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Hypothermia cardiac arrest

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https://www.readbyqxmd.com/read/28098670/understanding-therapeutic-hypothermia
#1
Christian S Yacono, Stephanie Eider
Therapeutic hypothermia is a relatively new protocol that can improve patients' chances of favorable neurologic outcomes after cardiac arrest. However, implementation rates remain low nationwide. This article describes recommendations for and benefits of therapeutic hypothermia in postresuscitation care.
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#2
Salvatore Brugaletta, Giancarla Scalone, Ana Paula Dantas, Luis Ortega-Paz, Manel Garabito, Mercè Roqué, Victoria Martin, Monica Masotti, Xavier Freixa, Manel Sabaté
BACKGROUND: Therapeutic hypothermia (HT) in out-of-hospital cardiac arrest STEMI patients aims to improve their neurological prognosis, but it has been associated with slow coronary flow and cardiac thrombotic events. We sought to serially assess endothelial function during the first 48h after admission in out-of-hospital cardiac arrest STEMI patients, under therapeutic hypothermia (HT). METHODS: From January 2015 to August 2015, eighteen consecutive out-of-hospital cardiac arrest STEMI patients eligible for primary PCI received HT at admission and were included in the study (HT group)...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#3
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28053858/a-major-miss-in-prognostication-after-cardiac-arrest-burst-suppression-and-brain-healing
#4
Danielle A Becker, Nicholas D Schiff, Lance B Becker, Manisha G Holmes, Joseph J Fins, James M Horowitz, Orrin Devinsky
We report a case with therapeutic hypothermia after cardiac arrest where meaningful recovery far exceeded anticipated negative endpoints following cardiac arrest with loss of brainstem reflexes and subsequent status epilepticus. This man survived and recovered after an out-of-hospital cardiac arrest followed by a 6-week coma with absent motor responses and 5 weeks of burst suppression. Standard criteria suggested no chance of recovery. His recovery may relate to the effect of burst-suppression on EEG to rescue neurons near neuronal cell death...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28042368/neurological-prognostication-of-cardiac-arrest-in-an-era-of-extracorporeal-membrane-oxygenation
#5
Supreet K Sahai, Tamara Majic, Jignesh Patel, Michael Nurok, Asma M Moheet, Axel J Rosengart, Shouri Lahiri
A neuron-specific enolase level greater than 33 ng/mL at days 1 to 3 or status myoclonus within 1 day are traditional indicators of poor neurological prognosis in survivors of cardiac arrest. We report the case of a 70-year-old man who received extracorporeal membrane oxygenation following cardiac arrest. Despite having both an elevated neuron-specific enolase concentration of 68 ng/mL and status myoclonus, he made an excellent neurological recovery. The value of traditional markers of poor prognosis such as elevated neuron-specific enolase or status myoclonus has not been systematically validated in patients treated with extracorporeal membrane oxygenation or therapeutic hypothermia...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28024551/end-of-life-issues-in-cardiac-critical-care-the-option-of-organ-donation
#6
REVIEW
Karim Serri, Pierre Marsolais
Despite important advances in the care of postcardiac arrest patients, severe brain injury remains one of the major causes of death in the cardiac intensive care unit. Neurological prognostication after cardiac arrest has evolved significantly since the introduction of therapeutic hypothermia. It now relies on a multimodal approach and a minimal observation period of 72 hours is usually advocated. However, when brain injury is severe and the prognosis considered dismal, patients become eligible for organ donation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#7
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28011292/utilization-of-palliative-care-services-for-cardiac-arrest-patients-undergoing-therapeutic-hypothermia-a-retrospective-analysis
#8
Emily K Zern, Michael N Young, Taylor Triana, Meng Xu, Benjamin Holmes, Nyal Borges, John A McPherson, Mohana B Karlekar
BACKGROUND: Palliative care (PC) services are integral to the care of patients with advanced medical illnesses. Given the significant morbidity and mortality associated with cardiac arrest, we sought to measure the use and impact of PC in the care of patients treated with therapeutic hypothermia (TH). METHODS: We conducted a retrospective study of 317 consecutive patients undergoing TH after cardiac arrest. We compared intensive care unit (ICU) characteristics and clinical outcomes of subjects who received PC consultation (n=125) to those who did not (n=192)...
