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Hypothermia cardiac arrest

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https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#1
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29769006/role-of-cardiac-catheterization-lab-post-resuscitation-in-patients-with-st-elevation-myocardial-infarction
#2
Sridhar Reddy, Kwan S Lee, Karl Kern, Kapildeo Lotun
BACKGROUND: Cardiac arrest remains a common and lethal condition associated with high morbidity and mortality. Even with improving survival rates, the successfully resuscitated post cardiac arrest patient is also at risk for poor neurological outcomes, functional status and long- term survival if not managed appropriately. Given that acute coronary occlusion has been found to be the leading cause of cardiac arrest, long-term prognosis is good in selected patients after successful out-of-hospital resuscitation and ST elevation myocardial infarction who are taken for immediate coronary angiography, treated with primary percutaneous coronary intervention and hypothermia when indicated...
May 16, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29763714/optic-nerve-sheath-diameter-measured-using-early-unenhanced-brain-computed-tomography-shows-no-correlation-with-neurological-outcomes-in-patients-undergoing-targeted-temperature-management-after-cardiac-arrest
#3
Dong Hoon Lee, Sun Hwa Lee, Je Hyeok Oh, In Soo Cho, Young Hwan Lee, Chul Han, Wook Jin Choi, You Dong Sohn
AIM: Previous studies indicated that the optic nerve sheath diameter (ONSD) measured using brain computed tomography (CT) is a prognostic factor for poor neurological outcome after cardiac arrest. However, these studies were retrospective or included a small sample size. We performed a prospective multi-centre observational study to investigate the correlation between the ONSD on early brain CT and neurological outcomes in patients undergoing targeted temperature management (TTM). METHODS: This study used data from the Korean Hypothermia Network prospective registry between November 2015 and October 2016...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29756194/efficacy-and-safety-of-prolonged-mild-therapeutic-hypothermia-treatment-in-patients-after-out-of-hospital-cardiac-arrest-preliminary-data
#4
Robert Kowalik, Ewa Szczerba, Katarzyna Żukowska, Katarzyna Szepietowska, Łukasz Kołtowski, Michał Peller, Anna Fojt, Grzegorz Opolski
No abstract text is available yet for this article.
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29739265/therapeutic-hypothermia-promotes-cerebral-blood-flow-recovery-and-brain-homeostasis-after-resuscitation-from-cardiac-arrest-in-a-rat-model
#5
Qihong Wang, Peng Miao, Hiren R Modi, Sahithi Garikapati, Raymond C Koehler, Nitish V Thakor
Laboratory and clinical studies have demonstrated that therapeutic hypothermia (TH), when applied as soon as possible after resuscitation from cardiac arrest (CA), results in better neurological outcome. This study tested the hypothesis that TH would promote cerebral blood flow (CBF) restoration and its maintenance after return of spontaneous circulation (ROSC) from CA. Twelve Wistar rats resuscitated from 7-min asphyxial CA were randomized into two groups: hypothermia group (7 H, n = 6), treated with mild TH (33-34℃) immediately after ROSC and normothermia group (7 N, n = 6,37...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29737260/targeted-temperature-management-review-of-literature-and-guidelines-a-cardiologist-s-perspective
#6
Taimoor Hashim, Ranjith Shetty
Out of hospital cardiac arrest (OHCA) remains not an uncommon occurrence in USA and rest of the world. However, the survival to discharge following an episode of OHCA in adults is still very disappointing at around 10%. Several areas of improvement including education of general public in early Cardio Pulmonary resuscitation (CPR) by bystander, chest compression first, and improvement of Emergency Medical response time have had a positive effect in outcomes and survival but much still needs to be done. Recently new data has emerged with regards to post resuscitation care and mild induced hypothermia (now preferably called; targeted temperature management {TTM}) and several advances have been made...
May 7, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29737259/refractory-out-of-hospital-cardiac-arrest
#7
Madhan Shanmugasundaram, Kapildeo Lotun
Refractory out of hospital cardiac arrest is a common problem that is associated with poor overall survival rates and neurological outcomes. There are various definitions that have been used but the most accepted one is cardiac arrest that requires more than 10 minutes of cardiopulmonary resuscitation (CPR) efforts or more than 3 defibrillation attempts. There have been different pharmacologic and non-pharmacologic therapies that were studied in these patients. None of the antiarrhythmic or vasopressor medications have been consistently shown to improve survival or neurological outcomes in this subset of patients...
