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In hospital cardiac arrest

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https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#1
Michael W Hubble, Clark Tyson
: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28221206/significance-of-new-q-waves-and-their-location-in-postoperative-ecgs-after-elective-on-pump-cardiac-surgery-an-observational-cohort-study
#2
Eckhard Mauermann, Daniel Bolliger, Jens Fassl, Martin Grapow, Esther E Seeberger, Manfred D Seeberger, Miodrag Filipovic, Giovanna A L L Buse
BACKGROUND: The clinical significance of new pathological Q waves after on-pump cardiac surgery is uncertain. OBJECTIVES: To determine whether or not either the occurrence per se or the location of new pathological Q waves after on-pump cardiac surgery is associated with 12-month, all-cause mortality and/or major adverse cardiac events (MACEs). DESIGN: Observational cohort study. SETTING: Single university hospital from January 2007 to October 2010...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28216475/the-effect-of-ticagrelor-administered-through-a-nasogastric-tube-to-comatose-patients-undergoing-acute-percutaneous-coronary-intervention-the-ticoma-study
#3
Hanna Ratcovich, Golnaz Sadjadieh, Hedvig B Andersson, Martin Frydland, Sebastian Wiberg, Nadia P Dridi, Jesper Kjaergaard, Lene Holmvang
AIMS: Patients in a coma after cardiac arrest may have adversely affected drug absorption and metabolism. This study, the first of its kind, aimed to investigate the early pharmacokinetic and pharmacodynamic effects of ticagrelor administered through a nasogastric tube (NGT) to patients resuscitated after an out of hospital cardiac arrest (OHCA) and undergoing primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Blood samples were drawn at baseline and at two, four, six, eight, 12, and 24 hours and then daily for up to five days after administration of a 180 mg ticagrelor loading dose (LD), followed by 90 mg twice daily in 44 patients...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28216090/gender-differences-in-early-invasive-strategy-after-cardiac-arrest-insights-from-the-procat-registry
#4
Wulfran Bougouin, Florence Dumas, Eloi Marijon, Guillaume Geri, Benoit Champigneulle, Jean-Daniel Chiche, Olivier Varenne, Christian Spaulding, Jean-Paul Mira, Xavier Jouven, Alain Cariou
AIM: Early invasive strategy, including percutaneous coronary intervention (PCI), may improve survival in out-of-hospital-cardiac-arrest (OHCA) due to coronary artery disease but selection of suitable patients is challenging. Differences and results across gender remain unknown. We aimed to assess the relationship between gender and the use of an early invasive strategy after OHCA, and the relationship with outcome according to gender. METHODS: All patients admitted after OHCA were prospectively included (2000-2013)...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28216089/health-status-and-psychological-distress-among-in-hospital-cardiac-arrest-survivors-in-relation-to-gender
#5
Johan Israelsson, Anders Bremer, Johan Herlitz, Åsa B Axelsson, Tobias Cronberg, Therese Djärv, Marja-Leena Kristofferzon, Ing-Marie Larsson, Gisela Lilja, Katharina S Sunnerhagen, Ewa Wallin, Susanna Ågren, Eva Åkerman, Kristofer Årestedt
AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender. METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS). RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28215592/association-between-delay-to-coronary-reperfusion-and-outcome-in-patients-with-acute-coronary-syndrome-undergoing-extracorporeal-cardiopulmonary-resuscitation
#6
Norihiro Kuroki, Daisuke Abe, Toru Iwama, Kou Suzuki, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe, Kazutaka Aonuma, Akira Sato
AIM: The prognostic effect of early coronary reperfusion therapy with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to acute coronary syndrome (ACS) has yet to be clarified. We investigated the relationship between time interval from collapse to start of ECPR (CtoE) and coronary reperfusion (CtoR) time and neurological outcome in patients with cardiac arrest due to ACS. METHODS: A cohort of 119 consecutive patients (63±12 years old) with ACS who underwent ECPR and percutaneous coronary intervention(PCI) at our hospital was registered from January 2005 to June 2016...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28215590/does-an-individualized-feedback-mechanism-improve-quality-of-out-of-hospital-cpr
#7
B Weston, J Jasti, E B Lerner, A Szabo, T Aufderheide, M R Colella
BACKGROUND: Despite its prevalence, survival from out-of-hospital cardiac arrest remains low. Early defibrillation, greater compression fraction, optimal compression rate, sufficient compression depth, and shorter pre-shock pause have been associated with improved survival in cardiac arrest patients. In early 2014, a program was initiated to provide feedback on CPR quality to prehospital providers after every treated cardiac arrest. OBJECTIVE: To assess whether individualized CPR feedback was associated with improved CPR quality measures in the prehospital setting...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#8
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28215127/characteristics-and-outcomes-of-critically-ill-patients-with-drug-overdose-in-australia-and-new-zealand
#9
Luca Cioccari, Nora Luethi, Michael Bailey, David Pilcher, Rinaldo Bellomo
OBJECTIVE: The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. DESIGN, SETTING AND PATIENTS: Retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database, including all patients admitted to an ICU with OD from 2005 to 2013...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#10
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28212839/incidence-and-prognosis-of-nosocomial-infection-after-recovering-of-cardiac-arrest-in-children
#11
Andrés Fernández, Ana Solís, Paloma Cañete, Jimena Del Castillo, Javier Urbano, Angel Carrillo, Jesús López-Herce
OBJECTIVE: to analyze the incidence of infection in children who have suffered an in-hospital cardiac arrest (CA) and the association with mortality. METHODS: A retrospective unicenter observational study on a prospective database with children between one month and 16 years old, who have suffered an in-hospital CA was performed. Clinical, analytical and monitorization data, treatment, mortality and cause of death were recorded. RESULTS: 57 children were studied (57...
