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https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#1
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28873019/the-effects-of-in-hospital-intravenous-cold-saline-in-postcardiac-arrest-patients-treated-with-targeted-temperature-management
#2
Nissi Suppogu, Gregory A Panza, Sena Kilic, Shreyas Gowdar, Kamala R Kallur, Ramya Jayaraman, Justin Lundbye, Antonio B Fernandez
BACKGROUND: Recent data suggest that rapid infusion of intravenous (IV) cold saline for Targeted Temperature Management (TTM) after cardiac arrest is associated with higher rates of rearrest, pulmonary edema, and hypoxia, with no difference in neurologic outcomes or survival when administered by Emergency Medical Services. We sought to determine the effects of IV cold saline administration in the hospital setting in postcardiac arrest patients to achieve TTM and its effect on clinical parameters and neurologic outcomes...
September 5, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28860012/continuous-versus-intermittent-neuromuscular-blockade-in-patients-during-targeted-temperature-management-after-resuscitation-from-cardiac-arrest-a-randomized-double-blinded-double-dummy-clinical-trial
#3
Mathias Stöckl, Christoph Testori, Fritz Sterz, Michael Holzer, Christoph Weiser, Andreas Schober, Graham Nichol, Martin Frossard, Harald Herkner, Jasmin Kechvar, Heidrun Losert
AIM OF THE STUDY: Current guidelines recommend targeted temperature management to improve neurological outcome after cardiac arrest. Evidence regarding an ideal sedative/analgesic regimen including skeletal muscle paralysis is limited. METHODS: Patients were randomized to either a continuous administration of rocuronium (continuous-NMB-group) or to a continuous administration of saline supplemented by rocuronium bolus administration if demanded (bolus-NMB-group)...
August 30, 2017: Resuscitation
https://www.readbyqxmd.com/read/28857853/valproic-acid-combined-with-postcardiac-arrest-hypothermic-targeted-temperature-management-prevents-delayed-seizures-and-improves-survival-in-a-rat-cardiac-arrest-model
#4
Joo Suk Oh, Jinka Tulasi, Ren Xiaodan, William C Stacey, Robert W Neumar
OBJECTIVES: High-dose valproic acid in combination with hypothermic-targeted temperature management has been reported to synergistically improve neurologic outcomes after cardiac arrest. This study investigated the potential synergistic mechanisms. DESIGN: Prospective, randomized, experimental study. SETTING: University research institution. SUBJECTS: Male Long Evans rats. INTERVENTION: Rats resuscitated from asphyxial cardiac arrest were randomized to one of the three groups: normothermic-targeted temperature management (37°C ± 1°C), hypothermic-targeted temperature management (33° ± 1° × 24 hr + placebo infusion), hypothermic-targeted temperature management plus high-dose valproic acid (300 mg/kg IV × 1 initiated 5 min post return of spontaneous circulation and infused over 20 min) (hypothermic-targeted temperature management + valproic acid)...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28851561/ovarian-development-of-captive-f1-wreckfish-h%C3%A4-puku-polyprion-oxygeneios-under-constant-and-varying-temperature-regimes-implications-for-broodstock-management
#5
Matthew J Wylie, Alvin N Setiawan, Glen W Irvine, Jane E Symonds, Abigail Elizur, Marcileida Dos Santos, P Mark Lokman
In order to better understand how photo-thermal conditions affect oogenesis in captive-bred F1 hāpuku, a wreckfish considered for aquaculture in New Zealand, juvenile (pre-pubertal) fish were assigned to one of two regimes: exposed to a constant temperature of 17 °C (CT group) or to seasonally varying temperatures (VT group range: 10-17 °C), both under simulated ambient photoperiod, for nearly 2 years. Development in females was monitored through repeated gonadal biopsies (histology; target gene mRNA levels) and blood sampling (plasma levels of estradiol-17β; E2)...
August 26, 2017: General and Comparative Endocrinology
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
#6
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/28833890/fit-to-predict-ecoinformatics-for-predicting-the-catchability-of-a-pelagic-fish-in-near-real-time
#7
Kylie L Scales, Elliott L Hazen, Sara M Maxwell, Heidi Dewar, Suzanne Kohin, Michael G Jacox, Christopher A Edwards, Dana K Briscoe, Larry B Crowder, Rebecca L Lewison, Steven J Bograd
The ocean is a dynamic environment inhabited by a diverse array of highly migratory species, many of which are under direct exploitation in targeted fisheries. The timescales of variability in the marine realm coupled with the extreme mobility of ocean-wandering species such as tuna and billfish complicates fisheries management. Developing ecoinformatics solutions that allow for near real-time prediction of the distributions of highly mobile marine species is an important step towards the maturation of dynamic ocean management and ecological forecasting...
August 21, 2017: Ecological Applications: a Publication of the Ecological Society of America
https://www.readbyqxmd.com/read/28830715/neurological-outcome-after-cardiac-arrest-managed-with-targeted-temperature-management-are-hemodynamic-variables-useful
#8
EDITORIAL
Rachel M Riley, Joseph Varon
No abstract text is available yet for this article.
