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Pulseless electrical activity

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https://www.readbyqxmd.com/read/29220414/detection-of-spontaneous-pulse-using-the-acceleration-signals-acquired-from-cpr-feedback-sensor-in-a-porcine-model-of-cardiac-arrest
#1
Liang Wei, Gang Chen, Zhengfei Yang, Tao Yu, Weilun Quan, Yongqin Li
BACKGROUND: Reliable detection of return of spontaneous circulation with minimal interruptions of chest compressions is part of high-quality cardiopulmonary resuscitation (CPR) and routinely done by checking pulsation of carotid arteries. However, manual palpation was time-consuming and unreliable even if performed by expert clinicians. Therefore, automated accurate pulse detection with minimal interruptions of chest compression is highly desirable during cardiac arrest especially in out-of-hospital settings...
2017: PloS One
https://www.readbyqxmd.com/read/29191702/association-of-initial-recorded-rhythm-and-underlying-cardiac-disease-in-sudden-cardiac-arrest
#2
Janna P Kauppila, Antti Hantula, Marja-Leena Kortelainen, Lasse Pakanen, Juha Perkiömäki, Matti Martikainen, Heikki V Huikuri, M Juhani Junttila
BACKGROUND: Asystole (ASY) and pulseless electrical activity (PEA) are increasing and ventricular fibrillation (VF) or ventricular tachycardia (VT) declining as presenting rhythms of sudden cardiac arrest (SCA). Since there is limited information on possible differences in the etiology of underlying structural heart disease, we analyzed the clinical and/or autopsy findings of victims with ASY, PEA or VT/VF. METHODS: All SCA cases with recorded ASY, PEA or VT/VF occurring after onset of witnessed collapse were analyzed by the emergency personnel between the years 2007-2012 within the Oulu University Hospital area...
November 27, 2017: Resuscitation
https://www.readbyqxmd.com/read/29177620/revisiting-traumatic-cardiac-arrest-should-cpr-be-initiated
#3
Katie L Konesky, Weidun Alan Guo
OBJECTIVES: Traumatic cardiac arrest (TCA) represents a unique problem, and poses difficult challenges in the care of trauma patients. Although the literature has suggested that attempted resuscitation from TCA in trauma is futile and consumptive of medical and human resources, studies have recently demonstrated that the outcome of TCA is comparable cardiac arrest secondary to non-traumatic events. The objective of this study was to determine the incidence, predictors, and outcomes following TCA...
November 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29173410/sudden-cardiac-death-in-ischemic-heart-disease-pathophysiology-and-risk-stratification
#4
REVIEW
Nabil El-Sherif, Mohamed Boutjdir, Gioia Turitto
Sudden cardiac death (SCD) accounts for approximately 360,000 deaths annually in the United States. Ischemic heart disease is the major cause of death in the general adult population. SCD can be due to arrhythmic or nonarrhythmic cardiac causes. Arrhythmic SCD may be caused by ventricular tachyarrhythmia or pulseless electrical activity/asystole. This article reviews the most recent pathophysiology and risk stratification strategies for SCD, emphasizing electrophysiologic surrogates of conduction disorder, dispersion of repolarization, and autonomic imbalance...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#5
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122647/an-automatic-system-for-the-comprehensive-retrospective-analysis-of-cardiac-rhythms-in-resuscitation-episodes
#6
Ali Bahrami Rad, Trygve Eftestøl, Unai Irusta, Jan Terje Kvaløy, Lars Wik, Jo Kramer-Johansen, Aggelos K Katsaggelos, Kjersti Engan
AIM: An automatic resuscitation rhythm annotator (ARA) would facilitate and enhance retrospective analysis of resuscitation data, contributing to a better understanding of the interplay between therapy and patient response. The objective of this study was to define, implement, and demonstrate an ARA architecture for complete resuscitation episodes, including chest compression pauses (CC-pauses) and chest compression intervals (CC-intervals). METHODS: We analyzed 126...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29102470/long-term-survival-trends-of-medicare-patients-after-in-hospital-cardiac-arrest-insights-from-get-with-the-guidelines-resuscitation-%C3%A2
#7
Lauren E Thompson, Paul S Chan, Fengming Tang, Brahmajee K Nallamothu, Saket Girotra, Sarah M Perman, Somnath Bose, Stacie L Daugherty, Steven M Bradley
BACKGROUND: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. OBJECTIVE: To examine 1-year survival trends overall and by rhythm after IHCA. METHODS: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival...
