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https://www.readbyqxmd.com/read/29038737/significant-bradycardia-in-critically-ill-patients-receiving-dexmedetomidine-and-fentanyl
#1
Channing Hui, Maria Cardinale, Balaji Yegneswaran
PURPOSE: To report a case series of three patients who developed significant bradycardia while receiving the combination of dexmedetomidine and fentanyl for sedation and analgesia. MATERIALS AND METHODS: This is a case series of patients obtained from a mixed medical, surgical, and cardiac ICU in a community teaching hospital. Three intubated patients receiving fentanyl and dexmedetomidine infusion developed sudden bradycardia requiring intervention. In all three cases, adjustments to therapy were required...
2017: Case Reports in 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
#2
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/29029774/immediate-coronary-angiography-in-survivors-of-out-of-hospital-cardiac-arrest-without-obvious-extracardiac-cause-who-benefits
#3
Z Moutacalli, J-L Georges, B Ajlani, G Cherif, E El Beainy, G Gibault-Genty, E Blicq, C Charbonnel, R Convers-Domart, F Boutot, J-M Caussanel, B Lemaire, S Legriel, B Livarek
BACKGROUND: Immediate coronary angiography (iCA) and primary percutaneous coronary angioplasty (pPCI) in patients successfully resuscitated after out-of-hospital cardiac arrest (OHCA) of suspected cardiac cause is controversial. Our aims were to assess the results of iCA, the prognostic impact of pPCI after OHCA, and to identify subgroups most likely to benefit from this strategy. METHODS: In this single-centre retrospective study, patients aged ≥18 years with sustained return of spontaneous circulation after OHCA and no evidence of a non-cardiac cause underwent routine iCA at admission, with pPCI if indicated...
October 10, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29019723/accidental-hanging-injuries-in-children-recognition-and-management
#4
Siba P Paul, Ruby Paul, Paul A Heaton
Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival...
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29017644/-analysis-of-out-of-hospital-emergency-treatment-for-ventricular-fibrillation-between-2013-and-2016-in-shanghai
#5
Xingxiang Li, Feiyue Teng, Ping Xu, Minghua Li, Rongjiao Liu, Ping Fang, Jiawen Hu
OBJECTIVE: To investigate the epidemiological features of out-of-hospital patients with ventricular fibrillation (VF) in Shanghai and to analysis factors associated with outcomes, and to provide evidence for improving the success rate of VF. METHODS: The data of patients with VF admitted to Shanghai Medical Emergency Center from January 2013 to December 2016 were analyzed retrospectively. All the data were recorded including the clinical data, medical service time, return of spontaneous circulation (ROSC) at scene/en route, survival to hospital discharge...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28980391/the-duration-of-asystolic-ischemia-time-determines-the-risk-of-graft-failure-after-circulatory-dead-donor-kidney-transplantation-a-eurotransplant-cohort-study
#6
L Heylen, I Jochmans, U Samuel, I Tieken, M Naesens, J Pirenne, B Sprangers
Circulatory death donor (DCD) kidney transplantations are steadily increasing. Consensus reports recommend to limit donor warm ischemia time (DWIT) in DCD donation, although an independent effect on graft outcome has not been demonstrated. We investigated death-censored graft survival in 18,065 recipients of deceased-donor kidney transplants in the Eurotransplant region: 1,059 DCD and 17,006 brain-dead donor (DBD) kidney recipients. DWIT was defined as time from circulatory arrest until cold flush. DCD donation was an independent risk factor for graft failure (adjusted HR 1...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28974370/is-pulseless-electrical-activity-a-reason-to-refuse-cardiopulmonary-resuscitation-with-ecmo-support
#7
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/28964425/a-novel-ecg-detector-performance-metric-and-its-relationship-with-missing-and-false-heart-rate-limit-alarms
#8
Chathuri Daluwatte, Jose Vicente, Loriano Galeotti, Lars Johannesen, David G Strauss, Christopher G Scully
PURPOSE: Performance of ECG beat detectors is traditionally assessed on long intervals (e.g.: 30min), but only incorrect detections within a short interval (e.g.: 10s) may cause incorrect (i.e., missed+false) heart rate limit alarms (tachycardia and bradycardia). We propose a novel performance metric based on distribution of incorrect beat detection over a short interval and assess its relationship with incorrect heart rate limit alarm rates. BASIC PROCEDURES: Six ECG beat detectors were assessed using performance metrics over long interval (sensitivity and positive predictive value over 30min) and short interval (Area Under empirical cumulative distribution function (AUecdf) for short interval (i...
