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Hypothermia after out of hospital arrest

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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
#1
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...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29207432/-sonography-of-the-optic-nerve-a-new-bedside-tool-in-intensive-care
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/29096675/the-impact-of-sex-and-age-on-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients-with-targeted-temperature-management
#6
Sang Hoon Oh, Kyu Nam Park, Jeeyong Lim, Seung Pill Choi, Joo Suk Oh, In Soo Cho, Byung Kook Lee, Yong Hwan Kim, Young-Min Kim, Han Joon Kim, Chun Song Youn, Soo Hyun Kim
BACKGROUND: There are conflicting data regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients, and whether the specific sex advantage is age-specific remains unclear. We assessed the impact of the interactions between sex and age on the neurological outcomes of OHCA patients receiving targeted temperature management (TTM). METHODS: Data collected from 2007 to 2012 for a multicenter, registry-based study of the Korean Hypothermia Network were analyzed...
November 2, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#7
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29017646/-pre-hospital-therapeutic-hypothermia-for-survival-and-neuro-protection-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Yan Zhuang, Linfeng Dai, Mingqi Cheng, Haidong Zhang, Ning Chang
OBJECTIVE: To assess the effectiveness of pre-hospital therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) for survival and neuro-protection. METHODS: Databases such as Medline, ScienceDirect, Embase, Highwire, Cochrane Library, CNKI and Wanfang digital database were searched from January 2000 to March 2017 to retrieve randomized controlled trials (RCTs) on pre-hospital therapeutic hypothermia after OHCA. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28988657/experiences-of-surviving-a-cardiac-arrest-after-therapeutic-hypothermia-treatment-an-interview-study
#9
Margareta Brännström, Camilla Niederbach, Ann-Charlotte Rödin
BACKGROUND: Cardiac arrest (CA) is often associated with high mortality. In Sweden, it is reported that 13-52 per 100,000 people suffer out-of-hospital CA, and survival to one month is 2-14%. OBJECTIVE: This study aimed to describe people's experiences of surviving a CA after therapeutic hypothermia treatment. METHOD: A descriptive qualitative design was used. Data were collected through individual interviews with seven CA survivors. The collected data were analyzed using qualitative content analysis...
October 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28983759/myocardial-dysfunction-after-out-of-hospital-cardiac-arrest-predictors-and-prognostic-implications
#10
Yuan Yao, Nicholas James Johnson, Sarah Muirhead Perman, Vimal Ramjee, Anne Victoria Grossestreuer, David Foster Gaieski
We aim to determine the incidence of early myocardial dysfunction after out-of-hospital cardiac arrest, risk factors associated with its development, and association with outcome. A retrospective chart review was performed among consecutive out-of-hospital cardiac arrest (OHCA) patients who underwent echocardiography within 24 h of return of spontaneous circulation at three urban teaching hospitals. Our primary outcome is early myocardial dysfunction, defined as a left ventricular ejection fraction < 40% on initial echocardiogram...
October 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28807442/age-is-related-to-neurological-outcome-in-patients-with-out-of-hospital-cardiac-arrest-ohca-receiving-therapeutic-hypothermia-th
#11
Se Jong Oh, Jin Joo Kim, Jae Ho Jang, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang
INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28789562/patient-outcomes-after-palliative-care-consultation-among-patients-undergoing-therapeutic-hypothermia
#12
Priya Pinto, Tartania Brown, Michael Khilkin, Elizabeth Chuang
OBJECTIVES: To compare the clinical outcomes of patients who did and did not receive palliative care consultation among those who experienced out-of-hospital cardiac arrest and underwent therapeutic hypothermia. METHODS: We identified patients at a single academic medical center who had undergone therapeutic hypothermia after out-of-hospital cardiac arrest between 2009 and 2013. We performed a retrospective chart review for demographic data, hospital and critical care length of stay, and clinical outcomes of care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28758873/platelet-aggregation-during-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-a-randomised-clinical-trial
#13
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/28695976/adaptation-of-global-hemostasis-to-therapeutic-hypothermia-in-patients-with-out-of-hospital-cardiac-arrest-thromboelastography-study
#14
Aleksander Trąbka-Zawicki, Marek Tomala, Aleksander Zeliaś, Elżbieta Paszek, Wojciech Zajdel, Ewa Stępień, Krzysztof Żmudka
BACKGROUND: The use of mild therapeutic hypothermia (MTH) in patients after out-of-hospital cardiac arrest (OHCA) who are undergoing primary percutaneous coronary intervention (pPCI) can protect patients from thromboembolic complications. The aim of the study was to evaluate the adaptive mechanisms of the coagulation system in MTH-treated comatose OHCA survivors. METHODS: Twenty one comatose OHCA survivors with acute coronary syndrome undergoing immediate pPCI were treated with MTH...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28687073/association-of-neuron-specific-enolase-values-with-outcomes-in-cardiac-arrest-survivors-is-dependent-on-the-time-of-sample-collection
#15
Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Filip Malek, Vlasta Dudkova, Petr Neuzil, Petr Ostadal
BACKGROUND: Despite marked advances in intensive cardiology care, current options for outcome prediction in cardiac arrest survivors remain significantly limited. The aim of our study was, therefore, to compare the day-specific association of neuron-specific enolase (NSE) with outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with hypothermia. METHODS: Eligible patients were OHCA survivors treated with targeted temperature management at 33 °C for 24 h using an endovascular device...
