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Hypothermia after out of hospital arrest

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https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#1
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
https://www.readbyqxmd.com/read/27887653/intravascular-versus-surface-cooling-for-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-an-analysis-of-the-ttm-trial-data
#2
Guy W Glover, Richard M Thomas, George Vamvakas, Nawaf Al-Subaie, Jules Cranshaw, Andrew Walden, Matthew P Wise, Marlies Ostermann, Emma Thomas-Jones, Tobias Cronberg, David Erlinge, Yvan Gasche, Christian Hassager, Janneke Horn, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Michael Wanscher, Jørn Wetterslev, Hans Friberg, Niklas Nielsen
BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices...
November 26, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27807612/-early-onset-pneumonia-after-successful-resuscitation-incidence-after-mild-invasive-hypothermia-therapy
#3
J W Erath, J Hodrius, P Bushoven, S Fichtlscherer, A M Zeiher, F H Seeger, J Honold
BACKGROUND: Targeted temperature management (TTM) represents an effective therapy to improve neurologic outcome in patients who survive an out-of-hospital cardiac arrest (OHCA). First publications about this therapy reported a higher incidence of infections in patients who underwent TTM induced by external cooling devices. Whether intravascular cooling devices are also associated with an increased infection rate has not been investigated so far. METHODS: In a single center retrospective study, the incidence of early onset pneumonia (EOP) in OHCA patients with or without intravascular TTM at 33 °C target temperature for 24 h who survived at least 24 h after admission was analyzed...
November 2, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27782794/clinical-effect-of-rebound-hyperthermia-after-cooling-postcardiac-arrest-a-retrospective-cohort-study
#4
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27743918/influence-of-body-mass-index-on-the-prognosis-of-patients-successfully-resuscitated-from-out-of-hospital-cardiac-arrest-treated-by-therapeutic-hypothermia
#5
Guillaume Geri, Guillaume Savary, Stéphane Legriel, Florence Dumas, Sybille Merceron, Olivier Varenne, Bernard Livarek, Olivier Richard, Jean-Paul Mira, Jean-Pierre Bedos, Jean-Philippe Empana, Alain Cariou, David Grimaldi
BACKGROUND: Obesity prevalence has dramatically increased over recent years and is associated with cardiovascular diseases, but data are lacking on its prognostic impact in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Data of all consecutive OHCA patients admitted in two cardiac arrest centers from Paris and suburbs between 2005 and 2012 were prospectively collected. Patients treated by therapeutic hypothermia (TH) were included in the analysis. Logistic and Cox regression analyses were used to quantify the association between body mass index (BMI) at hospital admission and day-30 and 1-year mortality respectively...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27737774/exploring-the-safety-and-efficacy-of-targeted-temperature-management-amongst-infants-with-out-of-hospital-cardiac-arrest-due-to-apparent-life-threatening-events
#6
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To explore the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to an apparent life threatening event (ALTE) recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest Out-of-Hospital trial. METHODS: Fifty-four infants (48h to <1year of age) with ALTE who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation were included...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27701659/association-between-therapeutic-hypothermia-and-survival-after-in-hospital-cardiac-arrest
#7
Paul S Chan, Robert A Berg, Yuanyuan Tang, Lesley H Curtis, John A Spertus
Importance: Therapeutic hypothermia is used for patients following both out-of-hospital and in-hospital cardiac arrest. However, randomized trials on its efficacy for the in-hospital setting do not exist, and comparative effectiveness data are limited. Objective: To evaluate the association between therapeutic hypothermia and survival after in-hospital cardiac arrest. Design, Setting, and Patients: In this cohort study, within the national Get With the Guidelines-Resuscitation registry, 26 183 patients successfully resuscitated from an in-hospital cardiac arrest between March 1, 2002, and December 31, 2014, and either treated or not treated with hypothermia at 355 US hospitals were identified...
