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Post cardiac arrest encephalopathy

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https://www.readbyqxmd.com/read/29783851/the-death-debate-penumbra-conundrum
#1
Robert F Johnson
Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE)...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29698752/differential-effect-of-mild-therapeutic-hypothermia-depending-on-the-findings-of-hypoxic-encephalopathy-on-early-ct-images-in-patients-with-post-cardiac-arrest-syndrome
#2
Mitsuaki Nishikimi, Takayuki Ogura, Kazuki Nishida, Kunihiko Takahashi, Kenji Fukaya, Keibun Liu, Mitsunobu Nakamura, Shigeyuki Matsui, Naoyuki Matsuda
INTRODUCTION: The aim of this study was to evaluate the differential effects of mild therapeutic hypothermia (MTH) in post-cardiac arrest syndrome (PCAS) patients depending on the presence/absence of hypoxic encephalopathy (HE) in the early brain CT images obtained before the initiation of MTH. METHODS: We conducted a retrospective review of the data of a total of 129 patients with PCAS who were treated by MTH (34 °C) or normothermia treatment (NT) (35 °C or 36 °C), and had undergone brain CT examination prior to the initiation of these treatments...
April 23, 2018: Resuscitation
https://www.readbyqxmd.com/read/29476891/post-arrest-therapeutic-hypothermia-in-pediatric-patients-with-congenital-heart-disease
#3
Henry H Cheng, Satish K Rajagopal, Arnold J Sansevere, Erica McDavitt, Daniel Wigmore, Jessica Mecklosky, Kristofer Andren, Kathryn A Williams, Amy Danehy, Janet S Soul
BACKGROUND: While therapeutic hypothermia (TH) is an effective neuroprotective therapy for neonatal hypoxic-ischemic encephalopathy, TH has not been demonstrated to improve outcome in other pediatric populations. Patients with acquired or congenital heart disease (CHD) are at high risk of both cardiac arrest and neurodevelopmental impairments, and therapies are needed to improve neurologic outcome. The primary goal of our study was to compare safety/efficacy outcomes in post-arrest CHD patients treated with TH versus controls not treated with TH...
May 2018: Resuscitation
https://www.readbyqxmd.com/read/28861407/alterations-in-cerebral-blood-flow-after-resuscitation-from-cardiac-arrest
#4
REVIEW
Bistra Iordanova, Lingjue Li, Robert S B Clark, Mioara D Manole
Greater than 50% of patients successfully resuscitated from cardiac arrest have evidence of neurological disability. Numerous studies in children and adults, as well as in animal models have demonstrated that cerebral blood flow (CBF) is impaired after cardiac arrest. Stages of cerebral perfusion post-resuscitation include early hyperemia, followed by hypoperfusion, and finally either resolution of normal blood flow or protracted hyperemia. At the level of the microcirculation the blood flow is heterogeneous, with areas of no flow, low flow, and increased flow...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#5
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28434268/ubiquitin-c-terminal-hydrolase-l1-uch-l1-as-a-therapeutic-and-diagnostic-target-in-neurodegeneration-neurotrauma-and-neuro-injuries
#6
REVIEW
Kevin K Wang, Zhihui Yang, George Sarkis, Isabel Torres, Vijaya Raghavan
Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease...
June 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28268686/using-hilbert-huang-transform-to-assess-eeg-slow-wave-activity-during-anesthesia-in-post-cardiac-arrest-patients
#7
Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko
Hypoxic ischemic encephalopathy (HIE) is a severe consequence of cardiac arrest (CA) representing a substantial diagnostic challenge. We have recently designed a novel method for the assessment of HIE after CA. The method is based on estimating the severity of the brain injury by analyzing changes in the electroencephalogram (EEG) slow wave activity while the patient is exposed to an anesthetic drug propofol in a controlled manner. In this paper, Hilbert-Huang Transform (HHT) was used to analyze EEG slow wave activity during anesthesia in ten post-CA patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226873/using-hilbert-huang-transform-to-assess-eeg-slow-wave-activity-during-anesthesia-in-post-cardiac-arrest-patients
#8
Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko, Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko, Eero Vayrynen, Janne T Backman, Jukka Kortelainen, Tapio Seppanen, Jouko Laurila, Usko Huuskonen, Seppo Alahuhta, Tero Ala-Kokko, Juha Koskenkari
Hypoxic ischemic encephalopathy (HIE) is a severe consequence of cardiac arrest (CA) representing a substantial diagnostic challenge. We have recently designed a novel method for the assessment of HIE after CA. The method is based on estimating the severity of the brain injury by analyzing changes in the electroencephalogram (EEG) slow wave activity while the patient is exposed to an anesthetic drug propofol in a controlled manner. In this paper, Hilbert-Huang Transform (HHT) was used to analyze EEG slow wave activity during anesthesia in ten post-CA patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/27894023/persistent-generalized-periodic-discharges-a-specific-marker-of-fatal-outcome-in-cerebral-hypoxia
#9
Roland Renzel, Christian R Baumann, Ian Mothersill, Rositsa Poryazova
OBJECTIVES: Electroencephalography (EEG) is one of the methods used in predicting the outcome after cerebral hypoxia. In this study we aim to evaluate the significance of generalized periodic discharges (GPD) as a prognostic marker. METHODS: We retrospectively analyzed the medical histories of patients, who underwent an EEG after cardiac arrest during the time period from 2005 to 2013 at the University Hospital Zurich. All EEGs were re-interpreted using the 2012 American Clinical Neurophysiology Society (ACNS) classification for intensive care unit (ICU) EEGs...
