a prior study in 2008. METHODS: Between April and August 2014 a questionnaire was sent to all senior emergency physicians of emergency services in Baden Württemberg...
August 25, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28833689/cold-water-immersion-kill-or-cure
#10
M J Tipton, N Collier, H Massey, J Corbett, M Harper
Like other environmental constituents such as pressure, heat and oxygen, cold water can be either good or bad, threat or treatment depending on circumstance. Given the current increase in the popularly of open cold water swimming it is timely to review the various human responses to cold water immersion (CWI) and consider the strength of the claims made for the effects of CWI. As a consequence, in this review we look at the history of CWI and examine CWI as a pre-cursor to drowning, cardiac arrest and hypothermia...
August 23, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28812241/plasma-glycoproteomic-study-of-therapeutic-hypothermia-reveals-novel-markers-predicting-neurologic-outcome-post-cardiac-arrest
#11
Wenjun Deng, Jing Cao, Lei Chen, David McMullin, James L Januzzi, Ferdinando S Buonanno, Eng H Lo, MingMing Ning
Therapeutic hypothermia (TH) is a neuroprotective treatment post-cardiac arrest but is grossly underutilized. After TH induction, traditional biomarkers and parameters can no long predict clinical outcome due to a lack of understanding of hypothermic response. Innovative approaches to better understand the clinical effect of TH will help to prognosticate outcome and expand beneficial population. Protein glycosylation is an important extracellular post-translational modification, regulating various extracellular signaling pathways...
August 15, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28807442/age-is-related-to-neurological-outcome-in-patients-with-out-of-hospital-cardiac-arrest-ohca-receiving-therapeutic-hypothermia-th
#12
Se Jong Oh, Jin Joo Kim, Jae Ho Jang, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang
INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28789562/patient-outcomes-after-palliative-care-consultation-among-patients-undergoing-therapeutic-hypothermia
#13
Priya Pinto, Tartania Brown, Michael Khilkin, Elizabeth Chuang
OBJECTIVES: To compare the clinical outcomes of patients who did and did not receive palliative care consultation among those who experienced out-of-hospital cardiac arrest and underwent therapeutic hypothermia. METHODS: We identified patients at a single academic medical center who had undergone therapeutic hypothermia after out-of-hospital cardiac arrest between 2009 and 2013. We performed a retrospective chart review for demographic data, hospital and critical care length of stay, and clinical outcomes of care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28765736/factors-influencing-the-quality-of-standardized-treatment-for-patients-with-post-cardiac-arrest-syndrome
#14
Jing Lu, Lijun Liu, Jianliang Zhu, Xinying Guo
BACKGROUND AND OBJECTIVES: For the present study, we investigated the factors that influence the quality of standardized treatment for patients with post-cardiac arrest syndrome (PCAS) to improve the quality of PCAS treatment. SUBJECTS AND METHODS: We collected data on patients with cardiac arrest (CA) who were admitted to the intensive care units (ICUs) of 11 hospitals-Class II Grade A or above-in Suzhou from January to October 2013. Indexes of standardized treatment were observed within 72 hrs of CA...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28761020/changes-in-neutrophil-to-lymphocyte-ratios-in-postcardiac-arrest-patients-treated-with-targeted-temperature-management
#15
Kazım Başer, Hatice Duygu Baş, Pavan Attaluri, Terrance Rodrigues, Jacob Nichols, Kennetht Nugen
OBJECTIVE: The prognostic value of changes in neutrophil-to-lymphocyte ratios (NLR) in cardiac arrest survivors receiving targeted temperature management (TTM) is unknown. The current study investigated NLR in postcardiac arrest (PCA) patients undergoing TTM. METHODS: This retrospective single-center study included 95 patients (59 males, age: 55.0±17.0 years) with in-hospital and out-of-hospital cardiac arrests who underwent TTM for PCA syndrome within 6 h of cardiac arrest...
July 25, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28758873/platelet-aggregation-during-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-a-randomised-clinical-trial
#16
Anni Nørgaard Jeppesen, Anne-Mette Hvas, Anders Morten Grejs, Christophe Duez, Susanne Ilkjær, Hans Kirkegaard
Some studies conclude that mild hypothermia causes platelet dysfunction leading to an increased bleeding risk, whereas others state that platelet aggregation is enhanced during mild hypothermia. Therefore, the aim of this study was to clarify whether standard or prolonged duration of targeted temperature management affected platelet aggregation. We randomised 82 comatose patients resuscitated after out-of-hospital cardiac arrest to either 24 hours (standard group) or 48 hours (prolonged group) of targeted temperature management at 33±1°C...
July 31, 2017: Platelets
https://www.readbyqxmd.com/read/28745848/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest-digest
#17
Julianna Jung, Milana Zaurova
Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm...
October 22, 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28741002/extracorporeal-membrane-oxygenation-in-cardiac-arrest
#18
Boon Kiat Kenneth Tan
The survival of cardiac arrest patients is dependent on the efficient and timely application of the chain of survival. This includes early identification of cardiac arrest and activation of the emergency response system, high-quality cardiopulmonary resuscitation (CPR), rapid defibrillation, basic and advanced medical services, and advanced life support and post-cardiac arrest care. However, some patients may be refractory to these measures. Extracorporeal membrane oxygenation CPR (ECPR), otherwise known as extracorporeal life support, offers an alternative to such refractory cardiac arrest cases...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#19
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#20
Anders Wetting Carlsen, Nils K Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson, Alexander Wahba
BACKGROUND: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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