November 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/29090256/pulseless-electrical-activity-during-general-anesthesia-induction-in-patients-with-amyotrophic-lateral-sclerosis
#8
Tae Min You, Seungoh Kim
Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia...
September 2017: Journal of dental anesthesia and pain medicine
https://www.readbyqxmd.com/read/29078850/pulmonary-embolism-in-transit-before-pulseless-electrical-activity-arrest
#9
Lance D McLeroy, David D Daly, Jeremy D Rier, Chitra Lal, Valerian L Fernandes
No abstract text is available yet for this article.
October 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29076453/-in-hospital-cardiac-arrest-in-a-69-year-old-woman-treated-with-extracorporeal-cardiopulmonary-resuscitation
#10
Ali Akkawi, Joachim Hoffmann Petersen, Lars Riber
A 69-year-old woman was admitted to the emergency unit due to respiratory distress. Initially the blood pressure was normal. However, it decreased concomitant with low saturation (70%), and it was decided to intubate her due to hypoxia. During intubation, she developed in-hospital cardiac arrest with pulseless electric activity as initial rhythm. Cardio pulmonary resuscitation was initiated, but sufficient spontaneous circulation was not obtained. We successfully initiated extracorporeal life support, and the patient survived with a good outcome...
October 23, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29068499/changes-in-paced-signals-may-predict-in-hospital-cardiac-arrest
#11
Mina Attin, Spencer Rosero, Jimmy Ding, Scot Nolan, Rebecca Tucker
BACKGROUND: An increasing number of patients with chronic illnesses have implanted cardiac rhythm devices such as pacemakers and implantable cardioverter-defibrillators (ICD). This study was conducted to identify potentially useful predictors of in-hospital cardiac arrest (I-HCA) within paced electrocardiogram (ECG) signals from cardiovascular patients with implanted medical devices. METHODS: In this retrospective study of 17 subjects, full-disclosure ECG traces prior to the time of documented I-HCA were analyzed to determine R-R intervals and QRS durations (QRSd)...
October 25, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29055890/utility-of-prehospital-electrocardiogram-characteristics-as-prognostic-markers-in-out-of-hospital-pulseless-electrical-activity-arrests
#12
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29054204/electroceuticals-in-medicine-the-brave-new-future
#13
Sundeep Mishra
Electroceuticals are a new category of therapeutic agents which act by targeting the neural circuits of organs. The therapy involves mapping the neural circuitry and delivering neural impulses to these specific targets. The impulse is administered via an implantable device. In cardiology besides pacemaker, defibrillation and resynchronization applications it could have usefulness in heart failure, atrial fibrillation, coronary artery disease, myocarditis, resistant hypertension, atrial and ventricular tachyarrhythmias, pulseless electrical activity, and refractory angina...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#14
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29033721/an-audit-of-in-hospital-cardiopulmonary-resuscitation-in-a-teaching-hospital-in-saudi-arabia-a-retrospective-study
#15
Abdullah Mohammed Kaki, Kamal Waheeb Alghalayini, Mohamed Nabil Alama, Adnan Abdullah Almazroaa, Norah Abdullah A Khathlan, Hassan Sembawa, Beena M Ouseph
OBJECTIVES: Data reflecting cardiopulmonary resuscitation (CPR) efforts in Saudi Arabia are limited. In this study, we analyzed the characteristics, and estimated the outcome, of in-hospital CPR in a teaching hospital in Saudi Arabia over 4 years. METHODS: A retrospective, observational study was conducted between January 2009 and December 2012 and included 4361 patients with sudden cardiopulmonary arrest. Resuscitation forms were reviewed. Demographic data, resuscitation characteristics, and survival outcomes were recorded...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28974370/is-pulseless-electrical-activity-a-reason-to-refuse-cardiopulmonary-resuscitation-with-ecmo-support
#16
Dirk Pabst, Christoph E Brehm
BACKGROUND: Cardiopulmonary resuscitation with ECMO support (ECPR) has shown to improve outcome in patients after cardiac arrest under resuscitation. Most current recommendations for ECPR do not include patients with a non-shockable rhythm such as PEA and asystole. AIM: The aim of this study was to investigate the outcome of 3 patient groups separated by initial rhythm at time of ECMO placement during CPR: asystole, PEA and shockable rhythm. METHODS: We made a retrospective single-center study of adults who underwent ECPR for in-hospital cardiac arrest between June 2008 and January 2017...
