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https://www.readbyqxmd.com/read/28801484/predicting-outcomes-in-traumatic-out-of-hospital-cardiac-arrest-the-relevance-of-utstein-factors
#1
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28800036/improved-outcomes-of-cardiopulmonary-resuscitation-in-rats-treated-with-vagus-nerve-stimulation-and-its-potential-mechanism
#2
Peng Sun, Jiangang Wang, Shen Zhao, Zhengfei Yang, Ziren Tang, Navami Ravindra, Jennifer Bradley, Joseph P Ornato, Mary Ann Peberdy, Wanchun Tang
Studies have demonstrated that vagus nerve stimulation (VNS) reduces ischemia/reperfusion (I/R) injury. In this study, we investigated the protective effects of VNS in a rat model of cardiopulmonary resuscitation (CPR). We further investigated whether the beneficial effects of VNS were dependent on the alpha 7 nicotinic acetylcholine receptor (α7nAChR). Forty animals were randomized into 4 groups and all underwent CPR (n = 10 each): (1) CPR alone (control); (2) VNS during CPR; (3) α7nAChR antagonist methyllycaconitine citrate (MLA) with VNS; (4) α7nAChR agonist 3-(2, 4-dimethoxybenzylidene) anabaseine (GTS-21) without VNS...
August 9, 2017: Shock
https://www.readbyqxmd.com/read/28795675/-clinical-application-of-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-method-for-treatment-of-patients-with-cardiac-arrest
#3
Haishan Li, Liu Ji, Jingjing Wang
OBJECTIVE: To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.). METHODS: The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28793963/the-effect-of-team-based-cardiopulmonary-resuscitation-on-outcomes-in-out-of-hospital-cardiac-arrest-patients-a-meta-analysis
#4
Sola Kim, Ki Ok Ahn, Seungmin Jeong
OBJECTIVES: The objective of this systematic review and meta-analysis was to determine the effects of team cardiopulmonary resuscitation (CPR) on outcomes of patients with out-of-hospital cardiac arrest (OHCA). METHODS: A systematic literature review was performed using PubMed, EMBASE, and the Cochrane database to identify relevant articles for this meta-analysis. All studies that described the implementation of team CPR performed by emergency medical services for OHCA patients with presumed cardiac etiology were included in this study...
July 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28793036/effect-of-mild-hypothermia-on-renal-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-in-a-swine-model
#5
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded...
July 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28768280/chest-compressions-during-sustained-inflations-improve-recovery-when-compared-to-a-3-1-compression-ventilation-ratio-during-cardiopulmonary-resuscitation-in-a-neonatal-porcine-model-of-asphyxia
#6
Elliott S Li, Immanuel Görens, Po-Yin Cheung, Tze-Fun Lee, Min Lu, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). OBJECTIVE: To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia...
August 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28763260/patterns-of-resuscitation-care-and-survival-after-in-hospital-cardiac-arrest-in-patients-with-advanced-cancer
#7
Jeffrey T Bruckel, Sandra L Wong, Paul S Chan, Steven M Bradley, Brahmajee K Nallamothu
PURPOSE: Little is known regarding patterns of resuscitation care in patients with advanced cancer who suffer in-hospital cardiac arrest (IHCA). METHODS: In the Get With The Guidelines - Resuscitation registry, 47,157 adults with IHCA with and without advanced cancer (defined as the presence of metastatic or hematologic malignancy) were identified at 369 hospitals from April 2006 through June 2010. We compared rates of return of spontaneous circulation (ROSC) and survival to discharge between groups using multivariable models...
August 1, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28754320/efficacy-of-vasopressin-epinephrine-compared-to-epinephrine-alone-for-out-of-hospital-cardiac-arrest-patients-a-systematic-review-and-meta-analysis
#8
REVIEW
Qiang Zhang, Bo Liu, Lianxing Zhao, Zhijiang Qi, Huan Shao, Le An, Chunsheng Li
OBJECTIVE: The aim of this study was to conduct a meta-analysis to evaluate the efficacy of vasopressin-epinephrine compared to epinephrine alone in patients who suffered out-of-hospital cardiac arrest (OHCA). METHODS: Relevant studies up to February 2017 were identified by searching in PubMed, EMBASE, the Cochrane Library, Wanfang for randomized controlled trials(RCTs) assigning adults with cardiac arrest to treatment with vasopressin-epinephrine (VEgroup) vs adrenaline (epinephrine) alone (E group)...
