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Hypothermia cardiac arrest

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https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#1
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
#2
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
https://www.readbyqxmd.com/read/28698413/-aortic-stenosis-combined-with-cold-agglutinin-disease
#3
Zaiqiang Yu, Masahito Minakawa, Takashi Aoki, Norihiro Kondo, Kazuyuki Daitoku, Yasuyuki Suzuki, Ikuo Fukuda
Cardiac surgery on a patient with cold agglutinin disease is high risk for thromboembolism due to hypothermia perioperative. A 75-year-old woman with cold agglutinin disease underwent aortic valve replacement for severe aortic stenosis. Cold antibody was detected by preoperative screening test for blood transfusion. In order to prevent thromboembolic event during the operation, we maintained rectal temperature at around 36 degrees centigrade during the cardiopulmonary bypass by warming blood in the bypass circuit...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28695976/adaptation-of-global-hemostasis-to-therapeutic-hypothermia-in-patients-with-out-of-hospital-cardiac-arrest-thromboelastography-study
#4
Aleksander Trąbka-Zawicki, Marek Tomala, Aleksander Zeliaś, Elżbieta Paszek, Wojciech Zajdel, Ewa Stępień, Krzysztof Żmudka
BACKGROUND: The use of mild therapeutic hypothermia (MTH) in patients after out-of-hospital cardiac arrest (OHCA) who are undergoing primary percutaneous coronary intervention (pPCI) can protect patients from thromboembolic complications. The aim of the study was to evaluate the adaptive mechanisms of the coagulation system in MTH-treated comatose OHCA survivors. METHODS: Twenty one comatose OHCA survivors with acute coronary syndrome undergoing immediate pPCI were treated with MTH...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28693536/hypothermia-induced-alteration-of-repolarization-impact-on-acute-and-long-term-outcome-a-prospective-cohort-study
#5
Sophie von Ulmenstein, Christian Storm, Thomas G K Breuer, Sebastian Lask, Philipp Attanasio, Andreas Mügge, Alexander Wutzler
BACKGROUND: The effects of target temperature management (TTM) on the heart aren't thoroughly studied yet. Several studies showed the prolongation of various ECG parameters including Tpeak-Tend-time under TTM. Our study's goal is to evaluate the acute and long-term outcome of these prolongations. METHODS: In this study we included patients with successful resuscitation after cardiac arrest who were admitted to the Charité Virchow Klinikum Berlin or the Heart and Vascular Centre of the Ruhr University Bochum between February 2006 and July 2013 (Berlin) or May 2014 to November 2015 (Bochum)...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#6
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
July 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#7
Alain Cariou, Jean-Francois 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...
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
#8
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...
July 5, 2017: Neuroscience
https://www.readbyqxmd.com/read/28687073/association-of-neuron-specific-enolase-values-with-outcomes-in-cardiac-arrest-survivors-is-dependent-on-the-time-of-sample-collection
#9
Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Filip Malek, Vlasta Dudkova, Petr Neuzil, Petr Ostadal
BACKGROUND: Despite marked advances in intensive cardiology care, current options for outcome prediction in cardiac arrest survivors remain significantly limited. The aim of our study was, therefore, to compare the day-specific association of neuron-specific enolase (NSE) with outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with hypothermia. METHODS: Eligible patients were OHCA survivors treated with targeted temperature management at 33 °C for 24 h using an endovascular device...
July 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28680635/prolonged-duration-of-apnea-test-during-brain-death-examination-in-a-case-of-intraparenchymal-hemorrhage
#10
Premkumar Nattanmai, Christopher R Newey, Ishpreet Singh, Keerthivaas Premkumar
OBJECTIVE: Apnea test is required as part of the brain death examination. The duration of the apnea test is variable but typically requires 8-10 min. Prolonged apnea tests have been reported in the setting of hypothermia. Here, we describe a case of prolonged duration of apnea test secondary to a phenomenon called cardiac ventilation. METHODS: The patient presented in coma with brainstem areflexia after having an intracerebral hemorrhage resulting in subfalcine, central, uncal, and tonsillar herniations...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28678010/-prognostic-factors-in-renal-cancer-with-venous-thrombus-survival-analysis
#11
Angela Pascual-Fernández, Jesús Calleja-Escudero, Cristina Gómez de Segura, Laura Pesquera-Ortega, James Taylor, José Antonio Fajardo, Javier González de Zárate, Jesús Monllor-Gisbert, José Ramón Cortiñas-González
OBJECTIVES: To analyze surgery for renal cancer with venous thrombus at different levels, perioperative complications and prognostic factors associated to overall, cancer-specific and disease-free survival. MATERIAL AND METHODS: Retrospective analysis of 42 cases of renal cancer with venous thrombus performed between 2005 and 2015. The level reached by the thrombus was established according to the Mayo Clinic classification. Postoperative complications were staged according to Clavien-Dindo classification...