May 7, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29723608/osborn-waves-following-out-of-hospital-cardiac-arrest-effect-of-level-of-temperature-management-and-risk-of-arrhythmia-and-death
#8
Edina Hadziselimovic, Jakob Hartvig Thomsen, Jesper Kjaergaard, Lars Køber, Claus Graff, Steen Pehrson, Niklas Nielsen, David Erlinge, Martin Frydland, Sebastian Wiberg, Christian Hassager
BACKGROUND: The Osborn or J-wave, an upright deflection of the J-point on the electrocardiogram (ECG), is often observed during severe hypothermia. A possible relation between Osborn waves (OW) and increased risk of ventricular arrhythmia has been reported. We sought to determine whether the level of targeted temperature management (TTM) following out-of-hospital cardiac arrest (OHCA) affects the prevalence of OW and to assess the associations between OW and risk of ventricular arrhythmia and death...
April 30, 2018: Resuscitation
https://www.readbyqxmd.com/read/29723201/performance-on-the-apache-ii-saps-ii-sofa-and-the-ohca-score-of-post-cardiac-arrest-patients-treated-with-therapeutic-hypothermia
#9
Jea Yeon Choi, Jae Ho Jang, Yong Su Lim, Jee Yong Jang, Gun Lee, Hyuk Jun Yang, Jin Seong Cho, Sung Youl Hyun
OBJECTIVE: This study assessed the ability of the Acute Physiologic and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA) score, and out-of-hospital cardiac arrest (OHCA) score to predict the outcome of OHCA patients who underwent therapeutic hypothermia (TH). METHODS: This study included OHCA patients treated with TH between January 2010 and December 2013. The APACHE II score, SAPS II, and SOFA score were calculated at the time of admission and 24 h and 48 h after intensive care unit admission...
2018: PloS One
https://www.readbyqxmd.com/read/29713000/effects-of-inhaled-nitric-oxide-on-outcome-after-prolonged-cardiac-arrest-in-mild-therapeutic-hypothermia-treated-rats
#10
Anne Brücken, Christian Bleilevens, Philipp Berger, Kay Nolte, Nadine T Gaisa, Rolf Rossaint, Gernot Marx, Matthias Derwall, Michael Fries
Guidelines endorse targeted temperature management to reduce neurological sequelae and mortality after cardiac arrest (CA). Additional therapeutic approaches are lacking. Inhaled nitric oxide (iNO) given post systemic ischemia/reperfusion injury improves outcomes. Attenuated inflammation by iNO might be crucial in brain protection. iNO augmented mild therapeutic hypothermia (MTH) may improve outcome after CA exceeding the effect of MTH alone. Following ten minutes of CA and three minutes of cardiopulmonary resuscitation, 20 male Sprague-Dawley rats were randomized to receive MTH at 33 °C for 6hrs or MTH + 20ppm iNO for 5hrs; one group served as normothermic control...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29706060/variability-of-extracorporeal-cardiopulmonary-resuscitation-utilization-for-refractory-adult-out-of-hospital-cardiac-arrest-an-international-survey-study
#11
Patrick J Coppler, Benjamin S Abella, Clifton W Callaway, Minjung Kathy Chae, Seung Pill Choi, Jonathan Elmer, Won Young Kim, Young-Min Kim, Michael Kurz, Joo Suk Oh, Joshua C Reynolds, Jon C Rittenberger, Kelly N Sawyer, Chun Song Youn, Byung Kook Lee, David F Gaieski
Objective: A growing interest in extracorporeal cardiopulmonary resuscitation (ECPR) as a rescue strategy for refractory adult out-of-hospital cardiac arrest (OHCA) currently exists. This study aims to determine current standards of care and practice variation for ECPR patients in the USA and Korea. Methods: In December 2015, we surveyed centers from the Korean Hypothermia Network (KORHN) Investigators and the US National Post-Arrest Research Consortium (NPARC) on current targeted temperature management and ECPR practices...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29705374/predictors-of-obstructive-coronary-disease-and-mortality-in-adults-having-cardiac-arrest
#12
Jignesh K Patel, Ganesh Thippeswamy, Abdo Kataya, Charles A Loeb, Puja B Parikh
Coronary angiography is a key component of systematic, multi-disciplinary post-cardiac arrest (CA) care, however, coronary angiogram is not routinely performed in the setting of CA. We sought to identify the predictors of obstructive coronary artery disease (CAD) and mortality in adults with CA undergoing coronary angiogram. The study population included 208 consecutive patients hospitalized with CA who underwent resuscitation and subsequent coronary angiogram at an academic tertiary medical center. The primary outcome of interest was presence of obstructive CAD, defined as >1 coronary artery with >70% stenosis or >1 coronary bypass graft with >70% stenosis...
