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Akira Funada, Yoshikazu Goto, Tetsuo Maeda, Hayato Tada, Ryota Teramoto, Yoshihiro Tanaka, Kenshi Hayashi, Masakazu Yamagishi
BACKGROUND: Population aging has rapidly progressed in Japan. However, few data exist regarding the characteristics of extremely elderly patients with out-of-hospital cardiac arrest (OHCA). We aimed to determine the prehospital predictors of one-month survival with favorable neurological outcomes (Cerebral Performance Category scale, category 1 or 2; CPC 1-2) in this population. METHODS: We investigated 23,520 OHCA patients aged ≥95 years from a prospectively recorded, nationwide, Utstein-style Japanese database between 2008 and 2012...
October 7, 2016: Journal of Cardiology
Yan Wang, Jian Song, Yuhong Liu, Yaqiang Li, Zhengxin Liu
BACKGROUND The purpose of this study was to determine the effect of mild hypothermia therapy on gastric mucosa after cardiopulmonary resuscitation (CPR) and the underlying mechanism. MATERIAL AND METHODS Ventricular fibrillation was induced in pigs. After CPR, the surviving pigs were divided into mild hypothermia-treated and control groups. The changes in vital signs and hemodynamic parameters were monitored before cardiac arrest and at intervals of 0.5, 1, 2, 4, 6, 12, and 24 h after restoration of spontaneous circulation...
October 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Patrik Gilje, Sasha Koul, Jakob Hartvig Thomsen, Yvan Devaux, Hans Friberg, Michael Kuiper, Janneke Horn, Niklas Nielsen, Tomasso Pellis, Pascal Stammet, Matthew P Wise, Jesper Kjaergaard, Christian Hassager, David Erlinge
AIM OF THE STUDY: Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA). Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA...
October 2016: Resuscitation
J Hope Kilgannon, Michael Kirchhoff, Lisa Pierce, Nicholas Aunchman, Stephen Trzeciak, Brian W Roberts
AIMS: Recent guidelines for management of cardiac arrest recommend chest compression rates of 100-120 compressions/min. However, animal studies have found cardiac output to increase with rates up to 150 compressions/min. The objective of this study was to test the association between chest compression rates during cardiopulmonary resuscitation for in-hospital cardiac arrest (IHCA) and outcome. METHODS: We conducted a prospective observational study at a single academic medical center...
September 22, 2016: Resuscitation
Joonghee Kim, Kyuseok Kim, Clifton W Callaway, Kibbeum Doh, Jungho Choi, Jongdae Park, You Hwan Jo, Jae Hyuk Lee
PURPOSE: The probability of the return of spontaneous circulation (ROSC) and subsequent favourable outcomes changes dynamically during advanced cardiac life support (ACLS). We sought to model these changes using time-to-event analysis in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Adult (≥18 years old), non-traumatic OHCA patients without prehospital ROSC were included. Utstein variables and initial arterial blood gas measurements were used as predictors...
September 19, 2016: Resuscitation
An-Yi Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Chih-Hung Wang, Wen-Jone Chen
INTRODUCTION: Monitoring the partial pressure of end-tidal carbon dioxide (PEtco2) has been advocated since 2010 as an index of resuscitation efforts. However, related research has largely focused on out-of-hospital cardiac arrest victims. In-hospital cardiac arrest (IHCA) differs in terms of etiologies and demographics, the merit of initial PEtco2 values was explored. METHODS: This was a retrospective study in a single medical center between February 2011 and August 2014...
August 27, 2016: American Journal of Emergency Medicine
Martin Christ, Katharina Isabel von Auenmueller, Michael Brand, Scharbanu Amirie, Benjamin Michel Sasko, Hans-Joachim Trappe
BACKGROUND The clinical effect of hyperoxia in patients with non-traumatic out-of-hospital cardiac arrest (OHCA) remains uncertain. We therefore initiated this study to find out whether there is an association between survival and hyperoxia early after return of spontaneous circulation (ROSC) in OHCA patients admitted to our hospital. MATERIAL AND METHODS All OHCA patients admitted to our hospital between 1 January 2008 and 30 June 2015 were identified by analysis of our central admission register. Data from individual patients were collected from patient health records and anonymously stored on a central database...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lars Wiklund, Aruna Sharma, Hari Shanker Sharma
Transient global ischemic cerebral injury is a consequence of cardiac arrest. Out of hospital cardiac arrests account for approximately 450,000 annual deaths with a mortality of approximately 90%. Serious morbidity follows for many of the survivors and up to 16% of patients achieving restoration of spontaneous circulation (ROSC) develop brain death. Among other survivors persistent cognitive impairment such as memory and sensimotor deficits, reducing quality of life and resulting in heavy costs on society. Many studies have over many years been devoted to improving outcome after cardiac arrest and have to some degree also succeeded, especially locally in areas where improvement of ambulance organizations have been effective...
