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advanced cardiac life support

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https://www.readbyqxmd.com/read/29150491/hypothermia-modulates-arrhythmia-substrates-during-different-phases-of-resuscitation-from-ischemic-cardiac-arrest
#1
Joseph S Piktel, Aurelia Cheng, Matthew McCauley, Zack Dale, Michelle Nassal, Danielle Maleski, Gary Pawlowski, Kenneth R Laurita, Lance D Wilson
BACKGROUND: We designed an innovative porcine model of ischemia-induced arrest to determine dynamic arrhythmia substrates during focal infarct, global ischemia from ventricular tachycardia or fibrillation (VT/VF) and then reperfusion to determine the effect of therapeutic hypothermia (TH) on dynamic arrhythmia substrates and resuscitation outcomes. METHODS AND RESULTS: Anesthetized adult pigs underwent thoracotomy and regional plunge electrode placement in the left ventricle...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#2
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29132595/remote-ecls-implantation-and-transport-for-retrieval-of-cardiogenic-shock-patients
#3
Sabina P W Guenther, Stefan Buchholz, Frank Born, Stefan Brunner, René Schramm, Dominik J Hoechter, Vera von Dossow, Maximilian Pichlmaier, Christian Hagl, Nawid Khaladj
OBJECTIVE: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29114008/2017-american-heart-association-focused-update-on-adult-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#4
REVIEW
Monica E Kleinman, Zachary D Goldberger, Thomas Rea, Robert A Swor, Bentley J Bobrow, Erin E Brennan, Mark Terry, Robin Hemphill, Raúl J Gazmuri, Mary Fran Hazinski, Andrew H Travers
Cardiopulmonary resuscitation is a lifesaving technique for victims of sudden cardiac arrest. Despite advances in resuscitation science, basic life support remains a critical factor in determining outcomes. The American Heart Association recommendations for adult basic life support incorporate the most recently published evidence and serve as the basis for education and training for laypeople and healthcare providers who perform cardiopulmonary resuscitation.
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29110791/preanesthetic-evaluation-of-the-patient-with-end-stage-heart-failure
#5
REVIEW
Michele Sumler, Ratna Vadlamudi
Heart failure (HF) currently affects more than 5 million patients in the United States [1]. Advanced HF is associated with high mortality and poor quality of life. It is estimated that between 5% and 10% of all patients with HF have an advanced form of the disease [1]. Orthotopic heart transplantation (OHT) is an accepted therapy for stage D HF [3] (Fig. 1). Unfortunately, the number of patients with the disease exceeds the number of available organs. This makes appropriate patient selection vital in the field of heart transplantation...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29056259/relationship-between-left-ventricle-position-and-haemodynamic-parameters-during-cardiopulmonary-resuscitation-in-a-pig-model
#6
Yong Hun Jung, Kyung Woon Jeung, Dong Hun Lee, Young Won Jeong, Sung Min Lee, Byung Kook Lee, In Seok Jeong, Sang-Kwon Lee, Jihye Choi
BACKGROUND: From the viewpoint of cardiac pump theory, the area of the left ventricle (LV) subjected to compression increases as the LV lies closer to the sternum, possibly resulting in higher blood flow in patients with LV closer to the sternum. However, no study has evaluated LV position during cardiac arrest or its relationship with haemodynamic parameters during cardiopulmonary resuscitation (CPR). The objectives of this study were to determine whether the position of the LV relative to the anterior-posterior axis representing the direction of chest compression shifts during cardiac arrest and to examine the relationship between LV position and haemodynamic parameters during CPR...
September 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29055890/utility-of-prehospital-electrocardiogram-characteristics-as-prognostic-markers-in-out-of-hospital-pulseless-electrical-activity-arrests
#7
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29046747/ventricular-fibrillation-due-to-overdose-of-loperamide-the-poor-man-s-methadone
#8
Amr Salama, Yana Levin, Pramod Jha, Richard Alweis
Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29044938/hot-off-the-press-prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest
#9
Corey Heitz, Justin Morgenstern, William K Milne
This retrospective cohort study examined the rate of survival to hospital discharge among adult patients with out of hospital cardiac arrest (OHCA), comparing patients who received care only from basic cardiac life support (BCLS) trained emergency medical service (EMS) crews to patients who had an advanced cardiac life support (ACLS) trained EMS crew on scene at some point during the resuscitation. There was no difference in the primary outcome of rate of survival to hospital discharge (10.9% with ACLS care and 10...
October 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29032875/ventilator-use-by-emergency-medical-services-during-911-calls-in-the-united-states
#10
Mazen El Sayed, Hani Tamim, Aurelie Mailhac, Mann N Clay
BACKGROUND: Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. METHODS: This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988724/antiarrhythmics-in-cardiac-arrest-a-systematic-review-and-meta-analysis
#11
REVIEW
Amelia Chowdhury, Brian Fernandes, Thomas M Melhuish, Leigh D White
INTRODUCTION: It is widely accepted that antiarrhythmics play a role in cardiopulmonary resuscitation (CPR) universally, but the absolute benefit of antiarrhythmic use and the drug of choice in advanced life support remains controversial. AIM: To perform a thorough, in-depth review and analysis of current literature to assess the efficacy of antiarrhythmics in advanced life support. MATERIAL AND METHODS: Two authors systematically searched through multiple bibliographic databases including CINAHL, SCOPUS, PubMed, Web of Science, Medline(Ovid) and the Cochrane Clinical Trials Registry...
