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Prognostication after OHCA

Idrees Salam, Jakob Hartvig Thomsen, Jesper Kjaergaard, John Bro-Jeppesen, Martin Frydland, Matilde Winther-Jensen, Lars Køber, Michael Wanscher, Christian Hassager, Helle Søholm
OBJECTIVE: Comorbidity prior to out-of-hospital cardiac arrest (OHCA) and primary rhythm in relation to survival is not well established. We aimed to assess the prognostic importance of comorbidity in relation to primary rhythm in OHCA-patients treated with Target Temperature Management (TTM). DESIGN: Consecutive comatose survivors of OHCA treated with TTM in hospitals in the Copenhagen area between 2002-2011 were included. Utstein-based pre- and in-hospital data collection was performed...
March 19, 2018: Scandinavian Cardiovascular Journal: SCJ
Alessandro Zorzi, Angela Susana, Manuel De Lazzari, Federico Migliore, Giovanni Vescovo, Daniele Scarpa, Anna Baritussio, Giuseppe Tarantini, Luisa Cacciavillani, Benedetta Giorgi, Cristina Basso, Sabino Iliceto, Chiara Bucciarelli Ducci, Domenico Corrado, Martina Perazzolo Marra
BACKGROUND: In patients who survived out-of-hospital cardiac arrest (OHCA) it is crucial to establish the underlying cause and its potential reversibility. OBJECTIVE: We assessed the incremental diagnostic and prognostic role of early cardiac magnetic resonance (CMR) in survivors of OHCA. METHODS: Among 139 consecutive OHCA patients, we enrolled 44 (median age 43 years; 84% males) patients who underwent coronary angiography and CMR ≤7 days after admission...
March 14, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Ward Eertmans, Cornelia Genbrugge, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans, Cathy De Deyne
BACKGROUND: We investigated the ability of bispectral index (BIS) monitoring to predict poor neurological outcome in out-of-hospital cardiac arrest (OHCA) patients fully treated according to guidelines. RESULTS: In this prospective, observational study, 77 successfully resuscitated OHCA patients were enrolled in whom BIS, suppression ratio (SR) and electromyographic (EMG) values were continuously monitored during the first 36 h after the initiation of targeted temperature management at 33 °C...
March 2, 2018: Annals of Intensive Care
Chia-Lung Kao, I-Lin Hsu
PURPOSE: Suicide becomes a serious problem in today's society and hanging is a common method of suicide. We want to find the factors which can predict the final functional outcomes of these cases. METHODS: All patients who presented to Accident and Emergency Department (ED) of the National Cheng Kung University Hospital from 1st January 2005 to 31th December 2013 with a hanging injury were included in this study. All cases were divided into good outcome group and bad outcome group according to Glasgow Outcome Scale (GOS)...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takashi Kawamura, Takeshi Shimazu, Tetsuhisa Kitamura
To assess whether serum albumin concentration measured upon hospital arrival was useful as an early prognostic biomarker for neurologically favorable outcome in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM). This prospective, multicenter observational study (The CRITICAL Study) carried out between July 1, 2012 and December 31, 2014 in Osaka Prefecture, Japan involving 13 critical care medical centers (CCMCs) and one non-CCMC with an emergency department. This study included patients ≥18 years of age who underwent an OHCA, for whom resuscitation was attempted by Emergency Medical Services personnel and were then transported to participating institutions, and who were then treated with TTM...
January 24, 2018: Therapeutic Hypothermia and Temperature Management
Signe Riddersholm, Kristian Kragholm, Rikke Nørmark Mortensen, Steen Moller Hansen, Mads Wissenberg, Freddy K Lippert, Christian Torp-Pedersen, Christian F Christiansen, Bodil Steen Rasmussen
AIM: With increased survival after out-of-hospital cardiac arrest (OHCA), impact of the post-resuscitation course has become important. Among 30-day OHCA survivors, we investigated associations between organ support therapy in the Intensive Care Unit (ICU) and return to work. METHODS: This Danish nationwide cohort-study included 30-day-OHCA-survivors who were employed prior to arrest. We linked OHCA data to information on in-hospital care and return to work. For patients admitted to an ICU and based on renal replacement therapy (RRT), cardiovascular support and mechanical ventilation, we assessed the prognostic value of organ support therapies in multivariable Cox regression models...
January 11, 2018: Resuscitation
Yong Soo Son, Kyung Su Kim, Gil Joon Suh, Woon Yong Kwon, Min Ji Park, Jung In Ko, Taegyun Kim
OBJECTIVE: To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA). METHODS: This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015...
December 2017: Clinical and Experimental Emergency Medicine
Pirkka T Pekkarinen, Giuseppe Ristagno, Erika Wilkman, Serge Masson, Roberto Latini, Johanna Laurikkala, Stepani Bendel, Tero Ala-Kokko, Tero Varpula, Jukka Vaahersalo, Sari Karlsson, Marjaana Tiainen, Monica M Mion, Mario Plebani, Ville Pettilä, Markus B Skrifvars
BACKGROUND: Patients resuscitated from cardiac arrest commonly develop an inflammatory response called post-cardiac arrest syndrome that clinically resembles septic shock.Procalcitonin and presepsin are associated with inflammation. We hypothesized that these biomarkers reflect the severity of post-cardiac arrest syndrome and predict short-term haemodynamical instability and long-term neurological outcome after cardiac arrest. METHODS: As a subcohort analysis of a prospective, observational, multi-centre study "FINNRESUSCI", we obtained plasma from 277 intensive care unit (ICU) patients treated following out-of-hospital cardiac arrest (OHCA)...