October 4, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27695505/history-and-current-use-of-mild-therapeutic-hypothermia-after-cardiac-arrest
#8
Jiří Bonaventura, David Alan, Jiri Vejvoda, Jakub Honek, Josef Veselka
In spite of many years of development and implementation of pre-hospital advanced life support programmes, the survival rate of out-of-hospital cardiac arrest (OHCA) used to be very poor. Neurologic injury from cerebral hypoxia is the most common cause of death in patients with OHCA. In the past two decades, post-resuscitation care has developed many new concepts aimed at improving the neurological outcome and survival rate of patients after cardiac arrest. Systematic post-cardiac arrest care after the return of spontaneous circulation, including induced mild therapeutic hypothermia (TH) in selected patients, is aimed at significantly improving rates of long-term neurologically intact survival...
October 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#9
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27658332/prehospital-therapeutic-hypothermia-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#10
Chaoran Nie, Jiaxu Dong, Pengjiao Zhang, Xintong Liu, Fei Han
BACKGROUND: The effectiveness and safety of the infusion of ice-cold fluids for prehospital hypothermia in cardiac arrest victims are unclear. This study assessed its effects in adult victims of out-of-hospital cardiac arrest. METHODS: An online search of PubMed and Cochrane Library databases was performed. Cooling methods were limited to ice-cold fluid perfusion. Randomized controlled trials were included in this review. The main outcomes were body temperature at hospital arrival, survival to hospital discharge, neurological recovery, incidence of pulmonary edema, and the rate of rearrest...
September 6, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27630031/continuous-quality-improvement-efforts-increase-survival-with-favorable-neurologic-outcome-after-out-of-hospital-cardiac-arrest
#11
Karl Sporer, Michael Jacobs, Leo Derevin, Sue Duval, James Pointer
OBJECTIVE: To assess system-wide implementation of specific therapies focused on perfusion during cardiopulmonary resuscitation (CPR) and cerebral recovery after Return of Spontaneous Circulation (ROSC). METHODS: Before and after retrospective analysis of an out-of-hospital cardiac arrest database. Implementation trial in the urban/suburban community of Alameda County, California, USA, population 1.6 million, from November 2009-December 2012. Adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA) who received CPR and/or defibrillation...
September 14, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27591054/a-multicentre-observational-study-of-inter-hospital-transfer-for-post-resuscitation-care-after-out-of-hospital-cardiac-arrest
#12
Jeong Ho Park, Ki Ok Ahn, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Joo Yong Kim, Eui Jung Lee, Yu Jin Lee
AIM: To provide therapeutic hypothermia (TH) to survivors after out-of-hospital cardiac arrest (OHCA), inter-hospital transfers (IHT) are frequently required. The safety of IHT remains controversial. The aim of this study was to investigate whether the effect of TH on brain recovery after OHCA differs between IHT and direct arrival groups. METHODS: We identified patients with OHCA of presumed cardiac aetiology who were resuscitated by emergency medical services and experienced return-of-spontaneous circulation in 27 hospitals between January and December 2014...
August 31, 2016: Resuscitation
https://www.readbyqxmd.com/read/27546775/the-association-between-hemoglobin-concentration-and-neurologic-outcome-after-cardiac-arrest
#13
Nicholas J Johnson, Babette Rosselot, Sarah M Perman, Kalani Dodampahala, Munish Goyal, David F Gaieski, Anne V Grossestreuer
PURPOSE: The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients. METHODS: We conducted a retrospective cohort study using the Penn Alliance for Therapeutic Hypothermia (PATH) cardiac arrest registry. Inclusion criteria were resuscitated cardiac arrest (inhospital or out of hospital) and an Hgb value recorded within 24 hours of return of spontaneous circulation. The primary outcome was favorable neurologic status at hospital discharge...
July 17, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27509385/functional-outcome-trajectories-after-out-of-hospital-pediatric-cardiac-arrest
#14
Faye S Silverstein, Beth S Slomine, James Christensen, Richard Holubkov, Kent Page, J Michael Dean, Frank W Moler
OBJECTIVES: To analyze functional performance measures collected prospectively during the conduct of a clinical trial that enrolled children (up to age 18 yr old), resuscitated after out-of-hospital cardiac arrest, who were at high risk of poor outcomes. DESIGN: Children with Glasgow Motor Scale score less than 5, within 6 hours of resuscitation, were enrolled in a clinical trial that compared two targeted temperature management interventions (THAPCA-OH, NCT00878644)...
