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Respiratory arrest

Wei-Dong Li, Shuai Yu, Shi-Ming Luo, Wei Shen, Shen Yin, Qing-Yuan Sun
Benzo[ghi]perylene (B[ghi]P) is a polycyclic aromatic hydrocarbon widely found in haze. Long-term exposure to humans or animals can cause serious damage to the respiratory system. Melatonin is an endogenous natural hormone synthesized and released by the pineal gland. In this study, we investigated the effects of melatonin on in vitro cultured B[ghi]P-exposed mouse oocytes and the protective roles of melatonin. Our data indicate that B[ghi]P exposure leads to meiotic maturation arrest and reduced ability of sperm binding and parthenogenetic activation...
October 14, 2018: Journal of Cellular Physiology
Furqan B Irfan, Maaret Castren, Zain A Bhutta, Pooja George, Isma Qureshi, Stephen H Thomas, Sameer A Pathan, Guillaume Alinier, Loua A Shaikh, Jassim A Suwaidi, Rajvir Singh, Ashfaq Shuaib, Tooba Tariq, William J McKenna, Peter A Cameron, Therese Djarv
AIMS: There are very few studies comparing epidemiology and outcomes of out-of-hospital cardiac arrest (OHCA) in different ethnic groups. Previous ethnicity studies have mostly determined OHCA differences between African American and Caucasian populations. The aim of this study was to compare epidemiology, clinical presentation, and outcomes of OHCA between the local Middle Eastern Gulf Cooperation Council (GCC) Arab and the migrant North African populations living in Qatar. METHODS: This was a retrospective cohort study of Middle Eastern GCC Arabs and migrant North African patients with presumed cardiac origin OHCA resuscitated by Emergency Medical Services (EMS) in Qatar, between June 2012 and May 2015...
October 10, 2018: Ethnicity & Health
Marco A F Pimentel, Oliver C Redfern, Stephen Gerry, Gary S Collins, James Malycha, David Prytherch, Paul E Schmidt, Gary B Smith, Peter J Watkinson
AIMS: To compare the ability of the National Early Warning Score (NEWS) and the National Early Warning Score 2 (NEWS2) to identify patients at risk of in-hospital mortality and other adverse outcomes. METHODS: We undertook a multi-centre retrospective observational study at five acute hospitals from two UK NHS Trusts. Data were obtained from completed adult admissions who were not fit enough to be discharged alive on the day of admission. Diagnostic coding and oxygen prescriptions were used to identify patients with type II respiratory failure (T2RF)...
October 1, 2018: Resuscitation
Richard Ng, Meer-Taher Shabani-Rad
BACKGROUND: Patients with hip fracture who present anticoagulated with warfarin often require reversal of anticoagulation for safe hip fracture surgery. Vitamin K is typically administered for this, but requires 24-48 hours for maximal effect. These patients have an increased delay to surgery and increased mortality. Octaplex is a prothrombin complex concentrate (PCC) that reverses warfarin anticoagulation in less than an hour. This study assesses the effectiveness and safety of Octaplex for reversal of warfarin anticoagulation for hip fracture surgery...
October 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
B R Matam, Heather Duncan, David Lowe
A cardiac arrest is a life-threatening event, often fatal. Whilst clinicians classify some of the cardiac arrests as potentially predictable, the majority are difficult to identify even in a post-incident analysis. Changes in some patients' physiology when analysed in detail can however be predictive of acute deterioration leading to cardiac or respiratory arrests. This paper seeks to exploit the causally-related changing patterns in signals such as heart rate, respiration rate, systolic blood pressure and peripheral cutaneous oxygen saturation to evaluate the predictability of cardiac arrests in critically ill paediatric patients in intensive care...