January 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27622966/effect-of-hypothermia-and-targeted-temperature-management-on-drug-disposition-and-response-following-cardiac-arrest-a-comprehensive-review-of-preclinical-and-clinical-investigations
#10
REVIEW
Kacey B Anderson, Samuel M Poloyac, Patrick M Kochanek, Philip E Empey
Targeted temperature management (TTM) has been shown to reduce mortality and improve neurological outcomes in out-of-hospital cardiac arrest (CA) patients and in neonates with hypoxic-ischemic encephalopathy (HIE). TTM has also been associated with adverse drug events in the critically ill patient due to its effect on drug pharmacokinetics (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA. MEDLINE/PubMed databases were searched for publications, which include the MeSH terms hypothermia, drug metabolism, drug transport, P450, critical care, cardiac arrest, hypoxic-ischemic encephalopathy, pharmacokinetics, and pharmacodynamics between July 2006 and October 2015...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27369692/minimal-eeg-montage-with-high-yield-for-the-detection-of-status-epilepticus-in-the-setting-of-postanoxic-brain-damage
#11
Pieternel Vanherpe, Maarten Schrooten
For the diagnosis of electrographic seizures or status epilepticus, we reduced the number of EEG-electrodes to make urgent EEG monitoring more feasible. Unlike the current existing research, with mixed results, we studied a specific population with postanoxic brain damage, expecting a higher yield of detection of ictal EEG patterns. In a population treated with therapeutic hypothermia post-cardiac arrest, the initial EEGs were reformatted in a longitudinal, a hairline and an 8-lead montage, and independently reviewed by two investigators...
March 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#12
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/26567031/the-prognostic-value-of-48-h-continuous-eeg-during-therapeutic-hypothermia-after-cardiac-arrest
#13
Marta Lamartine Monteiro, Fabio Silvio Taccone, Chantal Depondt, Irene Lamanna, Nicolas Gaspard, Noémie Ligot, Nicolas Mavroudakis, Gilles Naeije, Jean-Louis Vincent, Benjamin Legros
BACKGROUND: The aim of this study was to evaluate the prognostic value of continuous electroencephalogram (cEEG) during the first 48 h following cardiac arrest (CA) in patients treated with targeted temperature management (TTM). METHODS: We reviewed data from 92 comatose post-CA patients over a 6 year-period; cEEG recordings were performed during TTM and restoration of normothermia. EEG findings were divided into four time-periods: 0-8, 8-16, 16-24, and 24-48 h after CA...
April 2016: Neurocritical Care
https://www.readbyqxmd.com/read/26430341/targeted-temperature-management-current-evidence-and-practices-in-critical-care
#14
REVIEW
Saurabh Saigal, Jai Prakash Sharma, Ritika Dhurwe, Sanjay Kumar, Mohan Gurjar
Targeted temperature management (TTM) in today's modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21(st) century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings...
September 2015: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26388581/effectiveness-of-gk-2-a-nerve-growth-factor-mimetic-in-preventing-post-resuscitation-changes-in-the-brain
#15
Yu V Zarzhetskii, M Sh Avrushchenko, V V Moroz, T A Gudasheva, S B Seredenin
Neurological status was assessed and the numbers of neurons per 1 mm in pyramidal neuronal layer length in CA1 and CA4 hippocampal fields and cerebellar Purkinje cells were evaluated in albino male rats on post-resuscitation day 14 after 12-min cardiac arrest. Intraperitoneal administration of GK-2 (1 mg/kg 30 min after resuscitation and within the next 3 days with an interval of 24 h) accelerated neurological recovery of the animals, sharply reduced the intensity of cerebellar Purkinje cell death, and prevented loss of pyramidal neurons in the hippocampus...