September 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28943123/prognostic-significance-of-spontaneous-shockable-rhythm-conversion-in-adult-out-of-hospital-cardiac-arrest-patients-with-initial-non-shockable-heart-rhythms-a-systematic-review-and-meta-analysis
#17
REVIEW
Shengyuan Luo, Yongshu Zhang, Wanwan Zhang, Ruiying Zheng, Jun Tao, Yan Xiong
BACKGROUND: There remains controversy over the prognostic significance of spontaneous shockable rhythm conversion in out-of-hospital cardiac arrest (OHCA) patients with initial non-shockable heart rhythms (pulseless electrical activity [PEA] or asystole). The aim of this study was to examine the association of shockable rhythm conversion with multiple OHCA outcomes, and to explore effect modifiers. METHODS: A dual-reviewer search was conducted in PubMed and EMBASE databases in March 2017...
December 2017: Resuscitation
https://www.readbyqxmd.com/read/28941873/extracorporeal-life-support-and-digoxin-specific-fab-fragments-for-successful-management-of-taxus-baccata-intoxication-with-low-output-and-ventricular-arrhythmia
#18
Mina Farag, Dominika Badowski, Ronald Koschny, Gisela Skopp, Andreas Brcic, Gabor B Szabo
INTRODUCTION: Yew plants are evergreen shrubs which are widely spread throughout the northern hemisphere. Taxane alkaloid derivatives, mainly taxine B, represent the main toxins of Taxus baccata and are highly cardiotoxic. Due to the lack of randomized clinical trials, case reports on accidental or suicidal yew intoxications build the only source of knowledge of clinical treatment options. CASE REPORT: We report the case of a suicidal yew ingestion admitted to our hospital under prolonged cardiopulmonary resuscitation due to pulseless electrical activity...
September 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28927190/outcomes-differ-by-first-documented-rhythm-after-witnessed-out-of-hospital-cardiac-arrest-in-children-an-observational-study-with-prospective-nationwide-population-based-cohort-database-in-japan
#19
Masahiko Hara, Kenichi Hayashi, Tetsuhisa Kitamura
Aims: To evaluate and compare outcomes and impacts of delay of time to cardiopulmonary resuscitation (CPR) by type of first documented rhythm in paediatric patients with out-of-hospital cardiac arrest (OHCA). Methods and results: We enrolled 3968 paediatric (aged <18 years) OHCA patients whose events were witnessed between 2005 and 2012 from a prospective nationwide population-based cohort database in Japan. We assessed and compared their neurologically favourable 1-month survival according to first documented rhythm: pulseless ventricular tachycardia/ventricular fibrillation (pVT/VF), pulseless electrical activity (PEA), or asystole...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28916478/a-retrospective-study-of-pulseless-electrical-activity-bedside-ultrasound-identifies-interventions-during-resuscitation-associated-with-improved-survival-to-hospital-admission-a-reason-study
#20
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel Brown, Terrell Caffery, Emily Douglass, Jacqueline Fraser, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Fernando Lopez, Elke Platz, Michelle Mendoza, Hal Minnigan, Christopher Moore, Joseph Novik, Louise Rang, Will Scruggs, Christopher Raio
OBJECTIVE: Our objective was to determine whether organized or disorganized cardiac activity is associated with increased survival in patients who present in pulseless electrical activity (PEA) treated with either 1) standard advanced cardiac life support (ACLS) medications or 2) other interventions. METHODS: This was a secondary analysis of a prospective, multi-center observational study utilizing ultrasound in out-of-hospital or inemergency department PEA arrest...
November 2017: Resuscitation
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