July 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28750886/intubation-is-not-a-marker-for-coma-after-in-hospital-cardiac-arrest-a-retrospective-study
#9
Katherine M Berg, Anne V Grossestreuer, Amy Uber, Parth V Patel, Michael W Donnino
INTRODUCTION: In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. METHODS: Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28750883/delayed-return-of-spontaneous-circulation-the-lazarus-phenomenon-after-cessation-of-out-of-hospital-cardiopulmonary-resuscitation
#10
Markku Kuisma, Ari Salo, Jyrki Puolakka, Jouni Nurmi, Hetti Kirves, Taneli Väyrynen, James Boyd
INTRODUCTION: The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. METHODS: This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#11
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#12
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741013/prompt-use-of-mechanical-cardiopulmonary-resuscitation-in-out-of-hospital-cardiac-arrest-the-mecca-study-report
#13
Venkataraman Anantharaman, Boon Lui Benjamin Ng, Shiang Hu Ang, Chun Yue Francis Lee, Siew Hon Benjamin Leong, Marcus Eng Hock Ong, Siang Jin Terrance Chua, Antony Charles Rabind, Nagaraj Baglody Anjali, Ying Hao
INTRODUCTION: Early use of mechanical cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) may improve survival outcomes. Current evidence for such devices uses outcomes from an intention-to-treat (ITT) perspective. We aimed to determine whether early use of mechanical CPR using a LUCAS 2 device results in better outcomes. METHODS: A prospective, randomised, multicentre study was conducted over one year with LUCAS 2 devices in 14 ambulances and manual CPR in 32 ambulances to manage OHCA...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741007/role-of-peak-current-in-conversion-of-patients-with-ventricular-fibrillation
#14
Venkataraman Anantharaman, Paul Weng Wan, Seow Yian Tay, Peter George Manning, Swee Han Lim, Siang Jin Terrance Chua, Tiru Mohan, Antony Charles Rabind, Sudarshan Vidya, Ying Hao
INTRODUCTION: Peak currents are the final arbiter of defibrillation in patients with ventricular fibrillation (VF). However, biphasic defibrillators continue to use energy in joules for electrical conversion in hopes that their impedance compensation properties will address transthoracic impedance (TTI), which must be overcome when a fixed amount of energy is delivered. However, optimal peak currents for conversion of VF remain unclear. We aimed to determine the role of peak current and optimal peak levels for conversion in collapsed VF patients...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#15
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28734702/impact-of-hypotension-after-return-of-spontaneous-circulation-on-survival-in-patients-of-out-of-hospital-cardiac-arrest
#16
Yu Koon Chiu, Chun Tat Lui, Kwok Leung Tsui
OBJECTIVE: To investigate the relationship between hypotension in the first 3h after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest. METHOD: This retrospective cohort study occurred at two regional hospitals and included adult OHCA patients who experienced ROSC from July 1, 2014 to December 31, 2015. Hemodynamic and inotrope administration data were retrieved for 3h after ROSC. We calculated the hypotensive exposure index (HEI) as the surrogate marker of the exposure of hypotension...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28730843/clinical-value-of-st-segment-change-after-return-of-spontaneous-cardiac-arrest-and-emergent-coronary-angiography-in-patients-with-out-of-hospital-cardiac-arrest-diagnostic-and-therapeutic-importance-of-vasospastic-angina
#17
Kazuya Tateishi, Daisuke Abe, Tooru Iwama, Yuichi Hamabe, Kazutaka Aonuma, Akira Sato
BACKGROUND: We investigated the association between initial ST-segment change after return of spontaneous circulation (ROSC) and the incidence of acute coronary lesions in patients with out-of-hospital cardiac arrest (OHCA), and clinical outcomes of patients with OHCA caused by vasospastic angina pectoris (VSA). METHODS: Among 2779 OHCA patients in our institution, all patients with ROSC underwent emergent coronary angiography (CAG) except for those with an obvious extra-cardiac cause of OHCA...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28724904/hypertonic-saline-infusion-suppresses-apoptosis-of-hippocampal-cells-in-a-rat-model-of-cardiopulmonary-resuscitation
#18
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/28709953/association-of-hemodynamic-variables-with-in-hospital-mortality-and-favorable-neurological-outcomes-in-post-cardiac-arrest-care-with-targeted-temperature-management
#19
Chien-Hua Huang, Min-Shan Tsai, Hooi Nee Ong, Weiting Chen, Chih-Hung Wang, Wei-Tien Chang, Tzung-Dau Wang, Shyr-Chyr Chen, Matthew Huei-Ming Ma, Wen-Jone Chen
PURPOSE: Although hemodynamic instability is expected during the post-cardiac arrest period, the implications of hemodynamic parameters for outcomes remain unclear. Each phase of targeted temperature management (TTM) affects hemodynamic responses differently. This study aims to investigate the association of hemodynamic parameters with outcomes in patients receiving TTM after cardiac arrest. METHODS: The study prospectively enrolled patients who were treated with TTM (33°C for 24h) after cardiac arrest...
July 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/28701838/a-retrospective-study-of-physiological-observation-reporting-practices-and-the-recognition-response-and-outcomes-following-cardiopulmonary-arrest-in-a-low-to-middle-income-country
#20
Ambepitiyawaduge Pubudu De Silva, Jayasingha Arachchilage Sujeewa, Nirodha De Silva, Rathnayake Mudiyanselage Danapala Rathnayake, Lakmal Vithanage, Ponsuge Chathurani Sigera, Sithum Munasinghe, Abi Beane, Tim Stephens, Priyantha Lakmini Athapattu, Kosala Saroj Amarasiri Jayasinghe, Arjen M Dondorp, Rashan Haniffa
BACKGROUND AND AIMS: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC. PATIENTS AND METHODS: This retrospective study was carried out at District General Hospital Monaragala, Sri Lanka...
June 2017: Indian Journal of Critical Care Medicine
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