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out of hospital arrest

Zian H Tseng, Jeffrey E Olgin, Eric Vittinghoff, Philip C Ursell, Anthony S Kim, Karl Sporer, Clement Yeh, Benjamin Colburn, Nina M Clark, Rana Khan, Amy P Hart, Ellen Moffatt
BACKGROUND: Studies of out-of-hospital cardiac arrest and sudden cardiac death (SCD) use emergency medical services records, death certificates, or definitions that infer cause of death; thus, the true incidence of SCD is unknown. Over 90% of SCDs occur out-of-hospital; nonforensic autopsies are rarely performed, and therefore causes of death are presumed. We conducted a medical examiner-based investigation to determine the precise incidence and autopsy-defined causes of all SCDs in an entire metropolitan area...
June 19, 2018: Circulation
Maximilian Scharonow, Christian Weilbach
BACKGROUND: In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated...
June 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Mayureshkumar Pareek, Vandana Parmar, Jigisha Badheka, Nirmalyo Lodh
Background and Aims: Nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills to be able to implement effective interventions during in-hospital cardiac arrest. The aim of this descriptive study was to assess mortality impact after nurses' CPR training with pre-CPR training data at our institute. Methods: Training regarding CPR was given to nurses, and CPR mortality 1-year before basic life support (BLS) and advanced cardiac life support (ACLS) training were collected and compared with post-training 1-year CPR mortality...
May 2018: Indian Journal of Anaesthesia
Jessica R Balderston, Zachary M Gertz, Kenneth A Ellenbogen, Kelly P Schaaf, Joseph P Ornato
BACKGROUND: Several characteristics of the ventricular fibrillation (VF) waveform during cardiac arrest are associated with defibrillation success, including peak amplitude in the seconds prior to defibrillation. It is not known if immediate pre-defibrillation amplitude is associated with successful defibrillation, return of spontaneous circulation (ROSC) or survival to hospital discharge (SHD). METHODS: We analyzed automated external defibrillation recordings of 80 patients with out-of-hospital VF cardiac arrest who received 284 defibrillations...
July 2018: American Heart Journal
Ryan J Anderson, Sayuri P Jinadasa, Leeyen Hsu, Tiffany Bita Ghafouri, Sanjeev Tyagi, Jisha Joshua, Ariel Mueller, Daniel Talmor, Rebecca E Sell, Jeremy R Beitler
BACKGROUND: Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognostic and therapeutic value. METHODS: A two-hospital cohort was assembled of patients in shock following OHCA. Left ventricular ejection fraction (LVEF) was assessed via echocardiography or cardiac ventriculography within 1 day post arrest and used to delineate shock physiology...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
Jolande A Zijlstra, Rudolph W Koster, Marieke T Blom, Freddy K Lippert, Leif Svensson, Johan Herlitz, Jo Kramer-Johansen, Mattias Ringh, Mårten Rosenqvist, Thea Palsgaard Møller, Hanno L Tan, Stefanie G Beesems, Michiel Hulleman, Andreas Claesson, Fredrik Folke, Theresa Mariero Olasveengen, Mads Wissenberg, Carolina Malta Hansen, Soren Viereck, Jacob Hollenberg
BACKGROUND: In the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (AEDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. The aim of this study was to study the association between different defibrillation strategies on survival rates over time in Copenhagen, Stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-EMS defibrillation increased over time and was associated with increased survival...
June 14, 2018: Heart: Official Journal of the British Cardiac Society
Ludvig Elfwén, Rickard Lagedal, Stefan James, Martin Jonsson, Ulf Jensen, Mattias Ringh, Andreas Claesson, Jonas Oldgren, Johan Herlitz, Sten Rubertsson, Per Nordberg
BACKGROUND: The potential benefit of early coronary angiography in out-of-hospital cardiac arrest (OHCA) patients without ST elevation on ECG is unclear. The aim of this study was to evaluate the association between early coronary angiography and survival in these patients. METHODS: Nationwide observational study between 2008 and 2013. Included were patients admitted to hospital after witnessed OHCA, with shockable rhythm, age 18 to 80 years and unconscious. Patients with ST-elevation on ECG were excluded...
