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Epinephrine cardiac arrest

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https://www.readbyqxmd.com/read/29425976/non-invasive-characterization-of-hemodynamics-in-adult-out-of-hospital-cardiac-arrest-patients-soon-after-return-of-spontaneous-circulation
#1
Joseph P Ornato, Tammy Nguyen, Peter Moffett, Stephen Miller, Michael J Vitto, David Evans, Alan Payne, Kathy Baker, Mary Schaeffer
BACKGROUND: Little is known about hemodynamics in adult, out-of-hospital (OHCA) patients following return of spontaneous circulation (ROSC). A 1994 study when "high-dose epinephrine" use was common showed consistently elevated systemic vascular resistance (SVR) lasting ≥6 hours in 49 adult patients after return of spontaneous circulation (ROSC). STUDY AIM: To characterize hemodynamic abnormalities in adult OHCA patients soon after ROSC. Our hypothesis was that, unlike the consistently high SVR values reported when "high-dose" epinephrine was in common use, there would be a more heterogenous distribution of SVR values using current adrenergic therapy...
February 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29419933/a-serious-adverse-event-secondary-to-rapid-intravenous-levetiracetam-injection-in-a-dog
#2
Allison A Biddick, Lenore M Bacek, Amanda R Taylor
OBJECTIVE: To describe a serious adverse event as a result of rapid intravenous injection of undiluted levetiracetam in a dog. CASE SUMMARY: An 8-year-old female spayed Chihuahua was evaluated for cluster seizures and tachypnea. The patient was administered an intravenous dose of undiluted levetiracetam (60 mg/kg) and immediately developed tachycardia, hyperglycemia, hypotension, and a dull mentation. The patient's blood pressure and mentation did not respond to intravenous fluid boluses but improved immediately after administration of epinephrine intravenously...
February 8, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29413238/should-we-perform-an-immediate-coronary-angiogram-in-all-patients-after%C3%A2-cardiac-arrest-insights-from-a-large-french-registry
#3
Wulfran Bougouin, Florence Dumas, Nicole Karam, Carole Maupain, Eloi Marijon, Lionel Lamhaut, Daniel Jost, Guillaume Geri, Frankie Beganton, Olivier Varenne, Christian Spaulding, Xavier Jouven, Alain Cariou
OBJECTIVES: This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival. BACKGROUND: An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases. METHODS: From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France)...
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29393490/erythropoietin-alleviates-post-resuscitation-myocardial-dysfunction-in-rats-potentially-through-increasing-the-expression-of-angiotensin-ii-receptor-type-2-in-myocardial-tissues
#4
Hourong Zhou, Jia Huang, Li Zhu, Yu Cao
Activation of renin-angiotensin system (RAS) is one of the pathological mechanisms associated with myocardial ischemia-reperfusion injury following resuscitation. The present study aimed to determine whether erythropoietin (EPO) improves post‑resuscitation myocardial dysfunction and how it affects the renin‑angiotensin system. Sprague‑Dawley rats were randomly divided into sham, vehicle, epinephrine (EP), EPO and EP + EPO groups. Excluding the sham group, all groups underwent cardiopulmonary resuscitation (CPR) 4 min after asphyxia‑induced cardiac arrest (CA)...
January 24, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29392079/novel-modification-of-potassium-chloride-induced-cardiac-arrest-model-for-aged-mice
#5
Huaqin Liu, Zhui Yu, Ying Li, Bin Xu, Baihui Yan, Wulf Paschen, David S Warner, Wei Yang, Huaxin Sheng
Experimental cardiac arrest (CA) in aging research is infrequently studied in part due to the limitation of animal models. We aimed to develop an easily performed mouse CA model to meet this need. A standard mouse KCl-induced CA model using chest compressions and intravenous epinephrine for resuscitation was modified by blood withdrawal prior to CA onset, so as to decrease the requisite KCl dose to induce CA by decreasing the circulating blood volume. The modification was then compared to the standard model in young adult mice subjected to 8 min CA...