September 1, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28958328/dual-chamber-pacing-with-closed%C3%A2-loop%C3%A2-stimulation-in-recurrent%C3%A2-reflex%C3%A2-vasovagal-syncope-the-spain-study
#9
RANDOMIZED CONTROLLED TRIAL
Gonzalo Baron-Esquivias, Carlos A Morillo, Angel Moya-Mitjans, Jesus Martinez-Alday, Ricardo Ruiz-Granell, Javier Lacunza-Ruiz, Roberto Garcia-Civera, Encarnacion Gutierrez-Carretero, Rafael Romero-Garrido
BACKGROUND: Pacing in vasovagal syncope remains controversial. OBJECTIVES: The authors evaluated dual-chamber pacing with closed loop stimulation (DDD-CLS) in patients with cardioinhibitory vasovagal syncope. METHODS: This randomized, double-blind, controlled study included Canadian and Spanish patients age ≥40 years, with high burden syncope (≥5 episodes, ≥2 episodes in the past year), and a cardioinhibitory head-up tilt test (bradycardia <40 beats/min for 10 s or asystole >3 s)...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28947546/effect-of-organ-donation-after-circulatory-determination-of-death-on-number-of-organ-transplants-from-donors-with-neurologic-determination-of-death
#10
Vivek Rao, Sonny Dhanani, Janet MacLean, Clare Payne, Elizabeth Paltser, Atul Humar, Jeffrey Zaltzman
BACKGROUND: To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. METHODS: We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14)...
September 25, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
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
#11
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...
September 22, 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
#12
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/28939249/sudden-cardiac-death-in-a-dog-during-holter-recording-r-on-t-phenomenon
#13
T Gunasekaran, R A Sanders
A 6-year-old castrated male Golden Retriever was diagnosed with severe subaortic stenosis with severe left atrial enlargement and high heart rate due to atrial fibrillation. Treatment with digoxin and diltiazem to control ventricular response rate was initiated. Ambulatory electrocardiographic monitoring (Holter monitoring) was performed at the beginning of treatment and was repeated to evaluate the patient's response to drug therapy. Drug dose adjustments were made based on response to therapy as assessed by Holter monitoring...
September 19, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
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
#14
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/28920131/reversible-causes-in-cardiovascular-collapse-at-the-emergency-department-using-ultrasonography-revive-us
#15
Mui Teng Chua, Gene Wh Chan, Win Sen Kuan
INTRODUCTION: Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality...
August 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28915792/levosimendan-combined-with-epinephrine-improves-rescue-outcomes-in-a-rat-model-of-lipid-based-resuscitation-from-bupivacaine-induced-cardiac-arrest
#16
Fubei Nan, Xixi Cai, Yingchao Ye, Xuzhong Xu, Zhengqian Li, Min Li, Limei Chen
BACKGROUND: The effectiveness of a combination of a lipid emulsion with epinephrine in reversing local anesthetic-induced cardiac arrest has been confirmed. The combination of a lipid emulsion with levosimendan, was shown to be superior to administration of a lipid emulsion alone with regard to successful resuscitation. In this study, we compared the reversal effects of levosimendan, epinephrine, and a combination of the two agents in lipid-based resuscitation in a rat model of bupivacaine-induced cardiac arrest...
September 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28905989/assessment-of-futility-in-out-of-hospital-cardiac-arrest
#17
P Setälä, S Hoppu, I Virkkunen, A Yli-Hankala, A Kämäräinen
BACKGROUND: Our aim was to evaluate the impact of futile resuscitation attempts to the outcome calculations of attempted resuscitation in out-of-hospital cardiac arrest (OHCA). Defined as partial resuscitations, we focused on a subgroup of patients in whom cardiopulmonary resuscitation (CPR) was initiated, but further efforts were soon abandoned due to evidence of futility. METHODS: We conducted this study using the Utstein template during a 12-month study period...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-non-shockable-turned-shockable-out-of-hospital-cardiac-arrest-the-amiodarone-lidocaine-or-placebo-study-alps
#18
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra A Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
Background -Out-of-hospital cardiac arrest (OHCA) commonly presents with non-shockable rhythms (asystole and pulseless electrical activity (PEA)). Whether antiarrhythmic drugs are safe and effective when these evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/VT)) during resuscitation is not known. Methods -Adults with non-traumatic OHCA, vascular access and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine or placebo by paramedics...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28895705/-complete-heart-block-and-asystole-in-a-child-with-ataxia-telangiectasia
#19
Daniel Palanca Arias, Ariadna Ayerza Casas, Mercedes Domínguez Cajal, Marta López Ramón, Lorenzo Jiménez Montañés
Ataxia-telangiectasia is a disorder characterized by cerebellar ataxia, telangiectasia, immunodeficiency, and increased predisposition to cancer susceptibility. Mutations in the ataxia telangiectasia mutated gene seem to play an important role in normal cell function and in cardiovascular remodeling. We report a case of a 14-year-old boy with ataxia-telangiectasia and high-grade B-non-Hodgkin lymphoma who remained in continuous complete remission after chemotherapy and who was admitted into our Emergency Room presenting with episodes of presyncope...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28878543/reproducible-transient-asystolic-arrest-during-intramedullary-reaming-of-the-femoral-canal-a-case-report
#20
Benjamin M Wooster, Brian T Nickel, Julie A Neumann, David R Lindsay, Samuel S Wellman
The utilization of intramedullary devices in the surgical fixation of hip fractures is increasing. Although intramedullary devices offer many advantages in the treatment of these injuries, they are also associated with a unique set of potential complications, particularly during preparation of the femoral canal. Cardiac dysrhythmia resulting from reaming the femoral canal is rare and has not been previously described in detail in the literature. We present the case of a 69-year-old male with an infected right cephalomedullary femoral nail who underwent removal of hardware and experienced reproducible, transient asystolic cardiac arrest during reaming of the femoral canal and offer potential explanations for this event...
August 2017: Journal of Clinical Orthopaedics and Trauma
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