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https://www.readbyqxmd.com/read/28229199/-coronary-artery-disease-interventional-and-operative-therapeutic-options-after-cardiac-arrest
#1
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/28226872/multimodel-quantitative-analysis-of-somatosensory-evoked-potentials-after-cardiac-arrest-with-graded-hypothermia
#2
Leanne Moon Young, Rishabh Choudhary, Xiaofeng Jia, Leanne Moon Young, Rishabh Choudhary, Xiaofeng Jia, Xiaofeng Jia, Leanne Moon Young, Rishabh Choudhary
Cardiac arrest (CA) is one of the most prominent causes of morbidity and mortality in adults. Therapeutic hypothermia (TH) is a recommended treatment to improve survival and functional outcome following CA, however, it is unclear what degree of TH is most beneficial. It has been suggested that TH of 33°C provides no survival or outcome benefits over TH of 36°C. Additionally, there is a lack of verified objective quantitative prognostic tools for comatose CA patients under TH. In this study, we calculated three quantitative markers of somatosensory evoked potentials (SSEP) to examine their potential to track recovery in the early period following CA under graded TH...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225739/damage-control-laparotomy-utilization-rates-are-highly-variable-among-level-i-trauma-centers-pragmatic-randomized-optimal-platelet-and-plasma-ratios-findings
#3
Justin Jeremiah Joseph Watson, Jamison Nielsen, Kyle Hart, Priya Srikanth, John D Yonge, Christopher R Connelly, Phillip M Kemp Bohan, Hillary Sosnovske, Barbara C Tilley, Gerald van Belle, Bryan A Cotton, Terence S OʼKeeffe, Eileen M Bulger, Karen J Brasel, John B Holcomb, Martin A Schreiber
BACKGROUND: Damage control laparotomy (DCL) is intended to limit deleterious effects from trauma-induced coagulopathy. DCL has been associated with mortality reduction, but may increase complications including sepsis, abscess, respiratory failure, hernia, and gastrointestinal fistula. We hypothesized that (1) DCL incidence would vary between institutions; (2) mortality rates would vary with DCL rates; (3) standard DCL criteria of pH, international normalized ratio, temperature and major intra-abdominal vascular injury would not adequately capture all patients...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#4
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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
#5
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...
February 21, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#6
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...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28216296/cyclodextrin-modified-plla-parietal-reinforcement-implant-with-prolonged-antibacterial-activity
#7
G Vermet, S Degoutin, F Chai, M Maton, C Flores, C Neut, P E Danjou, B Martel, N Blanchemain
: The use of textile meshes in hernia repair is widespread in visceral surgery. Though, mesh infection is a complication that may prolong the patient recovery period and consequently presents an impact on public health economy. Such concern can be avoided thanks to a local and extended antibiotic release on the operative site. In recent developments, poly-L-lactic acid (PLLA) has been used in complement of polyethyleneterephthalate (Dacron(®)) (PET) or polypropylene (PP) yarns in the manufacture of semi-resorbable parietal implants...
February 12, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#8
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28215136/protocol-and-statistical-analysis-plan-for-the-randomised-evaluation-of-active-control-of-temperature-versus-ordinary-temperature-management-reactor-trial
#9
Paul J Young, Michael J Bailey, Richard W Beasley, Ross C Freebairn, Naomi E Hammond, Frank M P van Haren, Meg L Harward, Seton J Henderson, Diane M Mackle, Colin J McArthur, Shay P McGuinness, John A Myburgh, Manoj K Saxena, Anne Turner, Steve A R Webb, Rinaldo Bellomo
BACKGROUND: Body temperature can be reduced in febrile patients in the intensive care unit using medicines and physical cooling devices, but it is not known whether systematically preventing and treating fever reduces body temperature compared with standard care. OBJECTIVE: To describe the study protocol and statistical analysis plan for the Randomised Evaluation of Active Control of Temperature versus Ordinary Temperature Management (REACTOR) trial. DESIGN, SETTING AND PARTICIPANTS: Protocol for a phase II, multicentre trial to be conducted in Australian and New Zealand ICUs admitting adult patients...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical 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
#10
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
https://www.readbyqxmd.com/read/28194629/-68-ga-nota-galactosyl-human-serum-albumin-a-tracer-for-liver-function-imaging-with-improved-stability
#11
Roland Haubner, Andreas M Schmid, Andreas Maurer, Christine Rangger, Llanos Geraldo Roig, Bernd J Pichler, Irene J Virgolini
PURPOSE: Non-invasive techniques allowing quantitative determination of the functional liver mass are of great interest for patient management in a variety of clinical settings. Recently, we presented [(68)Ga]DTPA-GSA to target the hepatic asialoglycoprotein receptor for this purpose. Here, we introduce [(68)Ga]NOTA-GSA to improve metabolic stability of the radiopharmaceutical and compare the imaging properties with [(68)Ga]DTPA-GSA. PROCEDURES: Labeling of the compounds was carried out at room temperature using 1...
February 13, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28190402/preserving-brain-function-in-a-comatose-patient-with-septic-hyperpyrexia-41-6%C3%A2-%C3%A2-c-a-case-report
#12
Samantha Sterkel, Akinboyede Akinyemi, Marcos A Sanchez-Gonzalez, George Michel
BACKGROUND: Pyrexia is a physiological response through which the immune system responds to infectious processes. Hyperpyrexia is known to be neurodegenerative leading to brain damage. Some of the neurotoxic effects of hyperpyrexia on the brain include seizures, decreased cognitive speed, mental status changes, coma, and even death. In the clinical management of hyperpyrexia, the goal is to treat the underlying cause of elevated temperature and prevent end organ damage. CASE PRESENTATION: This case illustrates a 39-year-old white American man referred from another medical facility where he had undergone an upper gastrointestinal tract diagnostic procedure which became complicated by blood aspiration and respiratory distress...
