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Emergency preservation resuscitation

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https://www.readbyqxmd.com/read/27917163/severely-heat-injured-survivors-of-e-coli-o157-h7-atcc-43888-display-variable-and-heterogeneous-stress-resistance-behavior
#1
Elisa Gayán, Sander K Govers, Chris W Michiels, Abram Aertsen
Although minimal food processing strategies aim to eliminate foodborne pathogens and spoilage microorganisms through a combination of mild preservation techniques, little is actually known on the resistance behavior of the small fraction of microorganisms surviving an inimical treatment. In this study, the conduct of severely heat stressed survivors of E. coli O157:H7 ATCC 43888, as an indicator for the low infectious dose foodborne enterohemorrhagic strains, was examined throughout their resuscitation and outgrowth...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27608941/the-introduction-of-emergency-cricothyroidotomy-simulation-training-in-zimbabwe-contributed-to-the-saving-of-two-lives
#2
M B Avnstorp, P V F Jensen, T Dzongodza, N Matinhira, C Chidziva, J Melchiors, C Von Buchwald
BACKGROUND: In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors into a video-guided simulation training programme on emergency cricothyroidotomy. This paper presents the positive effect of this training, illustrated by two case reports. CASE REPORTS: A 56-year-old female presented with upper airway obstruction due to a rapidly progressing infectious swelling of the head and neck progressing to cardiac arrest...
September 9, 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27533415/in-hospital-resuscitation-recognising-and-responding-to-adults-in-cardiac-arrest
#3
Elizabeth Simpson
Survival rates following in-hospital cardiac arrest remain low. The majority of patients who survive a cardiac arrest will be in a monitored environment, have a witnessed cardiac arrest and present with a shockable rhythm, usually ventricular fibrillation. Nurses have a responsibility to preserve safety, which requires the ability to accurately assess patients for signs of deterioration in physical health, and to provide assistance when an emergency arises in practice. Nurses must work within the limits of their competence and be able to establish the urgency of a situation...
August 17, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27136246/experience-with-a-new-process-condition-t-for-uncontrolled-donation-after-circulatory-determination-of-death-in-a-university-emergency-department
#4
Michael A DeVita, Clifton W Callaway, Charissa Pacella, Maria Mori Brooks, John Lutz, Susan Stuart
BACKGROUND: In the United States, organ donation after circulatory death (DCD) determination is increasing among those who are removed from life-sustaining therapy but is rare when death is unexpected. We created a program for uncontrolled DCD (uDCD). METHODS: A comprehensive program was created to train personnel to identify and respond quickly to potential donors after unexpected death. The process termed Condition T was implemented in the emergency department (ED) of 2 academic medical centers...
March 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27025140/-volemic-status-and-the-phasic-approach-to-the-treatment-of-critical-states-new-opportunites-and-prospects
#5
REVIEW
V V Kuz'kov, E V Fot, A A Smjotkin, K M Lebedinskij, M Yu Kirov
Current guidelines suggest that an early and aggressive fluid therapy is the best rescue approach to restore and preserve cardiac index, organ function and decrease the risk of multiple organ failure in shock of various origin. However, escala- tion of fluid resuscitation is a double-edged sword often associated with reperfusion, glicocalyx injury, capillary leakage, delayed weight gain and heperhydration. The body of evidences demons trates that an excessive fluid load in ICUpatient with global increased permeability syndrome, and, particularly, in ARDS and acute kidney injury can be devastating, particularly when guided with central venous pressure...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27022814/isolated-fournier-s-gangrene-of-the-penis
#6
A O Obi
To share experience on the presentation and management of 4 cases of isolated penile Fournier's gangrene. Clinical and demographic data of four patients with isolated penile Fournier's gangrene seen over an 8-year period (January 2006-December 2013) were reviewed. All patients had intravenous fluid resuscitation, emergency surgical debridement, and broad-spectrum intravenous antibiotics. Fournier's gangrene of the penis was, respectively, due to long segment anterior urethral stricture, penile edema from poorly controlled congestive cardiac failure, penile abrasion from oral sex and idiopathic...
May 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/26946212/past-present-and-future-of-dynamic-kidney-and-liver-preservation-and-resuscitation
#7
I Jochmans, M Z Akhtar, D Nasralla, P Kocabayoglu, C Boffa, M Kaisar, A Brat, J O'Callaghan, L H M Pengel, S Knight, R J Ploeg
The increased demand for organs has led to the increased usage of "higher risk" kidney and liver grafts. These grafts from donation after circulatory death or expanded criteria donors are more susceptible to preservation injury and have a higher risk of unfavorable outcomes. Dynamic, instead of static, preservation could allow for organ optimization, offering a platform for viability assessment, active organ repair and resuscitation. Ex situ machine perfusion and in situ regional perfusion in the donor are emerging as potential tools to preserve and resuscitate vulnerable grafts...