December 21, 2016: Resuscitation
https://www.readbyqxmd.com/read/28004333/the-relationship-between-the-decreased-rate-of-initial-blood-glucose-and-neurologic-outcomes-in-survivors-of-out-of-hospital-cardiac-arrest-receiving-therapeutic-hypothermia
#9
Jae-Hyug Woo, Yong Su Lim, Hyuk Jun Yang, Sung Youl Hyun, Jin Seong Cho, Jin Joo Kim, Gun Lee
BACKGROUND: Hyperglycemia in out-of-hospital cardiac arrest (OHCA) survivors is associated with poor outcomes. However, in the control of initial hyperglycemia, an adequate strategy to improve patients' neurologic outcomes remains undetermined. Prior to the establishment of such strategy, we need to determine whether a decreased rate of initial blood glucose (BG) affects patient outcomes. METHODS: One hundred and forty-five adult non-traumatic OHCA survivors treated with therapeutic hypothermia between April 2007 and December 2011 were enrolled in this single-center retrospective cohort study...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28004331/delayed-deterioration-of-eeg-background-rhythm-post-cardiac-arrest
#10
Tadeu A Fantaneanu, Rani Sarkis, Kathleen Avery, Benjamin M Scirica, Shelley Hurwitz, Galen V Henderson, Jong Woo Lee
BACKGROUND: Electroencephalogram (EEG) background continuity is associated with a favorable prognosis in cardiac arrest patients post-therapeutic hypothermia. However, the continuous EEG in a subset of patients will undergo 'delayed EEG deterioration'; they will invariably have poor outcome. The aim of this study was to characterize this phenomenon. METHODS: We studied a prospectively collected cohort of consecutive cardiac arrest patients who underwent therapeutic hypothermia between July 2012 and May 2015...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27998282/does-therapeutic-hypothermia-during-extracorporeal-cardiopulmonary-resuscitation-preserve-cardiac-function
#11
Harald A Bergan, Per S Halvorsen, Helge Skulstad, Erik Fosse, Jan F Bugge
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (E-CPR) is increasingly used as a rescue method in the management of cardiac arrest and provides the opportunity to rapidly induce therapeutic hypothermia. The survival after a cardiac arrest is related to post-arrest cardiac function, and the application of therapeutic hypothermia post-arrest is hypothesized to improve cardiac outcome. The present animal study compares normothermic and hypothermic E-CPR considering resuscitation success, post-arrest left ventricular function and magnitude of myocardial injury...
December 20, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#12
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27992926/therapeutic-hypothermia-during-cpr-did-not-improve-survival-to-discharge-in-out-of-hospital-cardiac-arrest
#13
Benton R Hunter
No abstract text is available yet for this article.
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27989737/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#14
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
October 27, 2016: Resuscitation
https://www.readbyqxmd.com/read/27988254/targeted-temperature-management-after-cardiac-arrest-with-anaphylaxis
#15
Woon Jeong Lee, Dae Hee Kim, Seon Hee Woo, Seung Hwan Seol, Seung Pill Choi
Fatal anaphylaxis is uncommon but not rare. Extrapolated mortality rates are 0.52% of total anaphylaxis patients Bock et al. (Jan. 2001) [1]. Nevertheless, compared with the incidence of the other cardiac arrest events, the incidence of cardiac arrest due to anaphylaxis is relatively small. As a result, the effect using targeted temperature management after anaphylaxis is not clearly understood. We report the case of a 63-year-old man who developed cardiac arrest after ingestion of two pieces of peach. He was resuscitated and his circulation returned spontaneously after approximately 11min of cardiopulmonary resuscitation, but he was unresponsive and had fixed dilated pupils...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27984152/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#16
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27982758/burst-suppression-in-hypothermia-after-cardiac-arrest-because-of-drowning-treated-with-targeted-temperature-management-a-case-report
#17
Tomoya Okazaki, Toru Hifumi, Satoshi Egawa, Hideyuki Hamaya, Natsuyo Shinohara, Shohei Kawamoto, Takuma Iwaki, Kohei Tsukahara, Kenya Kawakita, Takashi Kusaka, Yasuhiro Kuroda
Outcomes of cardiac arrest (CA) because of drowning in children are generally poor, but some reports show that cases with post-CA hypothermia because of drowning exhibit good recovery when treated with targeted temperature management (TTM). However, because electroencephalogram (EEG) findings are not reported in those cases, a complete examination of brain damage has not been performed during TTM. Here we report a case of a 15-month-old boy with post-CA hypothermia recovery after treating with TTM, along with EEG findings...
December 16, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27943347/clinical-significance-of-j-waves-in-patients-undergoing-therapeutic-hypothermia-for-out-of-hospital-cardiac-arrest
#18
Ahmed Harhash, Ihor Gussak, James Cassuto, Stephen L Winters
BACKGROUND: Hypothermia is associated with the development of J waves. However, little is known about the impact of these ECG findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) post resuscitation from out-of-hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in-hospital mortality for patients with and without J waves either at baseline, during TH, or both...
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27913267/a-comparison-between-intravascular-and-traditional-cooling-for-inducing-and-maintaining-temperature-control-in-patients-following-cardiac-arrest-traditional-or-modern-therapeutic-hypothermia-after-cardiac-arrest
#19
Jeremy Rosman, Maxime Hentzien, Moustapha Dramé, Vincent Roussel, Bernard Just, Damien Jolly, Philippe Mateu
: Therapeutic temperature control has been widely used during the last decade to improve clinical outcomes. We conducted this retrospective observational study to compare traditional cooling with endovascular cooling in post-cardiac arrest comatose survivors and to compare results with current guidelines. PATIENTS AND METHODS: All patients admitted to our ICU for cardiac arrest and for whom temperature control was performed were included. Traditional cooling included cold infusions, ice packs and cooling blankets...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#20
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
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