February 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28187798/critical-care-in-acute-ischemic-stroke
#13
M McDermott, T Jacobs, L Morgenstern
Most ischemic strokes are managed on the ward or on designated stroke units. A significant proportion of patients with ischemic stroke require more specialized care. Several studies have shown improved outcomes for patients with acute ischemic stroke when neurocritical care services are available. Features of acute ischemic stroke patients requiring intensive care unit-level care include airway or respiratory compromise; large cerebral or cerebellar hemisphere infarction with swelling; infarction with symptomatic hemorrhagic transformation; infarction complicated by seizures; and a large proportion of patients require close management of blood pressure after thrombolytics...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187733/early-detection-of-copd-patients-in-gold-0-population-an-observational-non-interventional-cohort-study-marko-study
#14
Žarko Vrbica, Marina Labor, Ivan Gudelj, Slavica Labor, Iva Jurić, Davor Plavec
BACKGROUND: Main risk factor for the development of chronic obstructive pulmonary disease (COPD) is smoking, although only less than 1/3 of smokers develop clinically manifest COPD. COPD's progressive nature with high disability and mortality makes it plausible to detect it as early as possible thus allowing for an early intervention. The only tool for an early diagnosis that could be used on the global scale is spirometry, even though symptoms and deprivation of health related quality of life (HRQoL) precede relevant spirometric changes...
February 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28182521/efficacy-and-safety-of-a-new-coverlet-device-on-skin-microclimate-management-a-pilot-study-in-critical-care-patients
#15
O Forriez, J Masseline, D Coadic, V David, P Trouiller, B Sztrymf
OBJECTIVE: To test the effect of a new coverlet device, allowing air circulation at the body/underlying surface interface, on skin microclimate management. METHOD: This prospective observational pilot study took place in a 15-bed university-affiliated intensive care unit. Overall, 34 mechanically ventilated patients were included. Skin humidity and temperature were monitored before and after the implementation of the tested device at the occiput, scapulas, buttocks and sacrum...
February 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#16
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28169132/electroencephalographic-characteristics-of-status-epilepticus-after-cardiac-arrest
#17
Sofia Backman, Erik Westhall, Irina Dragancea, Hans Friberg, Malin Rundgren, Susann Ullén, Tobias Cronberg
OBJECTIVE: To describe the electrophysiological characteristics and pathophysiological significance of electrographic status epilepticus (ESE) after cardiac arrest and specifically compare patients with unequivocal ESE to patients with rhythmic or periodic borderline patterns defined as possible ESE. METHODS: Retrospective cohort study of consecutive patients treated with targeted temperature management and monitored with simplified continuous EEG. Patients with ESE were identified and electrographically characterised until 72h after ESE start using the standardised terminology of the American Clinical Neurophysiology Society...
January 21, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28168412/neuroprognostication-after-adult-cardiac-arrest-treated-with-targeted-temperature-management-task-force-for-belgian-recommendations
#18
Fabio Silvio Taccone, Ingrid Baar, Cathy De Deyne, Patrick Druwe, Benjamin Legros, Geert Meyfroidt, Michel Ossemann, Nicolas Gaspard
The prognosis of patients who are admitted to the hospital after cardiac arrest often relies on neurological examination, which could be significantly influenced by the use of sedative drugs or the implementation of targeted temperature management. The need for early and accurate prognostication is crucial as up to 15-20% of patients could be considered as having a poor outcome and may undergo withdrawal of life-sustaining therapies while a complete neurological recovery is still possible. As current practice in Belgium is still based on a very early assessment of neurological function in these patients, the Belgian Society of Intensive Care Medicine created a multidisciplinary Task Force to provide an optimal approach for monitoring and refine prognosis of CA survivors...
February 6, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28164653/blast-burn-combined-injury-followed-by-immediate-seawater-immersion-induces-hemodynamic-changes-and-metabolic-acidosis-an-experimental-study-in-a-canine-model
#19
Yi Hu, Qingxiang Mao, Shaobing Ye, Ji Peng, Xiaoqin Gan, Xian Chen, Hong Yan
BACKGROUND: Severe burn-blast combined injury often causes systematic dysfunction related to blood coagulation, anticoagulation, and fibrinolysis. However, studies of burn-blast combined injury followed by immersion in seawater are rarely reported. METHODS: A canine burn-blast combined injury model was established including blast injury caused by explosion immediately followed by burning with gelatinized gasoline flames. The dogs were randomly divided into four groups: burn-blast injury (BB group); burn-blast injury followed by seawater immersion for four hours (BBI group); only immersed in seawater (I group); and sham treatment with no injury or immersion (S group)...
July 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28163232/prognostic-significance-of-clinical-seizures-after-cardiac-arrest-and-target-temperature-management
#20
Anna Lybeck, Hans Friberg, Anders Aneman, Christian Hassager, Janneke Horn, Jesper Kjærgaard, Michael Kuiper, Niklas Nielsen, Susann Ullén, Matthew P Wise, Erik Westhall, Tobias Cronberg
AIM: Clinical seizures are common after cardiac arrest and predictive of a poor neurological outcome. Seizures may be myoclonic, tonic-clonic or a combination of seizure types. This study reports the incidence and prognostic significance of clinical seizures in the target temperature management (TTM) after cardiac arrest trial. Our hypotheses were that seizures are associated with a poor prognosis and that the incidence of seizures is not affected by the target temperature. METHODS: Post-hoc analysis of reported clinical seizures during day 1-7 in the TTM-trial including their treatment, EEG-findings, and long-term neurological outcome...
February 3, 2017: Resuscitation
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