September 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/26644358/emergency-preservation-and-resuscitation-trial-a-philosophical-justification-for-non-voluntary-enrollment
#8
Daniel Tigard
In a current clinical trial for Emergency Preservation and Resuscitation (EPR), Dr. Samuel Tisherman of the University of Maryland aims to induce therapeutic hypothermia in order to 'buy time' for operating on victims of severe exsanguination. While recent publicity has framed this controversial procedure as 'killing a patient to save his life', the US Army and Acute Care Research appear to support the study on the grounds that such patients already face low chances of survival. Given that enrollment in the trial must be non-voluntary, the study has received an exemption from federal standards for obtaining informed consent...
June 2016: Bioethics
https://www.readbyqxmd.com/read/26626335/lesson-from-the-new-york-city-out-of-hospital-uncontrolled-donation-after-circulatory-determination-of-death-program
#9
Stephen P Wall, Bradley J Kaufman, Nicholas Williams, Elizabeth M Norman, Alexander J Gilbert, Kevin G Munjal, Shana Maikhor, Michael J Goldstein, Julia E Rivera, Harvey Lerner, Chad Meyers, Marion Machado, Susan Montella, Marcy Pressman, Lewis W Teperman, Nancy N Dubler, Lewis R Goldfrank
STUDY OBJECTIVE: In 2006, the Institute of Medicine emphasized substantial potential to expand organ donation opportunities through uncontrolled donation after circulatory determination of death (uDCDD). We pilot an out-of-hospital uDCDD kidney program for New York City in partnership with communities that it was intended to benefit. We evaluate protocol process and outcomes while identifying barriers to success and means for improvement. METHODS: We conducted a prospective, participatory action research study in Manhattan from December 2010 to May 2011...
April 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26603283/successful-transplantation-of-lungs-from-an-uncontrolled-donor-after-circulatory-death-preserved-in-situ-by-alveolar-recruitment-maneuvers-and-assessed-by-ex-vivo-lung-perfusion
#10
F Valenza, G Citerio, A Palleschi, A Vargiolu, B Safaee Fakhr, A Confalonieri, M Nosotti, S Gatti, S Ravasi, S Vesconi, A Pesenti, F Blasi, L Santambrogio, L Gattinoni
We developed a protocol to procure lungs from uncontrolled donors after circulatory determination of death (NCT02061462). Subjects with cardiovascular collapse, treated on scene by a resuscitation team and transferred to the emergency room, are considered potential donors once declared dead. Exclusion criteria include unwitnessed collapse, no-flow period of >15 min and low flow >60 min. After death, lung preservation with recruitment maneuvers, continuous positive airway pressure, and protective mechanical ventilation is applied to the donor...
April 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/26438457/emergency-neurological-life-support-airway-ventilation-and-sedation
#11
REVIEW
David B Seder, Andy Jagoda, Becky Riggs
Airway management and ventilation are central to the resuscitation of the neurologically ill. These patients often have evolving processes that threaten the airway and adequate ventilation. Furthermore, intubation, ventilation, and sedative choices directly affect brain perfusion. Therefore, airway, ventilation, and sedation was chosen as an emergency neurological life support protocol. Topics include airway management, when and how to intubate with special attention to hemodynamics and preservation of cerebral blood flow, mechanical ventilation settings, and the use of sedative agents based on the patient's neurological status...
December 2015: Neurocritical Care
https://www.readbyqxmd.com/read/26283075/the-pre-ecmo-simplified-acute-physiology-score-ii-as-a-predictor-for-mortality-in-patients-with-initiation-ecmo-support-at-the-emergency-department-for-acute-circulatory-and-or-respiratory-failure-a-retrospective-study
#12
COMPARATIVE STUDY
Kun Il Kim, Hee Sung Lee, Hyoung Soo Kim, Sang Ook Ha, Won Yong Lee, Sang Jun Park, Sun Hee Lee, Tae Hun Lee, Jeong Yeol Seo, Hyun Hee Choi, Kyu Tae Park, Sang Jin Han, Kyung Soon Hong, Sung Mi Hwang, Jae Jun Lee
BACKGROUND: In the emergency department (ED), extracorporeal membrane oxygenation (ECMO) can be used as a rescue treatment modality for patients with refractory circulatory and/or respiratory failure. Serious consideration must be given to the indication, and the PRESERVE and RESP scores for mortality have been investigated. However these scores were validated to predict survival in patients who received mainly veno-venous (VV) ECMO in the intensive care unit. The aim of the present study was to investigate the factors that predicted the outcomes for patients who received mixed mode (veno-arterial [VA] and VV) ECMO support in the ED...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26002261/coagulation-function-of-stored-whole-blood-is-preserved-for-14-days-in-austere-conditions-a-rotem-feasibility-study-during-a-norwegian-antipiracy-mission-and-comparison-to-equal-ratio-reconstituted-blood
#13
Geir Strandenes, Ivar Austlid, Torunn O Apelseth, Tor A Hervig, Jan Sommerfelt-Pettersen, Maryanne C Herzig, Andrew P Cap, Heather F Pidcoke, Einar K Kristoffersen
BACKGROUND: Formulation of a medical preparedness plan for treating severely bleeding casualties during naval deployment is a significant challenge because of territory covered during most missions. The aim of this study was to evaluate the concept of "walking blood bank" as a supportable plan for supplying safe blood and blood products. METHODS: In 2013, the Royal Norwegian Navy conducted antipiracy operations from a frigate, beginning in the Gulf of Aden and ending in the Indian Ocean...
