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https://www.readbyqxmd.com/read/28337603/multimodal-outcome-prognostication-after-cardiac-arrest-and-targeted-temperature-management-analysis-at-36%C3%A2-%C3%A2-c
#1
Spyridoula Tsetsou, Jan Novy, Christian Pfeiffer, Mauro Oddo, Andrea O Rossetti
BACKGROUND: Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. METHODS: In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5)...
March 23, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28323720/neuroprognostication-after-cardiac-arrest-in-the-light-of-targeted-temperature-management
#2
Mauro Oddo, Hans Friberg
PURPOSE OF REVIEW: Delayed awakening after targeted temperature management (TTM) and sedation is frequent among cardiac arrest patients. Differentiating between prolonged coma and irreversible cerebral damage can be challenging, therefore the utilization of a multimodal approach is recommended by international guidelines. Here, we discuss indications and advantages/disadvantages of available modalities for coma prognostication and describe new tools to improve our accuracy for outcome prediction...
March 20, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28315727/increasing-or-fluctuating-bispectral-index-values-during-post-resuscitation-targeted-temperature-management-can-predict-clinical-seizures-after-rewarming
#3
Kanae Ochiai, Atsushi Shiraishi, Yasuhiro Otomo, Yuuichi Koido, Takashi Kanemura, Masato Honma
AIM: To investigate whether an increasing bispectral index (BIS) value during targeted temperature management (TTM) correlates with increased clinical seizures after TTM or worse neurological prognoses after TTM. METHODS: We performed a retrospective prognostication study of patients who were treated with TTM after recovery of spontaneous circulation from cardiac arrest at a tertiary care hospital. We recorded the BIS regularly during TTM and calculated the correlations of the mean BIS values, standard deviations of the BIS values, and linear regression coefficient of the trend of the BIS values over time as index tests...
March 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28314170/-pseudo-subarachnoid-hemorrhage-sign-on-early-brain-computed-tomography-in-out-of-hospital-cardiac-arrest-survivors-receiving-targeted-temperature-management
#4
Byung Kook Lee, Youn-Jung Kim, Seung Mok Ryoo, Su Jin Kim, Dong Hun Lee, Kyung Woon Jeung, Won Young Kim
PURPOSE: Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. MATERIALS AND METHODS: We retrospectively evaluated the registries of 2 tertiary hospitals, identifying 836 adult (≥18 years) patients achieving return of spontaneous circulation after out-of-hospital cardiac arrest...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#5
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28302139/targeted-temperature-management-in-cardiac-arrest-survival-evaluated-by-propensity-score-matching
#6
Eirik A Buanes, Karl O Hufthammer, Jørund Langørgen, Anne-Berit Guttormsen, Jon-Kenneth Heltne
BACKGROUND: Targeted temperature management in cardiac arrest was introduced following evidence of increased survival from two controlled trials published in 2002. We wanted to investigate whether the introduction of targeted temperature management to clinical practice had increased the survival of cardiac arrest patients at Haukeland University Hospital, Norway. METHODS: We included 336 unresponsive patients admitted to the emergency department between December 2003 and December 2008 with return of spontaneous circulation following out-of-hospital cardiac arrest in the analysis...
March 16, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#7
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28285322/intensive-care-medicine-research-agenda-on-cardiac-arrest
#8
REVIEW
Jerry P Nolan, Robert A Berg, Stephen Bernard, Bentley J Bobrow, Clifton W Callaway, Tobias Cronberg, Rudolph W Koster, Peter J Kudenchuk, Graham Nichol, Gavin D Perkins, Tom D Rea, Claudio Sandroni, Jasmeet Soar, Kjetil Sunde, Alain Cariou
Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)-requiring mechanical ventilation and sedation-and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care...
March 11, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28284166/the-effect-of-targeted-temperature-management-on-qt-and-corrected-qt-intervals-in-patients-with-cardiac-arrest
#9
Zachary Rosol, David F Miranda, Yader Sandoval, Bradley A Bart, Stephen W Smith, Steven R Goldsmith
BACKGROUND: Targeted Temperature Management (TTM) improves outcomes after cardiac arrest but may affect the QT and QTc intervals which could increase the chance of subsequent arrhythmia. We report here the effects of TTM on both computer-derived and manually calculated QT and QTc as well as the relationship of the length of the QTc and serious arrhythmia in a retrospective single-center experience. METHODS: 193 patients undergoing TTM for cardiac arrest were studied...
February 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28274812/pediatric-cardiac-arrest-due-to-drowning-and-other-respiratory-etiologies-neurobehavioral-outcomes-in-initially-comatose-children
#10
Beth S Slomine, Vinay M Nadkarni, James R Christensen, Faye S Silverstein, Russell Telford, Alexis Topjian, Joshua D Koch, Jill Sweney, Ericka L Fink, Mudit Mathur, Richard Holubkov, J Michael Dean, Frank W Moler
AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28245642/flight-synchrony-among-the-major-moth-pests-of-cranberries-in-the-upper-midwest-usa
#11
Shawn A Steffan, Merritt E Singleton, Jayne Sojka, Elissa M Chasen, Annie E Deutsch, Juan E Zalapa, Christelle Guédot
The cranberry fruitworm (Acrobasis vaccinii Riley), sparganothis fruitworm (Sparganothis sulfureana Clemens), and blackheaded fireworm (Rhopobota naevana Hübner) are historically significant pests of cranberries (Vaccinium macrocarpon Aiton) in the Upper Midwest (Wisconsin), USA. Their respective natural histories are well documented but correlations between developmental benchmarks (e.g., larval eclosion) and degree-day accruals are not yet known. Treatment timings are critical to the optimization of any given control tactic, and degree-day accrual facilitates optimization by quantifying the developmental status of pest populations...
