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https://www.readbyqxmd.com/read/28728194/-relevance-of-living-wills-during-post-resuscitation-care
#1
Martin Christ, Katharina Isabel von Auenmüller, Martin Grett, Scharbanu Amirie, Michael Brand, Hans-Joachim Trappe
Background There is hardly any evidence about the influence of living wills on acute life-threatening disease like out-of-hospital cardiac-arrest (OHCA). We therefore initiated this study to quantify the percentage of victims of OHCA who's living wills are available during post-resuscitation care. Methods All victims of OHCA who were admitted to our hospital between January 1(st) 2008 and July 31(th) 2016 were identified by analysis of our central admission register. Data from individual patients were collected from the patient's health records and anonymously stored on a central database...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28724904/hypertonic-saline-infusion-suppresses-apoptosis-of-hippocampal-cells-in-a-rat-model-of-cardiopulmonary-resuscitation
#2
Xiang Zhou, Yong Liu, Yang Huang, ShuiBo Zhu, Jian Zhu, RongPing Wang
Hypertonic saline (HS) attenuates cerebral edema, improves microcirculation perfusion and alleviates inflammation. However, whether the beneficial effect of HS on neurological function after cardiopulmonary resuscitation (CPR) in rat model of asphyxial cardiac arrest (CA) is mediated via attenuating apoptosis of neurons is not known. We studied the neuroprotective effect of HS in rats after CA and CPR, and explored the likely underlying mechanisms. Animals were randomly assigned to 4 equal groups (n = 15 each) according to the different infusions administered during resuscitation: control (C), normal saline (NS), hypertonic saline (HS), and hydroxyethyl starch (HES) groups...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724608/erbb4-deletion-accelerates-renal-fibrosis-following-renal-injury
#3
Fenghua Zeng, Tomoki Miyazawa, Lance A Kloepfer, Raymond C Harris
Tubulointerstitial fibrosis (TIF) is a prominent factor in the progression of chronic kidney disease (CKD) regardless of etiology. ErbB4 expression levels were inversely correlated to renal fibrosis in human fibrotic kidneys. In both unilateral ureteral obstruction (UUO) and ischemia reperfusion injury followed by uninephrectomy (IRI/UNx) mouse models, expression levels of ErbB4 were elevated in the early stage of renal injury. Using mice with global ErbB4 deletion except for transgenic rescue in cardiac tissue (ErbB4-/-ht+), we determined that UUO induced similar injury in proximal tubules compared to wild-type mice but more severe injury in distal nephrons...
July 19, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28724277/suicide-by-fire-extinguisher-powder-ingestion-a-case-report
#4
Hamid Mohammadi Kojidi, Morteza Rahbar Taramsari, Alireza Badsar, Mirsaeed Attarchi
A 51-year-old man committed suicide by swallowing the contents of a fire extinguisher. A few hours after his suicide attempt, he was referred to the medical center for poisoning. At the time of admission, the patient was conscious with stable vital signs. The patient complained of burning lips and mouth, mentioning diarrhea. Initial treatments included gastric lavage with activated charcoal, while paraclinical measures were requested. The patient had undergone hypernatremia (Na: 152 mEq/l) and metabolic alkalosis...
May 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28723789/measuring-the-impact-of-emergency-medical-services-ems-on-out-of-hospital-cardiac-arrest-survival-in-a-developing-country-a-key-metric-for-ems-systems-performance
#5
Mazen El Sayed, Reem Al Assad, Yasmin Abi Aad, Nour Gharios, Marwan M Refaat, Hani Tamim
Out-of-hospital cardiac arrest (OHCA) can be used to evaluate the overall performance of the emergency medical services' (EMS) system. This study assessed the impact of EMS on OHCA survival rates in a setting where the prehospital system is underdeveloped.A retrospective chart review was carried out over a 5-year period of all adult OHCA patients admitted to the emergency department (ED) of a tertiary care center in Lebanon.A total of 271 patients with OHCA (179 [66.1%] men, mean age of 69.9 [standard deviation = 15...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#6
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720400/viewing-an-ultra-brief-chest-compression-only-video-improves-some-measures-of-bystander-cpr-performance-and-responsiveness-at-a-mass-gathering-event
#7
Daniel L Beskind, Uwe Stolz, Rebecca Thiede, Riley Hoyer, Whitney Robertson, Jeffrey Brown, Melissa Ludgate, Timothy Tiutan, Romy Shane, Deven McMorrow, Michael Pleasants, Karl B Kern, Ashish R Panchal
BACKGROUND: CPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. OBJECTIVE: To determine if showing a chest-compression only (CCO) Ultra-Brief Video (UBV) at a mass gathering event is effective in teaching lay bystanders CCO-CPR. METHODS: Prospective control trial in adults (age >18) who attended either a women's University of Arizona or a men's Phoenix Suns basketball game...
