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advanced cardiac life support

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https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#1
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#2
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29736378/confidence-level-of-pediatric-trainees-in-management-of-shock-states
#3
Kavita Morparia, Julie Berg, Sonali Basu
AIM: To assess overall confidence level of trainees in assessing and treating shock, we sought to improve awareness of recurrent biases in clinical decision-making to help address appropriate educational interventions. METHODS: Pediatric trainees on a national listserv were offered the opportunity to complete an electronic survey anonymously. Four commonly occurring clinical scenarios were presented, and respondents were asked to choose whether or not they would give fluid, rank factors utilized in decision-making, and comment on confidence level in their decision...
May 4, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29732189/vv-extracorporeal-life-support-for-the-third-millennium-will-we-need-anticoagulation
#4
REVIEW
Danny Eytan, Yuval Bitterman, Gail M Annich
Since the late 1600's medicine and science have entertained the idea of extracorporeal circulation. With this technology to allow for cardiac and pulmonary support came the development of anticoagulation. Although this advanced the technology and capabilities of extracorporeal life support, it was not without complications and risks. The most common complications in extracorporeal life support (ECLS) present day are related to hemorrhage and thrombus due to the need for systemic anticoagulation and the challenges associated with it...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29730094/dual-defibrillation-in-patients-with-refractory-ventricular-fibrillation-review-and-case-report
#5
REVIEW
Karim Hajjar, Iskandar Berbari, Chady El Tawil, Ralphe Bou Chebl, Gilbert Abou Dagher
In the setting of cardiac arrest, refractory ventricular fibrillation (VF) is difficult to manage, and mortality rates are high. Double sequential defibrillation (DSD) has been described in the literature as a successful means to terminate this malignant rhythm, after failure of traditional Advanced Cardiac Life Support (ACLS) measures. The authors herein present a case of refractory VF in a patient with cardiac arrest, on whom DSD was successful in reversion to sinus rhythm, and provide a thorough review of similar cases in the literature...
April 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29723609/advanced-vs-basic-life-support-in-the-treatment-of-out-of-hospital-cardiopulmonary-arrest-in-the-resuscitation-outcomes-consortium
#6
Michael Christopher Kurz, Robert H Schmicker, Brian Leroux, Graham Nichol, Tom P Aufderheide, Sheldon Cheskes, Brian Grunau, Jamie Jasti, Peter Kudenchuk, Gary M Vilke, Jason Buick, Lynn Wittwer, Ritu Sahni, Ronald Straight, Henry E Wang
BACKGROUND: Prior observational studies suggest no additional benefit from advanced life support (ALS) when compared with providing basic life support (BLS) for patients with out-of-hospital cardiac arrest (OHCA). We compared the association of ALS care with OHCA outcomes using prospective clinical data from the Resuscitation Outcomes Consortium (ROC). METHODS: Included were consecutive adults OHCA treated by participating emergency medical services (EMS) agencies between June 1, 2011, and June 30, 2015...
April 30, 2018: Resuscitation
https://www.readbyqxmd.com/read/29713689/improving-rates-of-implantable-cardioverter-defibrillator-deactivation-in-end-of-life-care
#7
M R Javaid, Suzanne Squirrell, Fahad Farooqi
Implantable cardioverter defibrillators (ICDs) save lives in selected patients at risk of sudden cardiac death. However, in patents suffering with terminal illness, ICD therapy could pose a risk of unnecessary futile shocks which could lead to undignified discomfort in their final days of life. National guidelines advise that patients approaching the end of their natural life should be offered a compassionate choice of having their defibrillator deactivated. Following an actual clinical incident involving a patient receiving avoidable ICD shocks in his final hours, we identified shortcomings in communication and gaps in knowledge about ICD management in end-of-life care...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29710131/in-blunt-traumatic-cardiac-arrest-does-it-really-matter-who-performs-prehospital-advanced-life-support
#8
Sandra DiBrito, Elliott R Haut
No abstract text is available yet for this article.
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29710068/association-of-prehospital-advanced-life-support-by-physician-with-survival-after-out-of-hospital-cardiac-arrest-with-blunt-trauma-following-traffic-collisions-japanese-registry-based-study
#9
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Kei Hayashida, Ichiro Kukita
Importance: Controversy remains as to whether advanced life support (ALS) or basic life support (BLS) is superior for critically ill and injured patients, including out-of-hospital cardiac arrest (OHCA) and major trauma, in the prehospital setting. Objective: To assess whether prehospital ALS should be provided for traumatic OHCA and who should perform it. Design, Setting, and Participants: Japanese government-managed nationwide population-based registry data of patients with OHCA transported to an emergency hospital were analyzed...
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29708915/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#10
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...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29669504/atrial-fibrillation-in-autoimmune-rheumatic-diseases-from-the-pathogenesis-to-the-treatment
#12
Giuseppe Ciconte, Manuel Conti, Martina Evangelista, Carlo Pappone
BACKGROUND: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the general population and is associated with an increased number of adverse outcomes. The onset and maintenance of this arrhythmia requires a trigger event and the presence of a predisposing substrate. Atrial fibrosis, a major characteristic of AF-related structural remodeling, represents a process closely related to inflammation as demonstrated by emerging evidence. Aim of this article is to review the evidence linking AF to systemic autoimmune diseases...
