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https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#1
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/28214793/evaluation-of-timing-and-route-of-epinephrine-in-a-neonatal-model-of-asphyxial-arrest
#2
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, William J Jusko, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Myra H Wyckoff, Satyan Lakshminrusimha
BACKGROUND: Epinephrine administered by low umbilical venous catheter (UVC) or endotracheal tube (ETT) is indicated in neonates who fail to respond to positive pressure ventilation and chest compressions at birth. Pharmacokinetics of ETT epinephrine via fluid-filled lungs or UVC epinephrine in the presence of fetal shunts is unknown. We hypothesized that epinephrine administered by ETT or low UVC results in plasma epinephrine concentrations and rates of return of spontaneous circulation (ROSC) similar to right atrial (RA) epinephrine...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28175939/good-neurological-outcome-after-accidental-hyopthermia-presenting-with-asytole
#3
I Eckert, P Imboden, P Paal, J Koppenberg
A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming...
February 7, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28131602/correlation-of-impedance-threshold-device-use-during-cardiopulmonary-resuscitation-with-post-cardiac-arrest-acute-kidney-injury
#4
Panagiota Niforopoulou, Nicoletta Iacovidou, Pavlos Lelovas, George Karlis, Αpostolos Papalois, Spyros Siakavellas, Vasileios Spapis, George Kaparos, Ioanna Siafaka, Theodoros Xanthos
PURPOSE: To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. METHODS: After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n=8) or with ACD-CPR plus an active ITD (ITD group, n=8)...
January 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28129898/-loss-of-capture-by-myocardial-ischemia-a-case-report
#5
A Sonou, P M Adjagba, M Hounkponou, L Codjo, C Houéhanou-Sonou, S Assani, T Yessoufou, J Sacca, M Houénassi
We report the case of a patient with pacemaker who presented chest pain during exercise followed by fainting. He has a history of arterial hypertension and diabetes. The initial examination was normal; the ventricular stimulation threshold was 1.125 volts (V) and cardiac enzymes were normal. Stress test has reproduced chest pain followed by loss of pacemaker capture and asystole. Coronary angiography showed a tight stenosis of the proximal anterior interventricular artery dilated by a drug-eluting stent. The control of stress test was normal...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28127134/inhaler-syncope
#6
Robert L Rosenthal, Jay O Franklin
Syncope can result from certain activities that trigger an exaggerated physiological response in susceptible individuals; examples include cough, laugh, and micturition syncope. We report a novel cause for syncope, that due to reflex bradycardia and asystole produced by the use of asthma inhalers. We discuss the possible mechanisms for this effect and briefly review other breathing-related causes of bradycardia.
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28122680/the-society-of-thoracic-surgeons-expert-consensus-for-the-resuscitation-of-patients-who-arrest-after-cardiac-surgery
#7
(no author information available yet)
The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet...
January 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28099640/cardiopulmonary-resuscitation-of-adults-with-in-hospital-cardiac-arrest-using-the-utstein-style
#8
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/28099588/dobutamine-stress-echocardiography-safety-in-chagas-disease-patients
#9
Daniela do Carmo Rassi, Marcelo Luiz Campos Vieira, Rogerio Gomes Furtado, Fabio de Paula Turco, Luciano Henrique Melato, Viviane Tiemi Hotta, Colandy Godoy de Oliveira Nunes, Luiz Rassi, Salvador Rassi
Background: A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease...
January 16, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28099159/reducing-false-arrhythmia-alarm-rates-using-robust-heart-rate-estimation-and-cost-sensitive-support-vector-machines
#10
Qiang Zhang, Xianxiang Chen, Zhen Fang, Qingyuan Zhan, Ting Yang, Shanhong Xia
To lessen the rate of false critical arrhythmia alarms, we used robust heart rate estimation and cost-sensitive support vector machines. The PhysioNet MIMIC II database and the 2015 PhysioNet/CinC Challenge public database were used as the training dataset; the 2015 Challenge hidden dataset was for testing. Each record had an alarm labeled with asystole, extreme bradycardia, extreme tachycardia, ventricular tachycardia or ventricular flutter/fibrillation. Before alarm onsets, 300 s multimodal data was provided, including electrocardiogram, arterial blood pressure and/or photoplethysmogram...
January 18, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28032928/integrity-of-the-ganglionated-plexi-is-essential-to-parasympathetic-innervation-of-the-atrioventricular-node-by-the-right-vagus-nerve
#11
Olivier Xhaet, Luc DE Roy, Mariana Floria, Olivier Deceuninck, Dominique Blommaert, Fabien Dormal, Elisabeth Ballant, Mark LA Meir
INTRODUCTION: Radiofrequency isolation of pulmonary vein can be accompanied by transient sinus bradycardia or atrioventricular nodal (AVN) block, suggesting an influence on vagal cardiac innervation. However, the importance of the atrial fat pads in relation with the vagal innervation of AVN in humans remains largely unknown. The aim of this study was to evaluate the role of ganglionated plexi (GP) in the innervation of the AVN by the right vagus nerve. METHODS AND RESULTS: Direct epicardial high-frequency stimulation (HFS) of the GP (20 patients) and the right vagus nerve (10 patients) was performed before and after fat pad exclusion or destruction in 20 patients undergoing thoracoscopic epicardial ablation for the treatment of persistent AF...