July 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#8
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#9
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28718877/takotsubo-syndrome-in-hemodynamically-unstable-patients-admitted-to-the-intensive-care-unit-a-retrospective-study
#10
J Oras, J Lundgren, B Redfors, D Brandin, E Omerovic, H Seeman-Lodding, S-E Ricksten
INTRODUCTION: Takotsubo syndrome (TS) is an acute cardiac condition that is often triggered by critical illness but that has rarely been studied in the intensive care unit (ICU) setting. The aim of this study was to (i) estimate the incidence of TS in a hemodynamically unstable ICU-population; (ii) identify predictors of TS in this population; (iii) study the impact of TS on prognosis and course of hospitalization. METHODS: Medical records from all patients admitted to our general ICU from 2012 to 2015 were analyzed...
July 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28717778/retention-of-cardiopulmonary-resuscitation-skills-after-hands-only-training-versus-conventional-training-in-novices-a-randomized-controlled-trial
#11
Young Joon Kim, Youngsuk Cho, Gyu Chong Cho, Hyun Kyung Ji, Song Yi Han, Jin Hyuck Lee
OBJECTIVE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. METHODS: Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717777/association-between-public-cardiopulmonary-resuscitation-education-and-the-willingness-to-perform-bystander-cardiopulmonary-resuscitation-a-metropolitan-citywide-survey
#12
Jeong Woo Son, Hyun Wook Ryoo, Sungbae Moon, Jong-Yeon Kim, Jae Yun Ahn, Jeong Bae Park, Kang Suk Seo, Jong Kun Kim, Yun Jeong Kim
OBJECTIVE: Bystander cardiopulmonary resuscitation (CPR) is an important factor associated with improved survival rates and neurologic prognoses in cases of out-of-hospital cardiac arrest. We assessed how factors related to CPR education including timing of education, period from the most recent education session, and content, affected CPR willingness. METHODS: In February 2012, trained interviewers conducted an interview survey of 1,000 Daegu citizens through an organized questionnaire...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717775/impact-of-early-coronary-angiography-on-the-survival-to-discharge-after-out-of-hospital-cardiac-arrest
#13
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
OBJECTIVE: Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated. METHODS: The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#14
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716539/association-of-bystander-interventions-and-hospital-length-of-stay-and-admission-to-intensive-care-unit-in-out-of-hospital-cardiac-arrest-survivors
#15
Signe Riddersholm, Kristian Kragholm, Rikke Nørmark Mortensen, Marianne Pape, Carolina Malta Hansen, Freddy K Lippert, Christian Torp-Pedersen, Christian F Christiansen, Bodil Steen Rasmussen
BACKGROUND: The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA. METHODS: This cohort study linked data of 4,641 one-day OHCA survivors from 2001-2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status...
July 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#16
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
June 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#17
Anders Wetting Carlsen, Nils K Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson, Alexander Wahba
BACKGROUND: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28714380/loperamide-and-cardiac-events-is-high-dose-use-still-safe-for-chemotherapy-induced-diarrhea
#18
Mário L de Lemos, Jolene Guenter, Victoria Kletas
High-dose loperamide is often used for the acute management of chemotherapy-induced diarrhea, with a maximum daily dosing of up to 24 mg. Recently, the US Food and Drug Administration has issued a warning that loperamide can cause rare serious cardiac events, including QT prolongation, torsades de pointes, cardiac arrest and death. Most events were reported in patients taking very high doses for an extended period of time. Daily intake ranged from 64 mg to 1600 mg, often continuously for weeks or months...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28713042/implementation-of-the-universal-bls-termination-of-resuscitation-rule-in-a-rural-ems-system
#19
Matthew R Jordan, Michael F O'Keefe, David Weiss, C Wes Cubberley, Charles D MacLean, Daniel L Wolfson
BACKGROUND: Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. OBJECTIVE: The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28712584/the-advantage-of-early-plication-in-children-diagnosed-with-diaphragm-paresis
#20
Alejandro A Floh, Intikhab Zafurallah, Cathy MacDonald, Osami Honjo, Chun-Po S Fan, Peter C Laussen
BACKGROUND: In this single-center study, we sought to determine the frequency of phrenic nerve injury leading to diaphragm paresis (DP) in children following open cardiac surgery over the last 10 years, and to identify possible variables that predict the need for plication and associated clinical outcomes. METHODS: Patients diagnosed with DP were identified from departmental databases and a review of clinical diaphragm ultrasound images. A cohort was analyzed for predictors of diaphragm plication and associations with clinical outcomes...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
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