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David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
Sheng-Der Hsu, Cheng-Jueng Chen, I-Duo Wang, Kuen-Tze Lin, Chia-Chi Wang, Wu-Chien Chien, Chi-Hsiang Chung, Wei-Kuo Chang
BACKGROUND: Pelvic fracture with hypovolemic shock is a known crucial injury in trauma patients. Pelvic fracture with vessel injury often leads to hemodynamic complications; in a trauma scenario, evidence of other systems being affected is often absent. Bleeding cessation and resuscitation are important for these types of trauma patients. For this purpose, pelvic angiographic embolization is frequently used. Multiple studies have reported that angiographic embolization may cause erectile dysfunction (ED) in hemodynamically stable patients with pelvic fracture...
September 21, 2018: World Journal of Surgery
Christina Engel Hoei-Hansen, Bjarne Laursen, Jens Langhoff-Roos, Gija Rackauskaite, Peter Uldall
AIM: To analyse trends in prevalence and severity of cerebral palsy (CP) in Denmark in birth years 1999-2007 and compare with previous periods. METHOD: Data has been collected uniformly in the Danish cerebral palsy national register nationwide since 1995. Rates in the time periods 1999-2001, 2002-2004 and 2005-2007 covering 585,393 births were analysed by gestational age and subtypes. RESULTS: Total number of CP cases in the period was 1165...
September 6, 2018: European Journal of Paediatric Neurology: EJPN
Caitlin A Fitzgerald, Dipan C Patel, Christopher J Dente, Anuradha Subramanian
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
Michael Curtis, Paul Dietze, Campbell Aitken, Amy Kirwan, Stuart A Kinner, Tony Butler, Mark Stoové
BACKGROUND: Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia. METHODS: The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration...
September 21, 2018: Harm Reduction Journal
Bonpei Takase, Yuko Higashimura, Kenichi Hashimoto, Haruka Asahina, Masayuki Ishihara, Hiromi Sakai
INTRODUCTION: Prolonged low blood pressure < 40 mmHg in hemorrhagic shock (HS) causes irreversible heart dysfunction, "Shock Heart Syndrome" (SHS), which is associated with lethal arrhythmias (VT/VF) leading to a poor prognosis. METHODS: To investigate whether the liposome-encapsulated human hemoglobin oxygen carrier (HbV) is comparable in effectiveness to autologous washed red blood cells (wRBCs) for improving arrhythmogenic properties in SHS, optical mapping analysis (OMP), electrophysiological study (EPS), and pathological examinations were performed in Sprague-Dawley rat hearts obtained from rats subjected to acute HS by withdrawing 30% of total blood volume...
September 19, 2018: Shock
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
To investigate the different effects of mild hypothermia on pathological and physiological stress conditions in piglets, 30 pigs were randomized into four groups: cardiac arrest and mild hypothermia (CA-MH group), cardiac arrest and normothermia (CA-NH group), non-CA-MH (NCA-MH group), and a sham operation. The same hypothermia intervention was implemented in both CA-MH and NCA-MH groups. The CA-NH group did not undergo therapeutic hypothermia after resuscitation. The hemodynamic parameters were recorded. Cerebral metabolism variables and neurotransmitters in the extracellular fluid were collected through microdialysis tubes...
September 21, 2018: Therapeutic Hypothermia and Temperature Management
Colette Dignam, Margaret Brown, Campbell H Thompson
OBJECTIVE: To compare 2011 and 2017 documentation of resuscitation decisions in older patients, including the frequency and clarity of documentation. METHODS: The clinical case notes of 130 patients aged 70 years and over were examined to identify how resuscitation decisions are discussed and documented at a major teaching hospital. Results were compared to 2011 data. RESULTS: The proportion of patients with a documented order significantly increased, from 34 to 63%, with a concurrent increased number of patients identified as Not For Cardiopulmonary Resuscitation (Not for CPR)...
September 21, 2018: Australasian Journal on Ageing
Yeo Jeong Song, Sang Jin Ha, Dong Seok Lee, Woo Dae Bang, Dong Geum Shin, Yeongmin Woo, Sangsig Cheong, Sang Yong Yoo
BACKGROUND AND OBJECTIVES: Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population. METHODS: We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed...
October 2018: Korean Circulation Journal
Femke Noorman, John R Hess
BACKGROUND: Thromboelastography (TEG) is widely advocated as a rapid method for obtaining critical blood coagulation data to guide resuscitation, but the method suffers well-known limits in sensitivity, repeatability, and interpretability. STUDY DESIGN AND METHODS: Mixtures of fresh human blood components were prepared that represent the range of blood element concentrations seen in health and disease and after injury. These mixtures were tested in a TEG device after kaolin, tissue factor and phospholipid, or tissue factor and phospholipid with abciximab activation...
September 20, 2018: Transfusion
Kritika Krishnamurthy, Siba El Hussein, Yumna Omarzai
Small intestinal volvulus (SBV) is the abnormal twisting of bowel around the axis of its mesentery, leading to obstruction and vascular compromise, resulting in bowel ischemia and necrosis which are life-threatening. Risk factors include malformation, malrotation, and adhesions. Its rare incidence and vague clinical presentation make it a difficult diagnosis, more so in a nonverbal patient who cannot express his pain, which is the first and most prominent symptom. Studies suggest an increased frequency of intestinal obstruction in cerebral palsy patients...