February 26, 2017: Insects
https://www.readbyqxmd.com/read/28243991/normothermia-and-stroke
#12
REVIEW
Jonathan Marehbian, David M Greer
In the past two decades, there has been much focus on the adverse effect of fever on neurologic outcome, the benefits of hypothermia on functional outcomes, and the interplay of associated complications. Despite decades of experience regarding randomized, safety and feasibility, case-controlled, retrospective studies, there has yet to be a large, randomized, multicenter, clinical trial with the appropriate power to address the potential benefits of targeted temperature modulation compared to hypothermia alone...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28242531/recent-developments-in-the-management-of-patients-resuscitated-from-cardiac-arrest
#13
REVIEW
Jacob C Jentzer, Casey M Clements, Joseph G Murphy, R Scott Wright
Cardiac arrest is the leading cause of death in Europe and the United States. Many patients who are initially resuscitated die in the hospital, and hospital survivors often have substantial neurologic dysfunction. Most cardiac arrests are caused by coronary artery disease; patients with coronary artery disease likely benefit from early coronary angiography and intervention. After resuscitation, cardiac arrest patients remain critically ill and frequently suffer cardiogenic shock and multiorgan failure. Early cardiopulmonary stabilization is important to prevent worsening organ injury...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28239054/critical-care-management-focused-on-optimizing-brain-function-after-cardiac-arrest
#14
Ryuta Nakashima, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Satoshi Egawa, Akihiko Inoue, Ryutaro Seo, Nobuhiro Inagaki, Yasuhiro Kuroda
The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28237225/end-season-daily-weight-gains-as-rationale-for-targeted-selective-treatment-against-gastrointestinal-nematodes-in-highly-exposed-first-grazing-season-cattle
#15
Aurélie Merlin, Alain Chauvin, Anne Lehebel, Nadine Brisseau, Sébastien Froger, Nathalie Bareille, Christophe Chartier
A two-year study was carried out to assess the feasibility of a targeted selective treatment to control gastrointestinal nematodes (GIN) in 24 groups of first grazing season (FGS) cattle. A two-step procedure aiming at defining exposure risk at group level and at identifying the most infected individuals within groups through measurement of the average daily weight gain (ADWG) at housing was used. The first step was to define retrospectively, by grazing management practices (GMP) indicators, two levels of groups' exposure to GIN determined by anti O...
March 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28229199/-coronary-artery-disease-interventional-and-operative-therapeutic-options-after-cardiac-arrest
#16
M Behnes, K Mashayekhi, M Borggrefe, I Akin
Coronary artery disease (CAD) represents a common structural cause for developing cardiac arrest in older patients, whereas in young adults cardiac arrest is more often caused by cardiomyopathies and cardiac channelopathies. A structural heart disease is known in almost 50% of patients prior to cardiac arrest. The present review outlines current interventional and operative therapeutic options for patients surviving cardiac arrest. The focus is on associations between epidemiological data on the incidence of malignant arrhythmias causing cardiac arrest depending on the presence or absence of CAD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28229026/spawning-aggregation-of-white-streaked-grouper-epinephelus-ongus-spatial-distribution-and-annual-variation-in-the-fish-density-within-a-spawning-ground
#17
Atsushi Nanami, Taku Sato, Yuuki Kawabata, Junichi Okuyama
White-streaked grouper (Epinephelus ongus) is an important fisheries target and forms spawning aggregations at particular spawning grounds. The aims of the present study were to investigate the ecological characteristics of annual spawning aggregations such as (1) spatial variations in the density of E. ongus at the spawning ground, (2) the relationship between fish density and environmental variables, (3) inter-annual variations in the spawning aggregation, (4) the proportion of males to females at the spawning ground for several days pre-and post-spawning and (5) the relationship between male density and female density at the protected spawning ground, based on observations over five years at an Okinawan coral reef...
2017: PeerJ
https://www.readbyqxmd.com/read/28220713/the-influence-of-targeted-temperature-management-on-the-pharmacokinetics-of-drugs-administered-during-and-after-cardiac-arrest-a-systematic-review
#18
Tessa Crombez, Said Hachimi-Idrissi
OBJECTIVE: Pharmacokinetic parameters of drugs are widely investigated under normothermic conditions and normal hemodynamic parameters. The European Resuscitation Council recommends the use of targeted temperature management (TTM) with a target temperature of 34 °C in cardiac arrest (CA) patients. The aim of this literature review is to investigate the influence of CA combined with TTM on the pharmacokinetics of drugs. Results of preclinical and clinical studies are compared with each other...
April 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#19
Anne-Laure Constant, Nicolas Mongardon, Quentin Morelot, Nicolas Pichon, David Grimaldi, Lauriane Bordenave, Alexis Soummer, Bertrand Sauneuf, Sybille Merceron, Sylvie Ricome, Benoit Misset, Cedric Bruel, David Schnell, Julie Boisramé-Helms, Etienne Dubuisson, Jennifer Brunet, Sigismond Lasocki, Pierrick Cronier, Belaid Bouhemad, Serge Carreira, Emmanuelle Begot, Benoit Vandenbunder, Gilles Dhonneur, Philippe Jullien, Matthieu Resche-Rigon, Jean-Pierre Bedos, Claire Montlahuc, Stephane Legriel
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67...
April 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28211002/factors-that-influence-effective-perioperative-temperature-management-by-anesthesiologists-a-qualitative-study-using-the-theoretical-domains-framework
#20
Sylvain Boet, Andrea M Patey, Justine S Baron, Karim Mohamed, Ashlee-Ann E Pigford, Gregory L Bryson, Jamie C Brehaut, Jeremy M Grimshaw
PURPOSE: Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. METHODS: After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital...
February 16, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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