February 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28210568/clozapine-induced-hypersensitivity-myocarditis-presenting-as-sudden-cardiac-death
#12
Natraj Katta, Sudarshan Balla, Kul Aggarwal
Hypersensitivity myocarditis is a rare but serious adverse effect of clozapine, a commonly used psychiatric drug. We report the case of sudden cardiac death from clozapine-induced hypersensitivity myocarditis diagnosed at autopsy. A 54-year-old Caucasian male on clozapine therapy for bipolar disorder presented with a sudden onset of shortness of breath. Laboratory studies were significant for elevated N-terminal prohormone of brain natriuretic peptide. During his hospital stay, the patient died of sudden cardiac arrest from ventricular tachycardia...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#13
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#14
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#15
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#16
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202421/predictors-of-long-term-functional-outcome-and-health-related-quality-of-life-after-out-of-hospital-cardiac-arrest
#17
Guillaume Geri, Florence Dumas, Franck Bonnetain, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Pierre Carli, Eloi Marijon, Olivier Varenne, Jean-Paul Mira, Jean-Philippe Empana, Alain Cariou
BACKGROUND: Even if a large majority of out-of-hospital cardiac arrest (OHCA) survivors appear to have a good neurological recovery with no important sequellae, whether health-related quality of life (HRQOL) is altered is less explored. PATIENTS AND METHODS: HRQOL was evaluated by telephone interview using SF-36 questionnaire. Each OHCA case was age and gender-matched with 4 controls from the French general population. Association between current condition of the survivors with the 8 dimensions of the SF-36 questionnaire was investigated using MANCOVA...
February 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28202420/out-of-hospital-cardiac-arrest-ohca-attended-by-mobile-emergency-teams-with-a-physician-on-board-results-of-the-spanish-ohca-registry-oshcar
#18
Fernando Rosell-Ortiz, José M Navalpotro-Pascual, Patricia Fernández Del Valle, Luis Sánchez-Santos, Xavier Escalada-Roig, Alfredo Echarri-Sucunza, José M Adsuar-Quesada, Isabel Ceniceros-Rozalén, José I Ruiz-Azpiazu, Karlos Ibarguren-Olalde, Nuria López-Cabeza, María V Mier-Ruiz, Enrique Martín-Sánchez, Marta Martínez Del Valle, Guadalupe Inza-Muñoz, Juan A Cordero Torres, María J García-Ochoa, José A Cortés-Ramas, Raúl Canabal-Berlanga, Rafael Zoyo López-Navarro, Juan B López-Messa, Javier García Del Águila, Daniel Alonso-Moreno, Carmen Pozo-Pérez, José Bravo-Castello, Natividad Ramos-García, Ignacio Gómez-Larrosa, Francisco J Mellado-Vergel
: Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by emergency medical teams (EMS) of 19 Public EMS in Spain, covering the period from 1 October 2013 to 30-October 2014 (13 months). RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence of 18...
February 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28202338/a-new-strategy-for-emergency-department-crowding-high-turnover-utility-bed-intervention
#19
I-Hsin Lee, Chung-Ting Chen, Yi-Tzu Lee, Yueh-Shuang Hsu, Chia-Ling Lu, Hsien-Hao Huang, Teh-Fu Hsu, Chorng-Kuang How, David Hung-Tsang Yen, Ueng-Cheng Yang
BACKGROUND: This study applied a new strategy, termed high-turnover utility bed intervention, to offer early admission chances for emergency department (ED) patients and alleviate ED crowding. METHODS: This before-and-after observational cohort study was conducted at the ED of an urban tertiary hospital. On January 1, 2012, 14 utility beds were prepared exclusively for ED patient use. A strict 48-hour course limit for each patient was formulated to govern these high-turnover beds...
February 12, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#20
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
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