September 27, 2018: Journal of Clinical Monitoring and Computing
Seher Erdoğan, Sevinç Kalın
Hashimoto encephalopathy (HE) is a steroid-responsive, acute or subacute encephalopathy, characterised by autoimmune thyroiditis associated with elevated antithyroid antibody titres. An 11-year-old girl was admitted to the Department of Paediatrics with generalised tonic-clonic seizures, left facial paralysis and right hemiparesis. Ceftriaxone and acyclovir were applied, and methyl prednisolone 2 mg kg-1 day-1 was administered orally. The hemiparesis improved on the 3rd day of treatment, but the facial paralysis persisted into the 15th day...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
Iqbal El-Assaad, Sadeer G Al-Kindi, Bryan McNally, Kimberly Vellano, Sarah Worley, Anne S Tang, Peter F Aziz
BACKGROUND: Little is known about the predictors of pre-emergency medical service (EMS) automated external defibrillator (AED) application in pediatric out-of-hospital cardiac arrests. We sought to determine patient- and neighborhood-level characteristics associated with pre-EMS AED application in the pediatric population. METHODS: We reviewed prospectively collected data from the Cardiac Arrest Registry to Enhance Survival on pediatric patients (age >1 to ≤18 years old) who had out-of-hospital nontraumatic arrest (2013-2015)...
October 2018: Pediatrics
Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
BACKGROUND: Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patients with tracheostomy was developed. Little is known, however, about the humidifying performance of HMEs or heated-and-humidified high-flow systems for spontaneous breathing patients with a tracheostomy...
September 25, 2018: Respiratory Care
Fawzia E Al Otaibi
To describe a fatal case of invasive Aspergillus flavus sinusitis in a 43-year old female with sickle cell disease (SCD) complicated by intracerebral aspergilloma and invasive Salmonella infection. Cerebral aspergilloma carries a very high mortality rate. The patient developed post-craniotomy intracerebral hemorrhage at the site of biopsy, Salmonella species sepsis and ventriculitis. She presented with a 2-month history of headache, dizziness, personality and behavioral changes, and vomiting. Initial clinical evaluation raised the suspicion of brain tumor...
September 2018: Saudi Medical Journal
Jared Netley, James Roy, Joseph Greenlee, Shaun Hart, Michael Todt, Bryan Statz
Anticoagulation with unfractionated heparin during extracorporeal membrane oxygenation (ECMO) is common, but alternative agents are being evaluated for safety and efficacy. The objective of this analysis was to assess if a comprehensive bivalirudin dosing and monitoring protocol effectively guides dose adjustments and monitoring of bivalirudin in patients during ECMO. Our analysis included 11 patients who received bivalirudin during ECMO therapy and had dosing managed using our hospital derived protocol. Patients treated over a 1-year period were included in this retrospective analysis...
September 2018: Journal of Extra-corporeal Technology
Jocelyn Y Cheng
Purpose: Positive airway pressure remains the gold-standard treatment for OSA, but many are intolerant. The neurotransmitter serotonin is involved in respiratory control. Evidence exists for SRIs in reducing OSA severity in the general population and ictal hypoxemia and seizure-induced respiratory arrest in people with epilepsy (PWE). However, the association between SRIs and OSA severity has not been studied in populations consisting of both groups. This study aims to determine if SRIs are associated with OSA severity in both PWE and people without epilepsy (PWO) and whether differences exist between the two groups...
2018: Neurology Research International
James B Carr, Jourdan M Cancienne, Brian C Werner
PURPOSE: Obstructive sleep apnea (OSA) has not been studied as a risk factor for complications following knee arthroscopy. The goals of this study were to: (1) compare complication rates after knee arthroscopy between patients with and without OSA and (2) evaluate whether continuous positive airway pressure (CPAP) mitigated complication rates. METHODS: A national private insurance database was queried for patients undergoing simple knee arthroscopy from 2007 to 2016...
September 22, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Carlos L Alviar, P Elliott Miller, Dorothea McAreavey, Jason N Katz, Burton Lee, Brad Moriyama, Jeffrey Soble, Sean van Diepen, Michael A Solomon, David A Morrow
Contemporary cardiac intensive care units (CICUs) provide care for an aging and increasingly complex patient population. The medical complexity of this population is partly driven by an increased proportion of patients with respiratory failure needing noninvasive or invasive positive pressure ventilation (PPV). PPV often plays an important role in the management of patients with cardiogenic pulmonary edema, cardiogenic shock, or cardiac arrest, and those undergoing mechanical circulatory support. Noninvasive PPV, when appropriately applied to selected patients, may reduce the need for invasive mechanical PPV and improve survival...