July 2018: Autopsy & Case Reports
Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby, Patrick Bosarge
Background: Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complications. Temporary abdominal closure is possible with multiple techniques, the choice of which may affect ability to achieve primary fascial closure and further complication. Methods: A retrospective analysis of all trauma patients requiring damage control laparotomy upon admission to an ACS-verified level one trauma center from 2011 to 2016 was performed...
2018: World Journal of Emergency Surgery: WJES
Anjan Trikha, Preet Mohinder Singh
One of the most important causes of maternal mortality is major obstetric haemorrhage. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. The management consists of fluid resuscitation, administration of blood and blood products, conservative measures such as uterine cavity tamponade and sutures, and finally hysterectomy...
September 2018: Indian Journal of Anaesthesia
Ikwan Chang, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Jeong Ho Park, So Yeon Kong
OBJECTIVE: We aimed to demonstrate the association of bystander cardiopulmonary resuscitation (BCPR) with survival outcomes after pediatric out-of-hospital cardiac arrest (OHCA) by community property value groups. METHODS: This observational study enrolled all emergency medical services (EMS)-treated pediatric OHCAs in Korea between 2012 and 2015. Enrolled patients were divided into three groups: BCPR with dispatcher-assistance (DA), BCRP-without-DA, and no-BCPR...
September 17, 2018: Resuscitation
Javier Trastoy-Quintela, Geethanjali Ramachandra, Vinay Nadkarni
No abstract text is available yet for this article.
September 17, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Leif Friberg
AIM: The aim of the study was to assess and compare the safety of antiarrhythmic drugs (AADs) in an unselected real-world population of patients with atrial fibrillation (AF). METHODS AND RESULTS: This is a study of all patients with diagnosed AF in the Swedish Patient register who filled a prescription for sotalol, amiodarone, dronedarone, flecainide or disopyramide during 2010 to 2015. The main end point consisted of arrhythmic death, successful resuscitation, new diagnosis of sustained ventricular tachycardia, ventricular fibrillation or implantation of ICD...
August 25, 2018: American Heart Journal
A Claire Watkins, Nathan L Maassel, Mehrdad Ghoreishi, Murtaza Y Dawood, Si M Pham, Zachary N Kon, Bradley S Taylor, Bartley P Griffith, James S Gammie
BACKGROUND: Cardiac surgery for structural heart disease has poor outcomes in the presence of cardiogenic shock or advanced heart failure. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients before high-risk cardiac operation. METHODS: Twelve patients with cardiogenic shock and end-organ failure were evaluated for cardiac surgery. The average Society of Thoracic Surgeons (STS) mortality risk was 24% (±13)...
September 17, 2018: Annals of Thoracic Surgery
Ankur Gupta, Meagan Harrington, Christine M Albert, Navkaranbir S Bajaj, Jon Hainer, Victoria Morgan, Courtney F Bibbo, Paco E Bravo, Michael T Osborne, Sharmila Dorbala, Ron Blankstein, Viviany R Taqueti, Deepak L Bhatt, William G Stevenson, Marcelo F Di Carli
OBJECTIVES: This study sought to investigate the association of myocardial scar and ischemia with major arrhythmic events (MAEs) in patients with left ventricular ejection fraction (LVEF) ≤35%. BACKGROUND: Although myocardial scar is a known substrate for ventricular arrhythmias, the association of myocardial ischemia with ventricular arrhythmias in stable patients with left ventricular dysfunction is less clear. METHODS: A total of 439 consecutive patients (median age, 70 years; 78% male; 55% with implantable cardioverter defibrillator [ICD]) referred for stress/rest positron emission tomography (PET) and resting LVEF ≤35% were included...
September 2018: JACC. Clinical Electrophysiology
Muharrem Akin, Jan-Thorben Sieweke, Florian Zauner, Vera Garcheva, Jörn Tongers, L Christian Napp, Lars Friedrich, Jens Treptau, Max-Udo Bahntje, Ulrike Flierl, Daniel G Sedding, Johann Bauersachs, Andreas Schäfer
OBJECTIVES: This study sought to analyze the impact of mandatory therapeutic hypothermia and cardiac catheterization in the absence of overt noncardiac cause of arrest as part of the Hannover Cardiac Resuscitation Algorithm before intensive care admission. BACKGROUND: Despite advanced therapies, out-of-hospital cardiac arrest (OHCA) is still associated with high mortality rates. Recently, the TTM (Target Temperature Management 33°C Versus 36°C After Out-of-Hospital Cardiac Arrest)-trial caused severe uncertainty about the efficacy of and need for therapeutic hypothermia...
September 24, 2018: JACC. Cardiovascular Interventions
Akihiro Hirakawa, Toshihiro Hatakeyama, Daisuke Kobayashi, Chika Nishiyama, Akiko Kada, Takeyuki Kiguchi, Takashi Kawamura, Taku Iwami
BACKGROUND: The quality of cardiopulmonary resuscitation (CPR) performed by emergency medical services (EMS) personnel affects patient outcomes after cardiac arrest. A CPR feedback device with an accelerometer mounted on a defibrillator can monitor the motion of the patient's sternum to display and record CPR quality in real time. To evaluate the utility of real-time feedback, debriefing, and retraining using a CPR feedback device outside of the hospital, an open-label, cluster randomized controlled trial will be conducted in five municipalities of Osaka Prefecture, Japan...
September 20, 2018: Trials
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