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Hypothermia after out of hospital arrest

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https://www.readbyqxmd.com/read/29884735/neurologic-outcomes-in-pediatric-cardiac-arrest-survivors-enrolled-in-the-thapca-trials
#1
Rebecca Ichord, Faye S Silverstein, Beth S Slomine, Russell Telford, James Christensen, Richard Holubkov, J Michael Dean, Frank W Moler
OBJECTIVE: To implement a standardized approach to characterize neurologic outcomes among 12-month survivors in the Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) trials. METHODS: Two multicenter trials enrolled children age 48 hours to 18 years who remained comatose after cardiac arrest (CA) occurring out-of-hospital (THAPCA-OH, NCT00878644) or in-hospital (THAPCA-IH, NCT00880087); patients were randomized to therapeutic hypothermia or therapeutic normothermia...
June 8, 2018: Neurology
https://www.readbyqxmd.com/read/29858987/neurologic-and-cognitive-outcomes-associated-with-the-clinical-use-of-xenon-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Lawrence Siu-Chun Law, Elaine Ah-Gi Lo, Caspar Chi-Chung Chan, Tong Joo Gan
BACKGROUND: Xenon has been shown to have positive neurologic effects in various pre-clinical models. This study systematically reviewed the randomized-controlled trials (RCTs) investigating neurologic and cognitive outcomes associated with the clinical use of xenon. METHODS: We searched PubMed, CENTRAL, EMBASE, CINAHL, elibrary.ru (for Russian studies), Google Scholar (for Russian studies), and Wanfang (for Chinese studies) for appropriate RCTs comparing neurologic or cognitive outcomes after clinical use of xenon with control treatment or with other anesthetic agents...
June 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29807760/thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-in-out-of-hospital-cardiac-arrest-with-and-without-therapeutic-hypothermia
#3
John García, Gustavo Jiménez-Brítez, Eduardo Flores-Umanzor, Guiomar Mendieta, Xavier Freixa, Manel Sabaté
No abstract text is available yet for this article.
May 25, 2018: Revista Española de Cardiología
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
#4
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
#5
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
#6
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
#7
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/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/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#10
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29573754/beyond-the-limits-ecpr-in-putative-fatal-circumstances
#11
Ingo Graeff, Sylvia Schacher, Stefan Lenkeit, Catherine N Widmann, Jens-Christian Schewe
The eligibility criteria for applying extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest are currently unclear. For those patients with hypothermic cardiac arrest, the European Resuscitation Council (ERC) Guidelines recommend considering ECPR only for patients with potassium <8 mmol/L and a body temperature below 32°C, whereas the American Heart Association Guidelines (AHA) do not express this in a specific manner. We report the case of an urban unwitnessed out-of-hospital cardiac arrest patient found with her head immersed in water at a temperature of 23°C...
March 25, 2018: CJEM
https://www.readbyqxmd.com/read/29544369/comparison-of-three-haemodynamic-monitoring-methods-in-comatose-post-cardiac-arrest-patients
#12
Henrik Staer-Jensen, Kjetil Sunde, Espen Rostrup Nakstad, Jan Eritsland, Geir Øystein Andersen
OBJECTIVES: Haemodynamic monitoring during post arrest care is important to optimise treatment. We compared stroke volume measured by minimally-invasive monitoring devices with or without thermodilution calibration, and transthoracic echocardiography (TTE), and hypothesised that thermodilution calibration would give stroke volume index (SVI) more in agreement with TTE during targeted temperature management (TTM). DESIGN: Comatose out-of-hospital cardiac arrest survivors receiving TTM (33 °C for 24 hrs) underwent haemodynamic monitoring with arterial pulse contour analyses with (PiCCO2®) and without (FloTrac® /Vigileo® monitor® ) transpulmonary thermodilution calibration...
June 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29534742/the-efficacy-and-safety-of-pre-hospital-cooling-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#13
Patrick J Lindsay, Danielle Buell, Damon C Scales
BACKGROUND: Mild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating TH for all eligible individuals presenting with OHCA; however, the timing of cooling initiation remains uncertain. This systematic review and meta-analysis was conducted with all available randomised controlled trials (RCTs) included to explore the efficacy and safety of initiating pre-hospital TH in patients with OHCA...