August 2015: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/26304276/novel-uses-of-targeted-temperature-management
#16
REVIEW
John McGinniss, Peter Marshall, Shyoko Honiden
Targeted temperature management has an established role in treating the post-cardiac arrest syndrome after out-of-hospital cardiac arrest with an initial rhythm of ventricular tachycardia/ventricular fibrillation. There is less certain benefit if the initial rhythm is pulseless electrical activity/asystole or for in-hospital cardiac arrest. Targeted temperature management may have a role as salvage modality for conditions causing intracranial hypertension, such as traumatic brain injury, hepatic encephalopathy, intracerebral hemorrhage, and acute stroke...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26301665/etiologies-clinical-features-and-outcome-of-cardiac-arrest-in-hiv-infected-patients
#17
Nicolas Mongardon, Guillaume Geri, Nicolas Deye, Romain Sonneville, Florence Boissier, Sébastien Perbet, Laurent Camous, Virginie Lemiale, Marina Thirion, Armelle Mathonnet, Laurent Argaud, Laurent Bodson, Stéphane Gaudry, Antoine Kimmoun, Stéphane Legriel, Nicolas Lerolle, David Luis, Charles-Edouard Luyt, Julien Mayaux, Bertrand Guidet, Frédéric Pène, Jean-Paul Mira, Alain Cariou
BACKGROUND: Compared to many other cardiovascular diseases, there is a paucity of data on the characteristics of successfully resuscitated cardiac arrest (CA) patients with human immunodeficiency virus (HIV) infection. We investigated causes, clinical features and outcome of these patients, and assessed the specific burden of HIV on outcome. METHODS: Retrospective analysis of HIV-infected patients admitted to 20 French ICUs for successfully resuscitated CA (2000-2012)...
December 15, 2015: International Journal of Cardiology
https://www.readbyqxmd.com/read/26118926/anesthesia-for-liver-transplantation
#18
REVIEW
Aparna Dalal
Patients with end stage liver disease (ESLD) have complex problems such as cirrhotic cardiomyopathy, coronary artery disease, hepatopulmonary syndrome (HPS), portopulmonary hypertension (POPH), hepatic encephalopathy, intracranial hypertension, (ICP), left ventricular outflow tract obstruction (LVOTO), high Model of end liver disease (MELD) scores, hyponatremia, and coagulopathies. The anesthesia management for liver transplantation can be very complex, dynamic and challenging. Anesthesia agents affect hepatic blood flow and anesthetic drug distribution, metabolism and elimination maybe altered in end stage liver disease...
January 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/25910792/fatal-water-intoxication-and-cardiac-arrest-in-runners-during-marathons-prevention-and-treatment-based-on-validated-clinical-paradigms
#19
REVIEW
Arthur J Siegel
Cerebral edema due to exercise-associated hyponatremia and cardiac arrest due to atherosclerotic heart disease cause rare marathon-related fatalities in young female and middle-aged male runners, respectively. Studies in asymptomatic middle-aged male physician-runners during races identified inflammation due to skeletal muscle injury after glycogen depletion as the shared underlying cause. Nonosmotic secretion of arginine vasopressin as a neuroendocrine stress response to rhabdomyolysis mediates hyponatremia as a variant of the syndrome of inappropriate antidiuretic hormone secretion...
October 2015: American Journal of Medicine
https://www.readbyqxmd.com/read/25828950/effects-of-paco2-derangements-on-clinical-outcomes-after-cerebral-injury-a-systematic-review
#20
REVIEW
Brian W Roberts, Paul Karagiannis, Michael Coletta, J Hope Kilgannon, Michael E Chansky, Stephen Trzeciak
OBJECTIVE: Partial pressure of arterial carbon dioxide (PaCO2) is a major regulator of cerebral blood flow (CBF). Derangements in PaCO2 have been thought to worsen clinical outcomes after many forms of cerebral injury by altering CBF. Our aim was to systematically analyze the biomedical literature to determine the effects of PaCO2 derangements on clinical outcomes after cerebral injury. METHODS: We performed a search of Cochrane Library, PUBMED, CINHAL, conference proceedings, and other sources using a comprehensive strategy...
June 2015: Resuscitation
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