June 2018: American Heart Journal
Mario Krammel, Sebastian Schnaubelt, David Weidenauer, Markus Winnisch, Matthias Steininger, Jakob Eichelter, Thomas Hamp, Raphael van Tulder, Patrick Sulzgruber
BACKGROUND: The 'chain of survival'-including early call for help, early cardiopulmonary resuscitation (CPR) and early defibrillation-represents the most beneficial approach for favourable patient outcome after out-of-hospital cardiac arrest (OHCA). Despite increasing numbers of publicly accessible automated external defibrillators (AED) and interventions to increase public awareness for basic life support (BLS), the number of their use in real-life emergency situations remains low. METHODS: In this prospective population-based cross-sectional study, a total of 501 registered inhabitants of Vienna (Austria) were randomly approached via telephone calls between 08/2014 and 09/2014 and invited to answer a standardized questionnaire in order to identify public knowledge and awareness of BLS and AED-use...
2018: PloS One
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with inhospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011 to 2014 (n = 607) were retrospectively reviewed to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
July 2018: Shock
Giacomo Veronese, Manlio Cipriani, Duccio Petrella, Patrizia Pedrotti, Cristina Giannattasio, Andrea Garascia, Fabrizio Oliva, Karin Klingel, Maria Frigerio, Enrico Ammirati
: Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation...
June 7, 2018: Journal of Cardiovascular Medicine
J A Barea-Mendoza, L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, M Valiente-Fernández, A Rodríguez-Biendicho, J C Montejo González, M Chico-Fernández
BACKGROUND: Hypoperfusion plays a central role in shock states, and has been proposed as a coagulopathy trigger. The study of the rotational thromboelastometry (ROTEM) profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states. OUTCOME: To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis. DESIGN: A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest (CA)...
June 7, 2018: Medicina Intensiva
Dong Keon Lee, Yong Sung Cha, Oh Hyun Kim, Kyoung Chul Cha, Kang Hyun Lee, Sung Oh Hwang, Hyun Kim, Young Hwan Lee, Minjung Kathy Chae
BACKGROUND: An automatic simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device is an apparatus that performs CPR by providing simultaneous cyclic compressions of the thorax with a thoracic strap and compression of the sternum with a piston. OBJECTIVE: This study was conducted to compare the hemodynamic effects of CPR with an automatic SST-CPR device to those with standard CPR (STD-CPR) in cardiac arrest patients. METHODS: A randomized trial was performed on victims of out-of-hospital cardiac arrest resistant to initial 20 min of CPR after emergency department (ED) arrival...
June 6, 2018: Journal of Emergency Medicine
Simon Foged Haugaard, Anni Nørgaard Jeppesen, Anne Troldborg, Hans Kirkegaard, Steffen Thiel, Anne-Mette Hvas
The lectin pathway (LP) of the complement system may initiate inflammatory reactions when body tissue is altered. We aimed to investigate levels of the LP proteins in out-of-hospital cardiac arrest patients, and to compare these with healthy individuals. Furthermore, we aimed to clarify whether duration of targeted temperature management influenced LP protein levels, and we further examined whether LP proteins were associated with 30-day mortality. We included 82 patients resuscitated from out-of-hospital cardiac arrest...
June 9, 2018: Scandinavian Journal of Immunology
Rebecca Ichord, Faye S Silverstein, Beth S Slomine, Russell Telford, James Christensen, Richard Holubkov, J Michael Dean, Frank W Moler
OBJECTIVE: To implement a standardized approach to characterize neurologic outcomes among 12-month survivors in the Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) trials. METHODS: Two multicenter trials enrolled children age 48 hours to 18 years who remained comatose after cardiac arrest (CA) occurring out-of-hospital (THAPCA-OH, NCT00878644) or in-hospital (THAPCA-IH, NCT00880087); patients were randomized to therapeutic hypothermia or therapeutic normothermia...