July 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28676267/neurologic-consultation-and-use-of-therapeutic-hypothermia-for-cardiac-arrest
#12
Elan L Guterman, Anthony S Kim, S Andrew Josephson
OBJECTIVE: To determine whether neurologic consultation influences the use of therapeutic hypothermia. METHODS: We identified adult patients treated for cardiac arrest from October 2009 through September 2015 at 149 academic medical centers and their affiliate hospitals using discharge diagnosis codes in Vizient database. Neurology consultation was defined as a neurologist participating in patient care at any point during the hospitalization. Use of therapeutic hypothermia was identified using procedure codes...
July 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28665234/magnesium-levels-and-neurologic-outcomes-in-patients-undergoing-therapeutic-hypothermia-after-cardiac-arrest
#13
William H Perucki, Brett Hiendlmayr, David M O'Sullivan, Angeline C Gunaseelan, Farruk Fayas, Antonio B Fernandez
Therapeutic hypothermia (TH) improves neurological outcomes after cardiac arrest by mitigating cerebral reperfusion injury. Serum magnesium (Mg) inhibits glutamate release, restores blood-brain barrier integrity, and decreases brain edema. The neuroprotective role of Mg in cardiac arrest patients undergoing TH is not well established. We analyzed 438 survivors of cardiac arrest who completed a TH protocol from 2008 through 2016. Multivariate and receiver operating characteristic (ROC) analyses examined the association between Mg supplementation and Mg levels before, during, and after TH with neurologic outcomes...
June 30, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28665071/feasibility-and-safety-of-mild-therapeutic-hypothermia-in-poor-grade-subarachnoid-hemorrhage-prospective-pilot-study
#14
Wookjin Choi, Soon Chan Kwon, Won Joo Lee, Young Cheol Weon, Byungho Choi, Hyeji Lee, Eun Suk Park, Ryeok Ahn
Therapeutic hypothermia (TH) improves the neurological outcome in patients after cardiac arrest and neonatal hypoxic brain injury. We studied the safety and feasibility of mild TH in patients with poor-grade subarachnoid hemorrhage (SAH) after successful treatment. Patients were allocated randomly to either the TH group (34.5°C) or control group after successful clipping or coil embolization. Eleven patients received TH for 48 hours followed by 48 hours of slow rewarming. Vasospasm, delayed cerebral ischemia (DCI), functional outcome, mortality, and safety profiles were compared between groups...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28652388/optimization-of-thermolytic-response-to-a1-adenosine-receptor-agonists-in-rats
#15
Isaac R Bailey, Bernard Laughlin, Lucille Moore, Lori K Bogren, Zeinab Barati, Kelly L Drew
Cardiac arrest is a leading cause of death in the United States and currently, therapeutic hypothermia, now called targeted temperature management (TTM), is the only recent treatment modality proven to increase survival rates and reduce morbidity for this condition. Shivering and subsequent metabolic stress, however, limits application and benefit of TTM. Stimulating CNS A1 adenosine receptors inhibits shivering and non-shivering thermogenesis in rats and induces a hibernation-like response in hibernating species...
June 26, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28644823/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients
#16
K Kim, Kimberly L Pargeon, Amy S Labar, Oren Friedman, Padmaja N Kandula, Douglas R Labar
PURPOSE: Continuous video EEG is a tool to assess brain function in injuries, including cardiac arrest (CA). In post-CA therapeutic hypothermia (TH) studies, some EEG features are linked to poor prognosis, but the evolvement of EEG characteristics during two temperature phases and its significance is unclear. We systematically analyzed EEG characteristics in cooled and rewarmed phases of post-CA therapeutic hypothermia patients and investigated their correlation to patient outcome. METHODS: This is a retrospective study of EEG analyses, from a single academic center, of 20 patients who underwent CA and therapeutic hypothermia...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#17
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28634504/the-reemergence-of-eeg-reactivity-after-cardiac-arrest
#18
Joseph Zachariah, Alejandro A Rabinstein
Electroencephalogram (EEG) reactivity has been increasingly utilized in prognostication after cardiac arrest. Recent studies have demonstrated a false-positive rate of 0% in predicting poor outcome with a nonreactive EEG. The reemergence of reactivity after an initial nonreactive EEG has been noted in cases of drug intoxication, rewarming after hypothermia, and after discontinuing sedation. This is the first case describing the reemergence of EEG reactivity without the confounding factors listed above. We describe a case of resuscitated cardiac arrest with initial EEG demonstrating a lack of reactivity...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#19
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/28622752/microvascular-fluid-exchange-during-cpb-with-deep-hypothermia-circulatory-arrest-or-low-flow
#20
Bjørg Elvevoll, Paul Husby, Venny L Kvalheim, Lodve Stangeland, Arve Mongstad, Øyvind S Svendsen
OBJECTIVE: Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively. MATERIALS AND METHODS: Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia...
June 1, 2017: Perfusion
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