July 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28592725/useful-computed-tomography-score-for-estimation-of-early-neurologic-outcome-in-post-cardiac-arrest-patients-with-therapeutic-hypothermia
#16
Kyu Sun Lee, Sung Eun Lee, Jun Young Choi, Yu-Rha Gho, Minjung Kathy Chae, Eun Jung Park, Mun Hee Choi, Ji Man Hong
BACKGROUND: The Alberta Stroke Program Early CT Score (ASPECTS) is used to assess early ischemic stroke damage. This study compared bilateral ASPECTS (ASPECTS-b) with the gray:white matter ratio (GWR) and quantitative regional abnormality (QRA) to evaluate the prognostic utility of early computed tomography (CT) findings in post-cardiac arrest patients.Methods and Results:Out-of-hospital cardiac arrest patients with return of spontaneous circulation (ROSC) who underwent brain CT (<6 h after onset) and therapeutic hypothermia were recruited from a university hospital over a 2-year period...
June 6, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28553435/therapeutic-hypothermia-reduces-oxidative-damage-and-alters-antioxidant-defenses-after-cardiac-arrest
#17
Fernanda S Hackenhaar, Tássia M Medeiros, Fernanda M Heemann, Camile S Behling, Jordana S Putti, Camila D Mahl, Cleber Verona, Ana Carolina A da Silva, Maria C Guerra, Carlos A S Gonçalves, Vanessa M Oliveira, Diego F M Riveiro, Silvia R R Vieira, Mara S Benfato
After cardiac arrest, organ damage consequent to ischemia-reperfusion has been attributed to oxidative stress. Mild therapeutic hypothermia has been applied to reduce this damage, and it may reduce oxidative damage as well. This study aimed to compare oxidative damage and antioxidant defenses in patients treated with controlled normothermia versus mild therapeutic hypothermia during postcardiac arrest syndrome. The sample consisted of 31 patients under controlled normothermia (36°C) and 11 patients treated with 24 h mild therapeutic hypothermia (33°C), victims of in- or out-of-hospital cardiac arrest...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#18
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 30, 2017: Neurology
https://www.readbyqxmd.com/read/28465012/mild-induced-hypothermia-and-survival-after-out-of-hospital-cardiac-arrest
#19
Louise Martinell, Johan Herlitz, Thomas Karlsson, Niklas Nielsen, Christian Rylander
BACKGROUND: Mild induced hypothermia (MIH) was introduced for post cardiac arrest care in Sweden in 2003, based on two clinical trials. This retrospective study evaluated its association with 30-day survival after out-of-hospital cardiac arrest (OHCA) in a Swedish community from 2003 to 2015. METHODS: Out of 3680 patients with OHCA, 1100 were hospitalized after return of spontaneous circulation and 871 patients who remained unconscious were included in the analysis...
November 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28407232/observed-survival-benefit-of-mild-therapeutic-hypothermia-reanalysing-the-circulation-improving-resuscitation-care-trial
#20
Alexander Nürnberger, Harald Herkner, Fritz Sterz, Jan-Aage Olsen, Michael Lozano, Pierre M van Grunsven, E Brooke Lerner, David Persse, Reinhard Malzer, Marc A Brouwer, Mark Westfall, Chris M Souders, David T Travis, Ulrich R Herken, Lars Wik
BACKGROUND: Mild therapeutic hypothermia is argued being beneficial for outcome after cardiac arrest. MATERIALS AND METHODS: Retrospective analysis of Circulation Improving Resuscitation Care (CIRC) trial data to assess if therapeutic cooling to 33 ± 1 °C core temperature had an association with survival. Of 4231 adult, out-of-hospital cardiac arrests of presumed cardiac origin initially enrolled, eligibility criteria for therapeutic hypothermia were met by 1812...
June 2017: European Journal of Clinical Investigation
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