December 29, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28032304/l-carnitine-reduces-susceptibility-to-bupivacaine-induced-cardiotoxicity-an-experimental-study-in-rats
#12
Gail K Wong, Carolyne Pehora, Mark W Crawford
BACKGROUND: The primary aim of this study was to evaluate the effect of acute administration of L-carnitine 100 mg·kg(-1) iv on susceptibility to bupivacaine-induced cardiotoxicity in rats. METHODS: In the first of two experiments, L-carnitine 100 mg·kg(-1) iv (n = 10) or saline iv (n = 10) was administered to anesthetized and mechanically ventilated Sprague-Dawley rats following which an infusion of bupivacaine 2.0 mg·kg(-1)·min(-1) iv was given until asystole occurred...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28027062/organ-donation-and-imminent-death-pro-position
#13
Paul E Morrissey
PURPOSE OF REVIEW: Donation after cardiac death is associated with many problems including ischemic injury, high rates of delayed allograft function, prolonged time to asystole, and frequent organ discard. Imminent death donation (IDD) has been proposed as a separate category of organ donation: distinct from living donation and donation after cardiac death. RECENT FINDINGS: A protocol for IDD was developed at Rhode Island Hospital and published in the ethics literature...
December 23, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28018465/ictal-sinus-pause-and-myoclonic-seizure-in-a-child
#14
Hye Ryun Kim, Gun-Ha Kim, So-Hee Eun, Baik-Lin Eun, Jung Hye Byeon
Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28011835/comparing-maximum-rate-and-sustainability-of-pacing-by-mechanical-vs-electrical-stimulation-in-the-langendorff-perfused-rabbit-heart
#15
T Alexander Quinn, Peter Kohl
AIMS: Mechanical stimulation (MS) represents a readily available, non-invasive means of pacing the asystolic or bradycardic heart in patients, but benefits of MS at higher heart rates are unclear. Our aim was to assess the maximum rate and sustainability of excitation by MS vs. electrical stimulation (ES) in the isolated heart under normal physiological conditions. METHODS AND RESULTS: Trains of local MS or ES at rates exceeding intrinsic sinus rhythm (overdrive pacing; lowest pacing rates 2...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28000148/regadenoson-induced-complete-heart-block-and-asystole-a-real-possibility-nuclear-laboratories-should-be-aware-of
#16
Faraz Kureshi, Mouin S Abdallah, Timothy M Bateman
No abstract text is available yet for this article.
December 20, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27988965/ictal-asystole-a-systematic-review
#17
Dalma Tényi, Csilla Gyimesi, Péter Kupó, Réka Horváth, Beáta Bóné, Péter Barsi, Norbert Kovács, Tamás Simor, Zsuzsa Siegler, László Környei, András Fogarasi, József Janszky
OBJECTIVE: To comprehensively analyze ictal asystole (IA) on a large number of subjects. METHODS: We performed a systematic review of case report studies of patients diagnosed with IA (1983-2016). Each included case was characterized with respect to patient history, IA seizure characteristics, diagnostic workup, and therapy. In addition, comparative analyses were also carried out: two alignments were developed based on the delay between epilepsy onset and IA onset ("new-onset" if <1 year, "late-onset" if ≥1 year) and asystole duration (asystole was "very prolonged" if lasted >30 s)...
December 18, 2016: Epilepsia
https://www.readbyqxmd.com/read/27988280/comparison-of-efficacy-pattern-of-response-occurrence-of-arrhythmias-and-the-tolerability-of-nitroglycerine-and-isoprenaline-as-provocative-drugs-during-head-up-tilt-test
#18
Mukund Aravind Prabhu, Vivek Pillai, Jayaprakash Shenthar
BACKGROUND: Various protocols exist for performing head-up tilt test (HUTT). Serious ventricular arrhythmias have been reported during HUTT using Isoprenaline (ISO) provocation and their incidence with sublingual Nitroglycerine provocation is unknown. This study aims to assess the efficacy, pattern of response, tolerability, and frequency of arrhythmias during head-up tilt test with sublingual Nitroglycerine (NTG) provocation compared to ISO) provocation. METHODS: This is a retrospective observational study...
November 23, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27986281/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-a-multicentre-experience
#19
Mark Dennis, Peter McCanny, Mario D'Souza, Paul Forrest, Brian Burns, David A Lowe, David Gattas, Sean Scott, Paul Bannon, Emily Granger, Roger Pye, Richard Totaro
AIM: To describe the ECPR experience of two Australian ECMO centres, with regards to survival and neurological outcome, their predictors and complications. METHODS: Retrospective observational study of prospectively collected data on all patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) at two academic ECMO referral centres in Sydney, Australia. MEASUREMENTS AND MAIN RESULTS: Thirty-seven patients underwent ECPR, 25 (68%) were for in-hospital cardiac arrests...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27973939/asystole-from-direct-laryngoscopy-a-case-report-and-literature-review
#20
Andrew J Redmann, Gregory D White, Benu Makkad, Rebecca Howell
The rare and potentially fatal complication of asystole during direct laryngoscopy is linked to direct vagal stimulation. This case describes asystole in an 85-year-old female who underwent suspension microlaryngoscopy with tracheal dilation for subglottic stenosis. Quick recognition of this rare event with immediate cessation of laryngoscopy resulted in the return of normal sinus rhythm. This incident emphasizes the implications of continued vigilance during laryngoscopy and the importance of communication between the anesthesia and surgical staff to identify and treat this rare complication...
2016: Anesthesia Progress
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