March 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29428249/computed-tomography-perfusion-aids-in-the-prognostication-of-comatose-postcardiac-arrest-patients
#14
Jai Jai Shiva Shankar, Brandie Stewart-Perrin, Ata-Ur-Rehman Quraishi, Iqbal Bata, Robert Vandorpe
Early assessment of the potential for neurologic recovery in comatose cardiac arrest patients (CCAP) has been a challenge despite significant evolution in management and imaging techniques. The purpose of study was to determine if the use of computed tomography perfusion (CTP) in CCAPs is feasible and if this technique can predict the likelihood that CCAPs will have a devastating outcome at hospital discharge. We prospectively enrolled 10 newly admitted comatose adults who had an out-of-hospital cardiac arrest and were treated with standard therapeutic hypothermia protocols...
April 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29317152/predicting-long-term-outcomes-after-cardiac-arrest-by-using-serum-neutrophil-gelatinase-associated-lipocalin
#15
Yu-Ri Park, Joo Suk Oh, Hyunho Jeong, Jungtaek Park, Young Min Oh, Semin Choi, Kyoung Ho Choi
OBJECTIVES: Neutrophil gelatinase-associated lipocalin (NGAL) is secreted by various tissues in pathologic states. Previous studies reported that post-cardiac arrest serum NGAL levels correlate with short-term neurologic outcomes and survival. The aim of this study was to examine the associations between NGAL levels post-cardiac arrest and long-term outcomes and survival. METHODS: This prospective observational study and retrospective review included adult out-of-hospital cardiac arrest survivors who were treated by hypothermia-targeted temperature management...
April 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#16
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
February 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29207432/-sonography-of-the-optic-nerve-a-new-bedside-tool-in-intensive-care
#17
Christopher Hohmann, Konrad R Koch, Roman Pfister, Guido Michels
History and clinical findings  Here, we present the case history of a 76-year old man with out-of-hospital cardiac arrest due to a cardiogenic shock and a consecutive no-flow-time of approximately 10 minutes. After 25 minutes of resuscitation procedures a spontaneous return of circulation could be established. The patient was admitted to our center for emergency coronary angiography. After coronary stenting the patient was admitted to our intensive care unit and treated in accordance with the guidelines on cardiogenic shock due to myocardial infarction...
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29201544/occurrence-of-overt-seizures-in-comatose-survivor-patients-treated-with-targeted-temperature
#18
Anda Eilam, Volodymyr Samogalskyi, Gennady Bregman, Sarit Eliner-Avishai, Ronit Gilad
Background: Unconscious patients after out-of-hospital cardiac arrest have a high risk of death. Therapeutic hypothermia is recommended by international resuscitation guidelines in order to attenuate secondary destructive physiological processes such as reperfusion injury, apoptosis, and cerebral edema. The target temperature to reach ranges between 32 and 34°C for at least 24 hr. Hypothermia can induce metabolic disturbances. There are some reports in the literature indicating the presence of seizures during targeted temperature management...
November 2017: Brain and Behavior
https://www.readbyqxmd.com/read/29169472/inhaled-xenon-attenuates-myocardial-damage-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-the-xe-hypotheca-trial
#19
RANDOMIZED CONTROLLED TRIAL
Olli Arola, Antti Saraste, Ruut Laitio, Juhani Airaksinen, Marja Hynninen, Minna Bäcklund, Emmi Ylikoski, Johanna Wennervirta, Mikko Pietilä, Risto O Roine, Veli-Pekka Harjola, Jussi Niiranen, Kirsi Korpi, Marjut Varpula, Harry Scheinin, Mervyn Maze, Tero Vahlberg, Timo Laitio
BACKGROUND: The authors previously reported that inhaled xenon combined with hypothermia attenuates brain white matter injury in comatose survivors of out-of-hospital cardiac arrest (OHCA). OBJECTIVES: A pre-defined secondary objective was to assess the effect of inhaled xenon on myocardial ischemic damage in the same study population. METHODS: A total of 110 comatose patients who had experienced OHCA from a cardiac cause were randomized to receive either inhaled xenon (40% end-tidal concentration) combined with hypothermia (33°C) for 24 h (n = 55; xenon group) or hypothermia treatment alone (n = 55; control group)...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29151422/-successful-perform-of-prolonged-cardiopulmonary-and-cerebral-resuscitation-on-repeated-cardiac-arrest-one-case-report
#20
Guanghui He, Yanping Liang, Jianjun Jing, Xiaofeng Li, Xin Jin, Yicheng Yang, Shibin Lyu, Jiaojiao Lu
Cardiac arrest (CA) is the most serious clinical emergency situation and cardiopulmonary-cerebral resuscitation (CPCR) performed on site with high quality is the optional therapy for its management. It has been reported that prolonging the resuscitation time after 30-minute failed conventional cardiopulmonary resuscitation (CPR) could improve the in-hospital survival rate of CA patients, and how to improve the out-hospital survival rate and survival quality of these patients is a research hot focus at present...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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