February 2018: Aging and Disease
https://www.readbyqxmd.com/read/29373368/adenosine-2a-receptor-activation-attenuates-ischemia-reperfusion-injury-during-extracorporeal-cardiopulmonary-resuscitation
#6
James H Mehaffey, Dustin Money, Eric J Charles, Sarah Schubert, Angela Fernandez Piñeros, Di Wu, Sai Vineela Bontha, Robert Hawkins, Nicholas R Teman, Victor E Laubach, Valeria R Mas, Curtis G Tribble, Daniel G Maluf, Ashish K Sharma, Zequan Yang, Irving L Kron, Mark E Roeser
OBJECTIVE: We tested the hypothesis that systemic administration of an A2AR agonist will reduce multiorgan IRI in a porcine model of ECPR. SUMMARY BACKGROUND DATA: Advances in ECPR have decreased mortality after cardiac arrest; however, subsequent IRI contributes to late multisystem organ failure. Attenuation of IRI has been reported with the use of an A2AR agonist. METHODS: Adult swine underwent 20 minutes of circulatory arrest, induced by ventricular fibrillation, followed by 6 hours of reperfusion with ECPR...
January 25, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#7
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29305926/lower-dose-epinephrine-administration-and-out-of-hospital-cardiac-arrest-outcomes
#8
Cameron A Fisk, Michele Olsufka, Lihua Yin, Andrew M McCoy, Andrew J Latimer, Charles Maynard, Graham Nichol, Jonathan Larsen, Leonard A Cobb, Michael R Sayre
BACKGROUND: International guidelines recommend administration of 1 mg of intravenous epinephrine every 3 to 5 minutes during cardiac arrest. The optimal dose of epinephrine is not known. We evaluated the association of reduced frequency and dose of epinephrine with survival after out-of-hospital cardiac arrest (OHCA). METHODS: Included were patients with non-traumatic OHCA treated by advanced life support (ALS) providers from January 1, 2008 to June 30, 2016...
January 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29279412/association-between-prompt-defibrillation-and-epinephrine-treatment-with-long-term-survival-after-in-hospital-cardiac-arrest
#9
Krishna K Patel, John A Spertus, Yevgeniy Khariton, Yuanyuan Tang, Lesley H Curtis, Paul S Chan
Background -Prior studies have reported higher in-hospital survival with prompt defibrillation and epinephrine treatment in patients suffering in-hospital cardiac arrest (IHCA). Whether this survival benefit persists after discharge is unknown. Methods -We linked data from a national IHCA registry with Medicare files and identified 36,961 patients aged ≥65 years with an IHCA at 517 hospitals between 2000 and 2011. Patients with IHCA due to pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) were stratified by prompt (≤2 min) vs...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29206063/age-discrimination-in-out-of-hospital-cardiac-arrest-care-a-case-control-study
#10
Eric Wiel, Christophe Di Pompéo, Nicolas Segal, Gérald Luc, Jean-Baptiste Marc, Carine Vanderstraeten, Carlos El Khoury, Joséphine Escutnaire, Karim Tazarourte, Pierre-Yves Gueugniaud, Hervé Hubert
BACKGROUND: Although some studies have questioned whether cardiopulmonary resuscitation (CPR) in older people could be futile, age is not considered an essential out-of-hospital cardiac arrest (OHCA) prognostic factor. However, in the daily clinical practice of mobile medical teams (MMTs), age seems to be an important factor affecting OHCA care. AIMS: The purpose of this study was to compare OHCA care and outcomes between young patients (<65 years old) and older patients...
December 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29197833/prehospital-intravenous-access-for-survival-from-out-of-hospital-cardiac-arrest-propensity-score-matched-analyses-from-a-population-based-cohort-study-in-osaka-japan
#11
Tomoko Fujii, Tetsuhisa Kitamura, Kentaro Kajino, Kosuke Kiyohara, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takashi Kawamura, Taku Iwami
OBJECTIVES: Prehospital intravenous access is a common intervention for patients with out-of-hospital cardiac arrest (OHCA). We aimed to assess the effectiveness of prehospital intravenous access and subsequent epinephrine administration on outcomes among OHCA patients. METHODS: We conducted a prospective cohort study of patients with OHCA from non-traumatic causes aged ≥18 years in Osaka, Japan from January 2005 through December 2012. The primary outcome was 1-month survival with favourable neurological outcome defined as a cerebral performance category of 1 or 2...