August 23, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28987857/intracranial-hemorrhage-in-patients-with-durable-mechanical-circulatory-support-devices-institutional-review-and-proposed-treatment-algorithm
#12
Wyatt L Ramey, Robyn L Basken, Christina M Walter, Zain Khalpey, G Michael Lemole, Travis M Dumont
OBJECTIVE: Spontaneous intracranial hemorrhage (ICH) is frequently managed in neurosurgery. Patients with durable mechanical circulatory support devices, including total artificial hearts (TAHs) and left ventricular assist devices (LVADs) are often encountered in the setting of ICH. While durable mechanical circulatory support devices have improved survival and quality of life for patients with advanced heart failure, ICH is one of the most feared complications following LVAD and TAH implantation...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#13
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28978527/dispatch-of-firefighters-and-police-officers-in-out-of-hospital-cardiac-arrest-a-nationwide-prospective-cohort-trial-using-propensity-score-analysis
#14
Ingela Hasselqvist-Ax, Per Nordberg, Johan Herlitz, Leif Svensson, Martin Jonsson, Jonny Lindqvist, Mattias Ringh, Andreas Claesson, Johan Björklund, Jan-Otto Andersson, Caroline Ericson, Pär Lindblad, Lars Engerström, Mårten Rosenqvist, Jacob Hollenberg
BACKGROUND: Dispatch of basic life support-trained first responders equipped with automated external defibrillators in addition to advanced life support-trained emergency medical services personnel in out-of-hospital cardiac arrest (OHCA) has, in some minor cohort studies, been associated with improved survival. The aim of this study was to evaluate the association between basic life support plus advanced life support response and survival in OHCA at a national level. METHODS AND RESULTS: This prospective cohort study was conducted from January 1, 2012, to December 31, 2014...
October 4, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28968162/severe-hypothermia-management-in-mountain-rescue-a-survey-study
#15
Paweł Podsiadło, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, Hermann Brugger
Podsiadło, Paweł, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, and Hermann Brugger. Severe hypothermia management in mountain rescue: a survey study. High Alt Med Biol 00:000-000, 2017. INTRODUCTION: Severe hypothermia is a rare but demanding medical emergency. Although mortality is high, if well managed, the neurological outcome of survivors can be excellent. The aim of the study was to assess whether mountain rescue teams (MRTs) are able to meet the guidelines in the management of severe hypothermia, regarding their equipment and procedures...
October 2, 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28967516/the-effect-of-successful-intubation-on-patient-outcomes-after-out-of-hospital-cardiac-arrest-in%C3%A2-taipei
#16
Wen-Chu Chiang, Ming-Ju Hsieh, Hsin-Lan Chu, Albert Y Chen, Shin-Yi Wen, Wen-Shuo Yang, Yu-Chun Chien, Yao-Cheng Wang, Bin-Chou Lee, Huei-Chih Wang, Edward Pei-Chuan Huang, Chih-Wei Yang, Jen-Tang Sun, Kah-Meng Chong, Hao-Yang Lin, Shu-Hsien Hsu, Shey-Ying Chen, Matthew Huei-Ming Ma
STUDY OBJECTIVE: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. METHODS: We analyzed 6 years of Utstein-based registry data from nontrauma adult patients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve-mask ventilation...
September 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28944111/how-resiliency-affects-quality-of-life-twenty-two-years-post-cardiac-transplant-a-case-report
#17
Joslyn Vo, Davin Agustines
Heart transplantation has been shown to prolong survival significantly for people who have advanced heart disease. Even with improved prognosis, heart transplant recipients experience a lower overall quality of life compared to their healthy counterparts, which is correlated with high rates of depression and other psychiatric disorders. Our case report examines factors affecting the quality of life over a long period of time in a patient who received a heart transplant 22 years ago. This case is unusual because the patient overcame depression with just a minimal dosage of antidepressants due to her unwavering hope, resilience, and strong social support...
July 14, 2017: Curēus
https://www.readbyqxmd.com/read/28941721/experience-with-integrating-pharmacist-documenters-on-cardiac-arrest-teams-to-improve-quality
#18
Mojdeh S Heavner, Ginger E Rouse, Steven M Lemieux, Kent A Owusu, David Pritchard, Marina Yazdi, Lorraine A Lee
OBJECTIVES: To determine if adding a clinical pharmacist to the cardiac arrest team in a documenter role improves completeness of documentation and quality of advanced cardiovascular life support (ACLS). SETTING: A 1541-bed, tertiary care, academic medical center with an integrated clinical pharmacy practice model. PRACTICE DESCRIPTION: In 2012, we identified documentation of resuscitation activities during cardiac arrest events and compliance with published ACLS guidelines as opportunities for systematic quality improvement at our tertiary care academic medical center...
September 20, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28937406/tolerance-in-xenotransplantation
#19
Kazuhiko Yamada, Megan Sykes, David H Sachs
PURPOSE OF REVIEW: This review describes recent progress in tolerance-inducing strategies across xenogeneic immunological barriers as well as the potential benefit of a tolerance strategy for islets and kidney xenotransplantation. RECENT FINDINGS: Using advanced gene editing technologies, xenotransplantation from multitransgenic alpha-1,3-galactosyltransferase knockout pigs has demonstrated marked prolongation of renal xenograft survival, ranging from days to greater than several months for life-supporting kidneys, and more than 2 years in a heterotopic nonlife-supporting cardiac xenograft model...
December 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28920131/reversible-causes-in-cardiovascular-collapse-at-the-emergency-department-using-ultrasonography-revive-us
#20
Mui Teng Chua, Gene Wh Chan, Win Sen Kuan
INTRODUCTION: Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality...
August 2017: Annals of the Academy of Medicine, Singapore
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