April 3, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#13
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698752/differential-effect-of-mild-therapeutic-hypothermia-depending-on-the-findings-of-hypoxic-encephalopathy-on-early-ct-images-in-patients-with-post-cardiac-arrest-syndrome
#14
Mitsuaki Nishikimi, Takayuki Ogura, Kazuki Nishida, Kunihiko Takahashi, Kenji Fukaya, Keibun Liu, Mitsunobu Nakamura, Shigeyuki Matsui, Naoyuki Matsuda
INTRODUCTION: The aim of this study was to evaluate the differential effects of mild therapeutic hypothermia (MTH) in post-cardiac arrest syndrome (PCAS) patients depending on the presence/absence of hypoxic encephalopathy (HE) in the early brain CT images obtained before the initiation of MTH. METHODS: We conducted a retrospective review of the data of a total of 129 patients with PCAS who were treated by MTH (34 °C) or normothermia treatment (NT) (35 °C or 36 °C), and had undergone brain CT examination prior to the initiation of these treatments...
April 23, 2018: Resuscitation
https://www.readbyqxmd.com/read/29687446/cost-utility-of-extracorporeal-membrane-oxygenation-rewarming-in-accidentally-hypothermic-patients-a-single-centre-retrospective-study
#15
S Kosiński, T Darocha, A Czerw, P Paal, M Pasquier, P Krawczyk, R Drwiła, R Gałązkowski
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has become the treatment of choice for severely hypothermic patients in cardiac arrest or acute cardiac failure. Highly specialized ECMO centres have been established, however, no centre has ever reported the costs of extracorporeal rewarming. The aim of this study was to assess the costs of the treatment of patients in Swiss Stage III and IV rewarmed with veno-arterial ECMO. METHODS: A retrospective exploratory cohort study analysed twenty-nine consecutive patients treated for hypothermia in the Severe Accidental Hypothermia Centre in Cracow, Poland...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#16
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29660066/accidental-hypothermia-cardiac-arrest-treated-successfully-with-invasive-body-cavity-lavage
#17
Jian Liang Tan, Mark Saks, Jessica M DelCollo, Mohammad Paryavi, Suren Visvanathan, Charles Geller
No abstract text is available yet for this article.
April 6, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29657946/too-cold-to-clot-does-intraoperative-hypothermia-contribute-to-bleeding-after-aortic-surgery
#18
Louis H Stein, Gregory Rubinfeld, Leora B Balsam, Patricia Ursomanno, Abe DeAnda
Background: We determined the impact of intraoperative hypothermia on postoperative bleeding after thoracic aortic surgery. Methods: We retrospectively analyzed 98 consecutive patients who underwent aortic surgery with deep hypothermic circulatory arrest between 2010 and 2014. We evaluated lowest temperature, absolute decrease in temperature, and rewarming rate. Univariate and multivariate regression were used to determine relationships between temperature, clinical characteristics, and measures of postoperative bleeding...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29623156/prognostic-value-of-the-neurological-examination-in-cardiac-arrest-patients-after-therapeutic-hypothermia
#19
Elizabeth A Matthews, Jessica Magid-Bernstein, Evie Sobczak, Angela Velazquez, Cristina Maria Falo, Soojin Park, Jan Claassen, Sachin Agarwal
Objectives: Current prognostication guidelines for cardiac arrest (CA) survivors predate the use of therapeutic hypothermia (TH). The prognostic value and ideal timing of the neurological examination remain unknown in the setting of TH. Design: Patients (N = 291) admitted between 2007 and 2015 to Columbia University intensive care units for TH following CA had neurological examinations performed on days 1, 3, 5, and 7 postarrest. Absent pupillary light response (PLR), absent corneal reflexes (CRs), and Glasgow coma scores motor (GCS-M) no better than extension were considered poor examinations...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29608502/xenon-an-emerging-neuroprotectant-with-potential-application-for-cardiac-arrest-care
#20
Mohammad Roostan, William H Frishman
Xenon is an inert, highly polarizable noble gas with demonstrated safety and application in general anesthesia for over fifty years. A potent inhibitor of the N-methyl-D-aspartate subtype of glutamate receptors, xenon has a well-documented ameliorating effect on excitotoxic neuronal injury in numerous cellular and animal models of hypoxic-ischemic brain injury. The most important determinant of overall survival and morbidity in out-of-hospital cardiac arrest is the severity of neurological injury. The only approved neuroprotective strategy in this setting is mild therapeutic hypothermia, which has demonstrated significant, albeit modest, improvements in mortality...
March 30, 2018: Cardiology in Review
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