June 8, 2018: Neurology
Kelly N Sawyer, Michael Mooney, Gregory Norris, Thomas Devlin, Justin Lundbye, Pratik B Doshi, Jonathan Kyle Hewett, Alan T Kono, Jesse P Jorgensen, Brian J O'Neil
Targeted temperature management (TTM) is recommended postcardiac arrest. The cooling method with the highest safety and efficacy is unknown. The COOL-ARREST pilot trial aimed to evaluate the safety and efficacy of the most contemporary ZOLL Thermogard XP Intravascular Temperature Management (IVTM) system for providing mild TTM postcardiac arrest. This multicenter, prospective, single-arm, observational pilot trial enrolled patients at eight U.S. hospitals between July 28, 2014, and July 24, 2015. Adult (≥18 years old), out-of-hospital cardiac arrest subjects of presumed cardiac etiology who achieved return of spontaneous circulation (ROSC) were considered for inclusion...
June 8, 2018: Therapeutic Hypothermia and Temperature Management
Takashi Mizutani, Norio Umemoto, Toshio Taniguchi, Hideki Ishii, Yuri Hiramatsu, Koji Arata, Horagaito Takuya, Sho Inoue, Tsuyoshi Sugiura, Toru Asai, Michiharu Yamada, Toyoaki Murohara, Kiyokazu Shimizu
Background: Serum lactate level can predict clinical outcomes in some critical cases. In the clinical setting, we noted that patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and with poor serum lactate improvement often do not recover from cardiopulmonary arrest. Therefore, we investigated the association between lactate clearance and in-hospital mortality in cardiac arrest patients undergoing ECPR. Methods: Serum lactate levels were measured on admission and every hour after starting ECPR...
2018: Journal of Intensive Care
Adam Viktorisson, Katharina S Sunnerhagen, Ulrika Pöder, Johan Herlitz, Åsa B Axelsson
OBJECTIVES: The psychological outcome of out-of-hospital cardiac arrest (OHCA) has been studied more extensively in recent years. Still, not much is known about the well-being among OHCA survivors. In this retrospective cross-sectional study, we aim to investigate post-OHCA well-being among patients with a good neurological outcome, 3 months after the cardiac event. To assess well-being, we analyse the frequency of anxiety, depression, post-traumatic stress disorder (PTSD) and health within this group...
June 6, 2018: BMJ Open
Yuka Nakatani, Takeo Nakayama, Kei Nishiyama, Yoshimitsu Takahashi
This data article contains raw data and supplementary analyzed data regarding to the article entitled "Effect of target temperature management at 32-34 °C in cardiac arrest patients considering assessment by regional cerebral oxygen saturation: A multicenter retrospective cohort study". We examined the effectiveness of target temperature management (TTM) at 32-34 °C considering degrees of patients' cerebral injury and cerebral circulation assessed by regional cerebral oxygen saturation (rSO2 )...
April 2018: Data in Brief
Seo Young Ko, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Seung Chul Lee
INTRODUCTION: The association between the detection time interval (DTI) from the call for ambulance to the detection of out-of-hospital cardiac arrest (OHCA) by the dispatcher and the neurological outcome in dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is unclear. METHODS: Adults who sustained OHCA with cardiac etiology received DA-CPR between 2013 and 2016 were analyzed. The main predictor was DTI defined as the time interval from the beginning of the emergency call to identification of OHCA by the dispatcher...
June 3, 2018: Resuscitation
Enrico Paolini, Elettra Conti, Federico Guerra, Alessandro Capucci
BACKGROUND: Despite the many recent improvements in basic life support (BLS) and the widespread training to a great number of lay rescuers, out-of-hospital cardiac arrest (OHCA) is still a major cause of death. Nowadays, BLS teaching protocols ask for many concepts to be learned and specific algorithms to be applied, without any available data on how much all these inputs are retained by the students. The present survey aims to evaluate how BLS is really retained by those rescuers (laypersons and nurses) who do not often put it into practice...
March 2018: Giornale Italiano di Cardiologia
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