June 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25719899/changing-paradigms-in-organ-preservation-and-resuscitation
#14
REVIEW
Fadwa Ali, Anahita Dua, David C Cronin
PURPOSE OF REVIEW: Shortage of donor organs has increased consideration for use of historically excluded grafts. Ex-vivo machine perfusion is an emerging technology that holds the potential for organ resuscitation and reconditioning, potentially increasing the quality and number of organs available for transplantation. This article aims to review the recent advances in machine perfusion and organ preservation solutions. RECENT FINDINGS: Flow and pressure-based machine perfusion has shown improved kidney graft function and survival, especially among expanded criteria donors...
April 2015: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/25420843/fourteen-years-of-experience-in-uncontrolled-organ-donation-after-cardio-circulatory-death
#15
F Dupriez, L De Pauw, T Darius, M Mourad, A Penaloza, D Van Deynse, C Baltus, F Verschuren
BACKGROUND: Since 1999, a protocol for uncontrolled donation after cardio-circulatory death (DCD) has been carried out in our institution. We aimed at evaluating those 14 years of local experience. METHODS: We reviewed the charts of uncontrolled donors from 1999 till 2013. Potential donors with a no-flow period less than 30 minutes were considered. Kidneys were perfused by the use of a double balloon triple lumen catheter after at least a 2-minute period of no touch...
November 2014: Transplantation Proceedings
https://www.readbyqxmd.com/read/25220961/emergency-preservation-and-resuscitation-a-lazarus-trial
#16
William Squiers
No abstract text is available yet for this article.
September 13, 2014: Lancet
https://www.readbyqxmd.com/read/25192593/differentiating-between-comatose-patients-resuscitated-from-acute-coronary-syndrome-associated-and-subarachnoid-hemorrhage-associated-out-of-hospital-cardiac-arrest
#17
Yoshihiro Yamashina, Tetsuo Yagi, Akihiko Ishida, Yoshiaki Mibiki, Hirokazu Sato, Takashi Nakagawa, Eiji Sato, Juri Komatsu
BACKGROUND: Upon initial evaluation in the emergency department (ED), it is often difficult to differentiate between comatose patients resuscitated following acute coronary syndrome (ACS)-associated and subarachnoid hemorrhage (SAH)-associated out-of-hospital cardiac arrest (OHCA). We assessed the clinical differences between resuscitated comatose ACS-OHCA and SAH-OHCA patients during initial evaluation in the ED. METHODS: Data of 1259 consecutive OHCA patients were analyzed retrospectively...
June 2015: Journal of Cardiology
https://www.readbyqxmd.com/read/24846357/ten-year-experience-of-an-invasive-cardiology-centre-with-out-of-hospital-cardiac-arrest-patients-admitted-for-urgent-coronary-angiography
#18
Aleksander Zeliaś, Janina Stępińska, Janusz Andres, Aleksander Trąbka-Zawicki, Jerzy Sadowski, Krzysztof Żmudka
BACKGROUND AND AIM: The aim of the study was to evaluate survival and neurological function of out-of-hospital cardiac arrest (OHCA) patients admitted for urgent coronary angiography (UCA) with a view to percutaneous coronary intervention (PCI). METHODS: Hospital records of OHCA patients admitted to an invasive cardiology centre (providing 24 h a day/7 days a week service) in 2000-2010 were reviewed retrospectively, and similar data collected in 2011 were reviewed prospectively...
2014: Kardiologia Polska
https://www.readbyqxmd.com/read/24783610/-case-of-papillary-fibroelastoma-which-caused-cardiopulmonary-arrest-leading-to-emergent-extirpation-surgery
#19
Satoshi Hayasaka, Satoko Terashima, Yurina Yanagida, Naoki Nishikawa, Nobuo Ito, Akira Watabe, Masahiro Yamane
A 73-year-old woman with cardiac tumor arising from aortic valve was scheduled for extirpation surgery. She has a symptom of chest discomfort during her walk. Contrasted CT scan around the aortic valve demonstrated a 1 cm-size tumor close to the left coronary inlet. Coronary blood flow was preserved. On the day of admission she became unconscious during preoperative interview with the surgeon. Cardiopulmonary resuscitation was immediately initiated and she regained her consciousness. Emergency operation was scheduled and started about two hours after the event of syncope...
April 2014: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/24768755/-resuscitation-of-marginal-liver-allografts-for-transplantation-with-machine-perfusion-technology
#20
Jay A Graham, James V Guarrera
As the rate of medically suitable donors remains relatively static worldwide, clinicians have looked to novel methods to meet the ever-growing demand of the liver transplant waiting lists worldwide. Accordingly, the transplant community has explored many strategies to offset this deficit. Advances in technology that target the ex vivo "preservation" period may help increase the donor pool by augmenting the utilization and improving the outcomes of marginal livers. Novel ex vivo techniques such as hypothermic, normothermic, and subnormothermic machine perfusion may be useful to "resuscitate" marginal organs by reducing ischemia/reperfusion injury...
August 2014: Journal of Hepatology
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