September 25, 2018: Journal of the American College of Cardiology
Jerry Y Du, Adam J Schell, Chang-Yeon Kim, Nikunj N Trivedi, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To determine incidence and timing of mortality following surgery for spinal epidural abscess (SEA), identify risk factors for mortality, and identify complications associated with mortality. SUMMARY OF BACKGROUND DATA: SEA is a serious condition with potentially devastating sequelae. There is a paucity of literature characterizing mortality following surgery for SEA. METHODS: The National Surgical Quality Improvement Program (NSQIP) database was used...
September 17, 2018: Spine
Fabrizio R Assis, M Emma G Bigelow, Raghuram Chava, Sunjeet Sidhu, Aravindan Kolandaivelu, Henry Halperin, Harikrishna Tandri
Targeted temperature management (TTM) is recommended as a standard of care for postcardiac arrest patients. Current TTM methods have significant limitations to be used in an ambulatory setting. We investigated the efficacy and safety of a novel noninvasive transnasal evaporative cooling device (CoolStat™). Eleven Yorkshire pigs underwent hypothermia therapy using the CoolStat device. CoolStat induces evaporative cooling by blowing dehumidified ambient air over the nasal turbinates in a unidirectional fashion...
September 20, 2018: Therapeutic Hypothermia and Temperature Management
Eli Jaffe, Ziv Dadon, Evan Avraham Alpert
Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Bystanders and organized volunteer first responders have often helped in extricating the victims, stopping the bleeding, and aiding in the evacuation of the victims...
September 17, 2018: Prehospital and Disaster Medicine
Sophia Villiere, Ko Nakase, Richard Kollmar, Hamid Arjomandi, Jason Lazar, Krishnamurthi Sundaram, Joshua B Silverman, Michael Lucchesi, David Wlody, Mark Stewart
Background: Acute laryngospasm sufficient to cause obstructive apnea is a medical emergency that can be difficult to manage within the very short time available for establishing an airway. We have presented substantial evidence that laryngospasm-based obstructive apnea is the cause of sudden death in epilepsy, and airway management is particularly challenging during seizure activity. Objective: We sought to determine if the transtracheal delivery of a bolus of oxygen or room air below the level of an obstruction to inflate the lungs could be an effective method to prolong the time available for responders seeking to establish a stable airway, and, if so, what could be learned about optimization of delivery parameters from a rat model...
August 2018: Laryngoscope Investigative Otolaryngology
Anne-Marie McBride
Obstetric emergencies often require intensive care intervention. Amniotic fluid embolism is a rare, unpredictable, and often catastrophic complication of pregnancy that is suspected in a woman who experiences cardiac arrest after a cesarean section. The condition occurs in approximately 1 in 40 000 births and has an average case-fatality rate of 16%. This complication may result from activation of an inflammatory response to fetal tissue in the maternal circulation. Risk factors may include maternal age over 35 years and conditions in which fluid can exchange between the maternal and fetal circulations...
2018: AACN Advanced Critical Care
Stephen M Spindel, Bobby Yanagawa, Javier Mejia, Matthew A Levin, Robin Varghese, Paul E Stelzer
INTRODUCTION: We report our initial surgical experience of intermittent upper and lower body retrograde perfusion during aortic repair under circulatory arrest. METHODS: Between 2007 and 2015, 148 consecutive patients underwent surgical aortic repair using moderate hypothermic circulatory arrest with intermittent upper and lower body retrograde perfusion. RESULTS: All patients underwent ascending aorta replacement; eight had hemiarch replacement (5...
September 5, 2018: Perfusion
Jimmy K Wong, T Edward Kim, Seshadri C Mudumbai, Stavros G Memtsoudis, Nicholas J Giori, Steven K Howard, Roberta K Oka, Robert King, Edward R Mariano
BACKGROUND: Hospital-related factors associated with mortality and morbidity after hip fracture surgery are not completely understood. The Veterans Health Administration (VHA) is the largest single-payer, networked healthcare system in the country serving a relatively homogenous patient population with facilities that vary in size and resource availability. These characteristics provide some degree of financial and patient-level controls to explore the association, if any, between surgical volume and facility resource availability and hospital performance regarding postoperative complications after hip fracture surgery...
August 30, 2018: Clinical Orthopaedics and related Research
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