August 19, 2017: Resuscitation
https://www.readbyqxmd.com/read/28830480/recorded-time-periods-of-bispectral-index-values-equal-to-zero-predict-neurological-outcome-after-out-of-hospital-cardiac-arrest
#9
Ward Eertmans, Cornelia Genbrugge, Gilles Haesevoets, Jo Dens, Willem Boer, Frank Jans, Cathy De Deyne
BACKGROUND: Prognostication in out-of-hospital cardiac arrest (OHCA) survivors is often difficult. Recent studies have shown the predictive ability of bispectral index (BIS) monitoring to assist with early neuroprognostication. The aim of this study was to investigate whether characteristics of BIS values equal to zero (BIS 0) (i.e. duration and/or uni- versus bilateral presence) instead of simply their occurrence are better indicators for poor neurological outcome after OHCA by aiming at a specificity of 100%...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28819446/incremental-value-of-circulating-mir-122-5p-to-predict-outcome-after-out-of-hospital-cardiac-arrest
#10
Yvan Devaux, Antonio Salgado-Somoza, Josef Dankiewicz, Adeline Boileau, Pascal Stammet, Anna Schritz, Lu Zhang, Mélanie Vausort, Patrik Gilje, David Erlinge, Christian Hassager, Matthew P Wise, Michael Kuiper, Hans Friberg, Niklas Nielsen
Rationale. The value of microRNAs (miRNAs) as biomarkers has been addressed in various clinical contexts. Initial studies suggested that miRNAs, such as the brain-enriched miR-124-3p, might improve outcome prediction after out-of-hospital cardiac arrest. The aim of this study is to determine the prognostic value of miR-122-5p in a large cohort of comatose survivors of out-of-hospital cardiac arrest. Methods. We analyzed 590 patients from the Targeted Temperature Management trial (TTM-trial). Circulating levels of miR-122-5p were measured in serum samples obtained 48 hours after return of spontaneous circulation...
2017: Theranostics
https://www.readbyqxmd.com/read/28819230/genomic-signatures-of-local-adaptation-reveal-source-sink-dynamics-in-a-high-gene-flow-fish-species
#11
Katherine Cure, Luke Thomas, Jean-Paul A Hobbs, David V Fairclough, W Jason Kennington
Understanding source-sink dynamics is important for conservation management, particularly when climatic events alter species' distributions. Following a 2011 'marine heatwave' in Western Australia, we observed high recruitment of the endemic fisheries target species Choerodon rubescens, towards the cooler (southern) end of its distribution. Here, we use a genome wide set of 14 559 single-nucleotide polymorphisms (SNPs) to identify the likely source population for this recruitment event. Most loci (76%) showed low genetic divergence across the species' range, indicating high levels of gene flow and confirming previous findings using neutral microsatellite markers...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28815564/target-temperature-34-vs-36%C3%A2-c-after-out-of-hospital-cardiac-arrest-a-retrospective-observational-study
#12
L Arvidsson, S Lindgren, L Martinell, S Lundin, C Rylander
BACKGROUND: Intensive care for comatose survivors of cardiac arrest includes targeted temperature management (TTM) to attenuate cerebral reperfusion injury. A recent multi-center clinical trial did not show any difference in mortality or neurological outcome between TTM targeting 33°C or 36°C after out-of-hospital-cardiac-arrest (OHCA). In our institution, the TTM target was changed accordingly from 34 to 36°C. The aim of this retrospective study was to analyze if this change had affected patient outcome...
October 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28813616/targeted-temperature-management-in-nursing-care
#13
Justin Lundbye, Heather Hand, Mark Adams, Lindsay Boyd
No abstract text is available yet for this article.
August 16, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28803654/temporal-pattern-and-prognostic-significance-of-hypokalemia-in-patients-undergoing-targeted-temperature-management-following-cardiac-arrest
#14
Arash Nayeri, Hannah Gluck, Eric Farber-Eger, Srikanth Krishnan, Kamran Shamsa, Michael Lee, Quinn S Wells, John A McPherson
Hypokalemia has been consistently reported as a common occurrence during targeted temperature management (TTM) in comatose survivors of cardiac arrest. We sought to better describe changes in serum potassium throughout the different stages of TTM and to assess for any prognostic significance. We analyzed a prospectively collected cohort of 240 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014. The primary outcome was poor neurologic outcome at hospital discharge, defined as a Cerebral Performance Category score >2...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28800291/therapeutic-hypothermia-and-targeted-temperature-management-with-or-without-the-cold-stress-response
#15
Patrick M Kochanek, Travis C Jackson
No abstract text is available yet for this article.
August 11, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28789766/-post-resuscitation-care-after-out-of-hospital-cardiac-arrest
#16
Johannes Grand, Christian Hassager, Jesper Kjærgaard
Survival from out-of-hospital cardiac arrest in Denmark has increased significantly since 2001, and important improvements have been made in the post-resuscitation care. The aim of this article is to summarize the most recent international guidelines for post-resuscitation care in a Danish perspective. The main aspects concern securing haemodynamic and respiratory functions and performing urgent coronary catheterization and targeted temperature management in selected patients. In prognostication a multi-modal approach should be applied...
July 24, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28761020/changes-in-neutrophil-to-lymphocyte-ratios-in-postcardiac-arrest-patients-treated-with-targeted-temperature-management
#17
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
#18
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/28750886/intubation-is-not-a-marker-for-coma-after-in-hospital-cardiac-arrest-a-retrospective-study
#19
Katherine M Berg, Anne V Grossestreuer, Amy Uber, Parth V Patel, Michael W Donnino
INTRODUCTION: In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. METHODS: Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28745848/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest-digest
#20
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
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