April 17, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29621571/ecg-changes-during-resuscitation-of-patients-with-initial-pulseless-electrical-activity-are-associated-with-return-of-spontaneous-circulation
#13
Gunnar Waage Skjeflo, Trond Nordseth, Jan Pål Loennechen, Daniel Bergum, Eirik Skogvoll
BACKGROUND: Pulseless electrical activity (PEA) is a frequent initial rhythm in cardiac arrest, and ECG characteristics have been linked to prognosis. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) and cardiopulmonary resuscitation (CPR) in initial PEA, and to assess any association with survival. METHODS: Patients with in-hospital cardiac arrest with initial PEA at St. Olav Hospital (Trondheim, Norway) over a three-year period were included...
April 2, 2018: Resuscitation
https://www.readbyqxmd.com/read/29613954/left-ventricular-compressions-improve-return-of-spontaneous-circulation-and-hemodynamics-in-a-swine-model-of-traumatic-cardiopulmonary-arrest
#14
Kenton L Anderson, Kristin C Fiala, Maria G Castaneda, Susan M Boudreau, Allyson A Araña, Vikhyat S Bebarta
BACKGROUND: Prehospital cardiopulmonary resuscitation, including closed chest compressions, has commonly been considered ineffective in traumatic cardiopulmonary arrest (TCPA) because traditional chest compressions do not produce substantial cardiac output. However, recent evidence suggests that chest compressions located over the left ventricle produce greater hemodynamics when compared to traditional compressions. We hypothesized that chest compressions located directly over the left ventricle would improve return of spontaneous circulation (ROSC) and hemodynamics, when compared to traditional chest compressions, in a swine model of traumatic cardiopulmonary arrest (TCPA)...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29607780/brain-death-in-intensive-care-units-problems-differences-in-methods-of-diagnosis-and-donor-care
#15
Aykut Sarıtaş, Burcu Acar Çinleti, Çiler Zincircioğlu, Uğur Uzun, Işıl Köse, Nimet Şenoğlu
OBJECTIVES: Our aim was to investigate the most common problems in diagnosing brain death, the care of the organ donor, and organ donation after death. MATERIALS AND METHODS: A survey was sent randomly to clinicians working in national intensive care units in Turkey. The survey, which consisted of 17 questions for clinicians, had 163 responders. RESULTS: The most common cause of brain death was traumatic brain injury. Although 22% of clinicians found the apnea test necessary for brain death diagnosis, 78% stated that it could be used as an optional confirmatory test...
April 2, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29596291/interprofessional-simulations-promote-knowledge-retention-and-enhance-perceptions-of-teamwork-skills-in-a-surgical-trauma-burn-intensive-care-unit-setting
#16
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29580958/cerebral-saturation-in-cardiac-arrest-patients-measured-with-near-infrared-technology-during-pre-hospital-advanced-life-support-results-from-copernicus-i-cohort-study
#17
Cornelia Genbrugge, Cathy De Deyne, Ward Eertmans, Anseeuw Kurt, Voet Dirk, Mertens Ilse, Sabbe Marc, Stroobants Jan, Bruckers Liesbeth, Mesotten Dieter, Frank Jans, Willem Boer, Jo Dens
AIM: To date, monitoring options during pre-hospital advanced life support (ALS) are limited. Regional cerebral saturation (rSO2 ) may provide more information concerning the brain during ALS. We hypothesized that an increase in rSO2 during ALS in out-of hospital cardiac arrest (OHCA) patients is associated with return of spontaneous circulation (ROSC). METHODS: A prospective, non-randomized multicenter study was conducted in the pre-hospital setting of six hospitals in Belgium...
March 23, 2018: Resuscitation
https://www.readbyqxmd.com/read/29561288/to-intubate-or-not-to-intubate
#18
Christopher J R Gough, Jerry P Nolan
PURPOSE OF REVIEW: Cardiac arrest mortality remains high, and the impact on outcome of most advanced life support interventions is unclear. The optimal method for managing the airway during cardiac arrest remains unknown. This review will summarize and critique recently published evidence comparing basic airway management with the use of more advanced airway interventions [insertion of supraglottic airway (SGA) devices and tracheal intubation]. RECENT FINDINGS: Systematic reviews generally document an association between advanced airway management and worse neurological outcome but they are subject to considerable bias...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29538568/impact-of-training-in-advanced-cardiac-life-support-acls-in-the-professional-career-and-work-environment
#19
Lunia Sofia Lima Azevedo, Lucas Gaspar Ribeiro, André Schmidt, Antônio Pazin Filho
We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years)...
March 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29532509/successful-placement-of-nasointestinal-feeding-tubes-using-an-electromagnetic-sensor-guided-enteral-access-system-in-patients-with-left-ventricular-assist-devices
#20
Kay Lash, Rachelle Oppel, Jeanette Hasse
Technology advances have made it possible to prolong life for patients with heart failure who are not transplant candidates or while awaiting transplant. Many different cardiac devices are available that can be used as a bridge to transplant (temporary support) or as a destination therapy (permanent support). Placement of these devices can cause complications that, if not addressed, could negatively impact the nutrition status of patients. Placement of nasointestinal feeding tubes using an electromagnetic sensor-guided enteral access system (EMS-EAS) has been difficult in patients with implantable devices because of the potential for interference with the EMS-EAS and the left ventricular assist device (LVAD)...
April 2018: Nutrition in Clinical Practice
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