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https://www.readbyqxmd.com/read/28108563/patient-management-in-aortic-arch-surgery%C3%A2
#1
REVIEW
Sven Peterss, Maximilian Pichlmaier, Alexander Curtis, Maximilian Luehr, Frank Born, Christian Hagl
SummaryAortic arch surgery requires complex patient management beyond the manual replacement of the diseased vessel. These procedures include (i) a thorough and pathologically adjusted preoperative evaluation, (ii) initiation and control of cardiopulmonary bypass, (iii) cerebral protection strategies and (iv) techniques to protect the abdominal end organs during prolonged operations. Due to the complexity of aortic arch procedures, multimodal real-time surveillance is required during all stages of the operation...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28108436/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#2
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28103127/extracorporeal-cardiopulmonary-resuscitation-ecpr-in-the-prehospital-setting-an-illustrative-case-of-ecpr-performed-in-the-louvre-museum
#3
Lionel Lamhaut, Alice Hutin, Juliette Deutsch, Jean-Herlé Raphalen, Romain Jouffroy, Jean-Pierre Orsini, Frédéric Baud, Pierre Carli
INTRODUCTION: Extracorporeal Cardiopulmonary Resuscitation (ECPR) is now considered for the treatment of refractory cardiac arrest. CASE REPORT: In an urban city like Paris, extraction times of in-hospital ECPR can be long for patients presenting with refractory cardiac arrest. Using the medicalized prehospital system, we developed a possible early prehospital ECPR implementation. This case report is an example of ECPR prehospital implementation in the Louvre Museum...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#4
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28099640/cardiopulmonary-resuscitation-of-adults-with-in-hospital-cardiac-arrest-using-the-utstein-style
#5
Rose Mary Ferreira Lisboa da Silva, Bruna Adriene Gomes de Lima E Silva, Fábio Junior Modesto E Silva, Carlos Faria Santos Amaral
Objective: The objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style. Methods: This study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year. Results: The study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28098197/dantrolene-versus-amiodarone-for-cardiopulmonary-resuscitation-a-randomized-double-blinded-experimental-study
#6
Thomas Wiesmann, Dennik Freitag, Wolfgang Dersch, Daphne Eschbach, Marc Irqsusi, Thorsten Steinfeldt, Hinnerk Wulf, Carsten Feldmann
Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg(-1), dantrolene 2...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28096999/decreasing-skeletal-muscle-as-a-risk-factor-for-mortality-in-elderly-patients-with-sepsis-a-retrospective-cohort-study
#7
Keita Shibahashi, Kazuhiro Sugiyama, Masahiro Kashiura, Yuichi Hamabe
BACKGROUND: Older patients account for the majority of patients with sepsis. The objective of this study was to determine if decreased skeletal muscle mass is associated with outcomes in elderly patients with sepsis. METHODS: Patients (60 years and older) who were admitted to a tertiary medical center intensive care unit with a primary diagnosis of sepsis between January 2012 and February 2016 were included. Patients who had not undergone abdominal computed tomography on the day of admission, had cardiopulmonary arrest on arrival, or had iliopsoas abscess were excluded from the analyses...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28096823/comparison-of-del-nido-cardioplegia-and-st-thomas-hospital-solution-two-types-of-cardioplegia-in-adult-cardiac-surgery
#8
Prashant Mishra, Ranjit B Jadhav, Chandan Kumar Ray Mohapatra, Jayant Khandekar, Chaitanya Raut, Ganesh Kumar Ammannaya, Harsh S Seth, Jaskaran Singh, Vaibhav Shah
INTRODUCTION: St. Thomas' cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. AIM: To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. MATERIAL AND METHODS: The study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#9
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28079659/suspected-malignant-hyperthermia-in-the-setting-of-hypothermic-circulatory-arrest-for-type-a-aortic-dissection-repair-a-case-report
#10
Bryant Bunting, Joshua Knight, Stephen M McHugh
Malignant Hyperthermia (MH) is a life-threatening biochemical process of hypermetabolism brought about in susceptible individuals by a triggering drug or event. Type A aortic dissections are surgical emergencies requiring cardiopulmonary bypass and frequently deep hypothermic circulatory arrest. We present a case of suspected MH in a patient undergoing emergent repair of a type A aortic dissection. Upon arrival at our institution, the patient had multiple signs of MH. However, no known triggering agent had been administered...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28078859/role-of-vitacamphore-in-improving-central-pro-inflammatory-cytokines-following-transient-global-ischemia
#11
J Lin, L Pang, X L Liu, J Xing
Pro-inflammatory cytokines (PICs) including interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) are responsive to ischemic stress. This process thereby modulates the responsiveness of many cell types under diseased conditions. The current study was to examine the role played by vitacamphore (VCP) in regulating the levels of PICs and protein expression of PIC receptors in the cerebral cortex and hippocampus of rats after cardiac arrest (CA)-induced transient global ischemia. CA was induced by asphyxia followed by cardiopulmonary resuscitation (CPR) in rats...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28078762/competence-in-the-use-of-supraglottic-airways-by-australian-surf-lifesavers-for-cardiac-arrest-ventilation-in-a-manikin
#12
Lachlan Holbery-Morgan, Cara Angel, Michelle Murphy, James Carew, Finn Douglas, Robert Murphy, Natalie Hood, Andrew Rechtman, Christopher Scarff, Nicholas Simpson, Andrew Stewardson, Daniel Steinfort, Sam Radford, Ned Douglas, Douglas Johnson
OBJECTIVES: Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation. METHODS: The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways...