December 14, 2017: Shock
Dante Antonelli, Ofir Koren, Menachem Nahir, Ehud Rozner, Nahum A Freedberg, Yoav Turgeman
BACKGROUND: Survival of patients who were discharged from the hospital following out-of-hospital cardiac arrest (OHCA) has not been well defined. OBJECTIVES: To verify predictor variables for prognosis of patients following OHCA who survived hospitalization. METHODS: We retrospectively reviewed clinical, demographic, and outcome data of consecutive patients who were hospitalized from January 1, 2009, through December 31, 2014, into the intensive coronary care unit (ICCU) after aborted OHCA and discharged alive...
December 2017: Israel Medical Association Journal: IMAJ
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
Johannes von Vopelius-Feldt
BACKGROUND: Improving survival after out-of-hospital cardiac arrest (OHCA) is a priority for modern emergency medical services (EMS) and prehospital research. Advanced life support (ALS) is now the standard of care in most EMS. In some EMS, prehospital critical care providers are also dispatched to attend OHCA. This systematic review presents the evidence for prehospital critical care for OHCA, when compared to standard ALS care. METHODS: We searched the following electronic databases: PubMed, EmBASE, CINAHL Plus and AMED (viaEBSCO), Cochrane Database of Systematic Reviews, DARE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, NIHR Health Technology Assessment Database, Google Scholar and ClinicalTrials...
December 2017: Emergency Medicine Journal: EMJ
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takeshi Shimazu, Takashi Kawamura, Tetsuhisa Kitamura
The aim of this study was to assess whether serum albumin concentration upon hospital arrival had prognostic indications on out-of-hospital cardiac arrest (OHCA). This prospective, multicenter observational study conducted in Osaka, Japan (the CRITICAL [Comprehensive Registry of Intensive Cares for OHCA Survival] study), enrolled all patients with consecutive OHCA transported to 14 participating institutions. We included adult patients aged ≥18 years with nontraumatic OHCA who achieved return of spontaneous circulation and whose serum albumin concentration was available from July 2012 to December 2014...
October 19, 2017: American Journal of Cardiology
Sang Hoon Oh, Kyu Nam Park, Jeeyong Lim, Seung Pill Choi, Joo Suk Oh, In Soo Cho, Byung Kook Lee, Yong Hwan Kim, Young-Min Kim, Han Joon Kim, Chun Song Youn, Soo Hyun Kim
BACKGROUND: There are conflicting data regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients, and whether the specific sex advantage is age-specific remains unclear. We assessed the impact of the interactions between sex and age on the neurological outcomes of OHCA patients receiving targeted temperature management (TTM). METHODS: Data collected from 2007 to 2012 for a multicenter, registry-based study of the Korean Hypothermia Network were analyzed...
November 2, 2017: Critical Care: the Official Journal of the Critical Care Forum
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...
November 2017: Annales de Cardiologie et D'angéiologie
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
Florence Dumas, Jennifer Blackwood, Lindsay White, Carol Fahrenbruch, Xavier Jouven, Alain Cariou, Thomas Rea
INTRODUCTION: The cumulative burden of chronic health conditions could contribute to out-of-hospital cardiac arrest (OHCA) physiology and response to attempted resuscitation. Yet little is known about how chronic health conditions influence prognosis. We evaluated the relationship between cumulative comorbidity and outcome following ventricular fibrillation OHCA using 3 different scales. METHODS: We performed a cohort investigation of persons >=18years who suffered non-traumatic OHCA and presented with ventricular fibrillation between January 1, 2007 and December 31, 2013 in a metropolitan emergency medical service (EMS) system...
November 2017: Resuscitation
Ward Eertmans, Cornelia Genbrugge, Gilles Haesevoets, Jo Dens, Willem Boer, Frank Jans, Cathy De Deyne
BACKGROUND: Prognostication in out-of-hospital cardiac arrest (OHCA) survivors is often difficult. Recent studies have shown the predictive ability of bispectral index (BIS) monitoring to assist with early neuroprognostication. The aim of this study was to investigate whether characteristics of BIS values equal to zero (BIS 0) (i.e. duration and/or uni- versus bilateral presence) instead of simply their occurrence are better indicators for poor neurological outcome after OHCA by aiming at a specificity of 100%...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
(no author information available yet)
BACKGROUND: Initial blood ammonia level is associated with neurologic outcomes in out-of-hospital cardiac arrest (OHCA). We tested the usefulness of blood ammonia for prediction of long-term neurological outcome of OHCA.Methods and Results:A total of 3,011 hospitalized adult OHCA patients were enrolled. Blood samples were obtained at the ED. Cut-offs (ammonia <100 μmol/L and lactate <12 mmol/L) were determined in a previous study. Neurological outcomes in survivors were assessed at 3 months...
November 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
Radka Hazuková, Martina Rezácová, Renata Köhlerová, Tomáš Tomek, Eva Cermáková, Jaromír Kocí, Miloslav Pleskot
OBJECTIVE: This study aimed to investigate whether out-of-hospital cardiac arrest (OHCA) may induce severe DNA damage measured using comet assay in successfully resuscitated humans and to evaluate a short-term prognostic role. METHODS: In this prospective, controlled, blinded study (1/2013-1/2014), 41 patients (age, 63±14 years) successfully resuscitated from non traumatic OHCA and 10 healthy controls (age, 53±17 years) were enrolled. DNA damage [double-strand breaks (DSBs) and single-strand breaks (SSBs)] was measured using comet assay in peripheral lymphocytes sampled at admission...
July 2017: Anatolian Journal of Cardiology
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