December 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/29173401/public-access-defibrillation-is-this-making-any-difference-controversial-issues-in-resuscitation-from-cardiac-arrest
#12
REVIEW
Myron L Weisfeldt, Ross A Pollack
Public access defibrillation is particularly valuable in witnessed cardiac arrests that occur in public places. Bystander and police use of automated external defibrillators (AEDs) has increased over the past 15 years, resulting in improved survival with normal or near-normal neurologic function. There is great promise for increasing bystander use of defibrillators as the technology is applied to linking patients with shockable arrests to volunteers committed to bringing AEDs to the patients. There continues to be controversy as to the value of epinephrine, antiarrhythmic drugs, hypothermia, and mechanical chest compression in resuscitative efforts...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29152600/role-of-epinephrine-and-extracorporeal-membrane-oxygenation-in-the-management-of-ischemic-refractory-ventricular-fibrillation-a-randomized-trial-in-pigs
#13
Jason A Bartos, Sebastian Voicu, Timothy R Matsuura, Adamantios Tsangaris, Georgios Sideris, Brett A Oestreich, Stephen A George, Matthew Olson, Kadambari Chandra Shekar, Jennifer N Rees, Kathleen Carlson, Pierre Sebastian, Scott McKnite, Ganesh Raveendran, Tom P Aufderheide, Demetris Yannopoulos
xtracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. We used a 2×2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 minutes of untreated VF, 10 minutes of CPR, and were randomized to receive epinephrine versus placebo for another 35 minutes. Animals were further randomized to LAD reperfusion at minute 45 with ongoing CPR versus veno-arterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion...
June 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/29089189/metformin-intoxication-vasopressin-s-key-role-in-the-management-of-severe-lactic-acidosis
#14
Francesca Galiero, Giovanni Consani, Gianni Biancofiore, Stefano Ruschi, Francesco Forfori
Vasopressin is a potent vasopressor used for improving organ perfusion during cardiac arrest, septic and catecholamine-resistant shock; with reference to this, it is useful for the treatment of vasoplegic shock because, restoring organ perfusion pressure by contraction of vascular smooth muscle through a non-catecholamine receptor pathway, it can be employed when catecholamines are ineffective. A 49-yr-old woman was admitted to the Emergency Department after having intentionally taken 95.2g of metformin, 1...
October 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29036580/time-to-epinephrine-and-survival-after-paediatric-out-of-hospital-cardiac-arrest
#15
Tatsuma Fukuda, Yutaka Kondo, Kei Hayashida, Hiroshi Sekiguchi, Ichiro Kukita
Aims: Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results: This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry...
July 11, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29033721/an-audit-of-in-hospital-cardiopulmonary-resuscitation-in-a-teaching-hospital-in-saudi-arabia-a-retrospective-study
#16
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/28983759/myocardial-dysfunction-after-out-of-hospital-cardiac-arrest-predictors-and-prognostic-implications
#17
Yuan Yao, Nicholas James Johnson, Sarah Muirhead Perman, Vimal Ramjee, Anne Victoria Grossestreuer, David Foster Gaieski
We aim to determine the incidence of early myocardial dysfunction after out-of-hospital cardiac arrest, risk factors associated with its development, and association with outcome. A retrospective chart review was performed among consecutive out-of-hospital cardiac arrest (OHCA) patients who underwent echocardiography within 24 h of return of spontaneous circulation at three urban teaching hospitals. Our primary outcome is early myocardial dysfunction, defined as a left ventricular ejection fraction < 40% on initial echocardiogram...
October 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28917022/epidemiology-pathogenesis-and-management-of-takotsubo-syndrome
#18
REVIEW
Shams Y-Hassan, Per Tornvall
Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome...
September 15, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
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
#19
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/28911510/long-term-prognostic-value-of-gasping-during-out-of-hospital-cardiac%C3%A2-arrest
#20
RANDOMIZED CONTROLLED TRIAL
Guillaume Debaty, Jose Labarere, Ralph J Frascone, Marvin A Wayne, Robert A Swor, Brian D Mahoney, Robert M Domeier, Michael L Olinger, Brian J O'Neil, Demetris Yannopoulos, Tom P Aufderheide, Keith G Lurie
BACKGROUND: Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR). OBJECTIVES: This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes. METHODS: The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health-funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009...
September 19, 2017: Journal of the American College of Cardiology
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