January 11, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28077373/determination-of-renal-function-and-injury-using-near-infrared-fluorimetry-in-experimental-cardiorenal-syndrome
#13
Mizuko Ikeda, Rumie Wakasaki, Katie J Schenning, Thomas Swide, Jeong Heon Lee, M Bernie Miller, Hak Soo Choi, Sharon Anderson, Michael P Hutchens
Cardiorenal syndrome type 1 causes acute kidney injury but is poorly understood; animal models and diagnostic aids are lacking. Robust noninvasive measurements of glomerular filtration rate are required for injury models and clinical use. Several have been described but are untested in translational models and suffer from biologic interference. We developed a mouse model of cardiorenal syndrome and tested the novel near-infrared fluorophore, ZW800-1, to assess renal and cardiac function. We performed murine cardiac arrest and cardiopulmonary resuscitation followed by transthoracic echocardiography, 2- and 24h later...
January 11, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28076830/rosuvastatin-improves-myocardial-and-neurological-outcomes-after-asphyxial-cardiac-arrest-and-cardiopulmonary-resuscitation-in-rats
#14
Yun Qiu, Yichen Wu, Min Meng, Man Luo, Hongmei Zhao, Hong Sun, Sumin Gao
Rosuvastatin, a potent HMG-CoA reductase inhibitor, is cholesterol-lowering drugs and reduce the risk of myocardial infarction and stroke. This study is to explore whether rosuvastatin improves outcomes after cardiac arrest in rats. Male Sprague-Dawley rats were subjected to 8min of cardiac arrest (CA) by asphyxia and randomly assigned to three experimental groups immediately following successful resuscitation: Sham; Control; and Rosuvastatin. The survival, hemodynamics, myocardial function, neurological outcomes and apoptosis were assessed...
January 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28076627/petco2-vco2-and-corpp-values-in-the-successful-prediction-of-the-return-of-spontaneous-circulation-an-experimental-study-on-unassisted-induced-cardiopulmonary-arrest
#15
Ana Carolina Longui Macedo, Luiz Claudio Martins, Ilma Aparecida Paschoal, Carlos Cesar Ivo Sant'Ana Ovalle, Sebastião Araújo, Marcos Mello Moreira
No abstract text is available yet for this article.
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#16
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#17
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28072500/ultrasound-guided-intracardiac-xenotransfusion-of-canine-packed-red-blood-cells-and-epinephrine-to-the-left-ventricle-of-a-severely-anemic-cat-during-cardiopulmonary-resuscitation
#18
Liron Oron, Yaron Bruchim, Sigal Klainbart, Efrat Kelmer
OBJECTIVE: To describe the use of an ultrasound-guided intracardiac xenotransfusion of canine packed red blood cells (pRBC) to the left ventricle of a severely anemic cat during cardiopulmonary resuscitation (CPR). CASE SUMMARY: An 8-year-old previously healthy neutered female cat was presented with severe weakness after she had disappeared for 1 month. On presentation, the cat was in hypovolemic shock, laterally recumbent, and severely anemic with massive flea infestation...
January 10, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28070473/renal-infiltration-by-diffuse-large-b-cell-lymphoma-as-a-rare-cause-of-fanconi-s-syndrome-a-case-report
#19
Shoab Saadat, Syed Nayer Mahmud, Asim Qureshi
We report the case of a 16-year-old female patient with a known history of coeliac disease, who presented with the complaints of diarrhea, vomiting and generalized body weakness. On examination, she was found to have dehydration, decreased power in all her limbs, cervical lymphadenopathy and hepatosplenomegaly. Investigations showed severe hypokalemia, hyponatremia, hypomagnesemia, hypoglycemia and mildly enlarged kidneys on ultrasonography. Biopsy of the duodenum confirmed the flare up of coeliac disease, while cervical lymph node biopsy was positive for atypical lymphoid infiltrate and a morphology suggestive of non-Hodgkin's lymphoma...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/28067688/perioperative-near-infrared-spectroscopy-monitoring-in-neonates-with-congenital-heart-disease-relationship-of-cerebral-tissue-oxygenation-index-variability-with-neurodevelopmental-outcome
#20
Michael C Spaeder, Darren Klugman, Kami Skurow-Todd, Penny Glass, Richard A Jonas, Mary T Donofrio
OBJECTIVES: To evaluate the value of perioperative cerebral near-infrared spectroscopy monitoring using variability analysis in the prediction of neurodevelopmental outcomes in neonates undergoing surgery for congenital heart disease. DESIGN: Retrospective cohort study. SETTING: Urban, academic, tertiary-care children's hospital. PATIENTS: Neonates undergoing surgery with cardiopulmonary bypass for congenital heart disease...
January 6, 2017: Pediatric Critical Care Medicine
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