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27449822/safety-of-glycoprotein-iib-iiia-inhibitors-in-patients-under-therapeutic-hypothermia-admitted-for-an-acute-coronary-syndrome
#15
Gustavo Jiménez-Brítez, Xavier Freixa, Eduardo Flores, Diego Penela, Marco Hernandez-Enríquez, Rodolfo San Antonio, Gala Caixal, John Garcia, Mercé Roqué, Victoria Martín, Salvatore Brugaletta, Mónica Masotti, Manel Sabaté
BACKGROUND: Mild therapeutic hypothermia (MTH) is associated with an increased risk of both thrombotic and bleeding events. Although little is known about the use of Glycoprotein IIb-IIIa inhibitors (GPi) in this setting, the early action and the intravenous administration of these agents in patients who cannot swallow might potentially translate into clinical benefits in patients with acute coronary syndromes (ACS). AIMS: To assess the incidence of bleeding/thrombotic events in patients with ACS under MTH after an Out-of-hospital cardiac arrest (OHCA) who received GPi or not...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27383062/the-association-between-arterial-oxygen-tension-and-neurological-outcome-after-cardiac-arrest
#16
Nicholas J Johnson, Kalani Dodampahala, Babette Rosselot, Sarah M Perman, Mark E Mikkelsen, Munish Goyal, David F Gaieski, Anne V Grossestreuer
A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included...
July 6, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27374413/predictors-of-death-among-cardiac-arrest-patients-after-therapeutic-hypothermia-a-non-tertiary-care-center-s-initial-experience
#17
Catarina Ruivo, Célia Jesus, João Morais, Paula Viana
INTRODUCTION AND OBJECTIVES: Therapeutic hypothermia (TH) is recommended for patients with return of spontaneous circulation (ROSC) after cardiac arrest (CA). There is still uncertainty about management, target temperature and duration of TH. In the present study we aim to describe the initial experience of a non-tertiary care center with TH after CA and to determine predictors of mortality. METHODS: During the period 2011-2014, out of 2279 patients hospitalized in the intensive care unit, 82 had a diagnosis of CA with ROSC...
July 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27362855/targeted-temperature-management-after-pediatric-cardiac-arrest-due-to-drowning-outcomes-and-complications
#18
Frank W Moler, Jamie S Hutchison, Vinay M Nadkarni, Faye S Silverstein, Kathleen L Meert, Richard Holubkov, Kent Page, Beth S Slomine, James R Christensen, J Michael Dean
OBJECTIVE: To describe outcomes and complications in the drowning subgroup from the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Exploratory post hoc cohort analysis. SETTING: Twenty-four PICUs. PATIENTS: Pediatric drowning cases. INTERVENTIONS: Therapeutic hypothermia versus therapeutic normothermia. MEASUREMENTS AND MAIN RESULTS: An exploratory study of pediatric drowning from the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital trial was conducted...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27289727/lactate-as-prognostic-factor-after-out-of-hospital-cardiac-arrest-treated-by-therapeutic-hypothermia
#19
J C Orban, M Novain, F Cattet, R Plattier, M Nefzaoui, H Hyvernat, O Raguin, M Kaidomar, C Ichai
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27278721/prognostic-value-of-gray-matter-to-white-matter-ratio-in-hypoxic-and-non-hypoxic-cardiac-arrest-with-non-cardiac-etiology
#20
Byung Kook Lee, Won Young Kim, Jonghwan Shin, Joo Suk Oh, Jung Hee Wee, Kyoung Chul Cha, Yooseok Park, Jae Hyung Choi, Kyung Woon Jeung
PURPOSE: This study evaluated the prognostic performance of the gray to white matter ratio (GWR) on brain computed tomography (CT) in out-of-hospital cardiac arrest (OHCA) survivors with a noncardiac etiology and compared the prognostic performance of GWR between hypoxic and nonhypoxic etiologies. METHODS: Using a multicenter retrospective registry of adult OHCA patients treated with targeted temperature management, we identified those with a noncardiac etiology who underwent brain CT within 24 hours after restoration of spontaneous circulation...
August 2016: American Journal of Emergency Medicine
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