September 15, 2016: CNS & Neurological Disorders Drug Targets
Lorissa Lamoureux, Jeejabai Radhakrishnan, Thomas G Mason, Jeffrey A Kraut, Raul J Gazmuri
Major myocardial abnormalities occur during cardiac resuscitation including intracellular acidosis - partly caused by CO2 accumulation - and activation of the Na(+)-H(+) exchanger isoform-1 (NHE-1). We hypothesized that a favorable interaction may result from NHE-1 inhibition during cardiac resuscitation followed by administration of a CO2-consuming buffer upon return of spontaneous circulation (ROSC). Ventricular fibrillation was electrically induced in 24 male rats and left untreated for 8 minutes followed by defibrillation after 8 minutes of CPR...
September 15, 2016: Journal of Applied Physiology
Karl Sporer, Michael Jacobs, Leo Derevin, Sue Duval, James Pointer
OBJECTIVE: To assess system-wide implementation of specific therapies focused on perfusion during cardiopulmonary resuscitation (CPR) and cerebral recovery after Return of Spontaneous Circulation (ROSC). METHODS: Before and after retrospective analysis of an out-of-hospital cardiac arrest database. Implementation trial in the urban/suburban community of Alameda County, California, USA, population 1.6 million, from November 2009-December 2012. Adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA) who received CPR and/or defibrillation...
September 14, 2016: Prehospital Emergency Care
Agnieszka Firszt-Adamczyk, Barbara Ruszkowska-Ciastek, Przemysław Adamczyk, Robert Szafkowski, Mirosława Firszt, Irena Ponikowska, Kristoffer Moe, Iza Iwan-Ziętek, Barbara Góralczyk, Krzysztof Góralczyk, Danuta Rość
BACKGROUND: The most common cause of death among people with obesity are cardiovascular complications as a result of a hypercoagulability state. OBJECTIVES: The purpose of the study was to assess the potential of coagulation system activation depending on the tissue factor and to analyze of the influence of a 3-week low-calorie diet and balneological treatment on selected coagulation parameters in morbidly obese patients. MATERIAL AND METHODS: The study included 36 patients (28 females and 8 males; mean age 46) with the value of BMI > 40 kg/m2...
July 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Jesús López-Herce
AIMS: Actual resuscitation guidelines recommend 10 respirations per minute (rpm) for advanced pediatric life support. This respiratory rate (RR) is much lower than what is physiological for children. The aim of this study is to compare changes in ventilation, oxygenation, haemodynamics and return of spontaneous circulation (ROSC) rates with three RR. METHODS: An experimental model of asphyxial cardiac arrest (CA) in 46 piglets (around 9.5 kg) was performed. Resuscitation with three different RR (10, 20 and 30 rpm) was carried out...
2016: PloS One
Qin Yin, Cai-Jun Wu, Jun Yang, Chen-Chen Hang, Chun-Sheng Li
OBJECTIVE: To investigate the effects of Shenfu Injection (, SFI) on cerebral metabolism in a porcine model of cardiac arrest (CA). METHODS: Thirty Wuzhishan minipigs were randomly assigned to the control group (n=6), epinephrine group (EP group, n=12) and Sfigroup (n=12). After 8 min of untreated ventricular fifibrillation (VF), pigs in the EP group or Sfigroup were administered with either EP (0.02 mg/kg) or Sfi(1.0 mL/kg), respectively. After successful resuscitation, cerebrospinal fluid (CSF) levels of glucose, pyruvate, lactate, glutamate and glycerol were measured at 1, 6, 12 and 24 h after recover from spontaneous circulation (ROSC)...
September 10, 2016: Chinese Journal of Integrative Medicine
Martin Frydland, Jesper Kjaergaard, David Erlinge, Pascal Stammet, Niklas Nielsen, Michael Wanscher, Tommaso Pellis, Hans Friberg, Jan Hovdenes, Janneke Horn, Jørn Wetterslev, Jakob H Thomsen, John Bro-Jeppesen, Matilde Winther-Jensen, Matthew P Wise, Michael Kuiper, Tobias Cronberg, Yvan Gasche, Yvan Devaux, Anders Åneman, Christian Hassager
N-terminal pro-B-type natriuretic (NT-proBNP) is expressed in the heart and brain, and serum levels are elevated in acute heart and brain diseases. We aimed to assess the possible association between serum levels and neurological outcome and death in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Of the 939 comatose OHCA patients enrolled and randomized in the Targeted Temperature Management (TTM) trial to TTM at 33°C or 36°C for 24 hours, 700 were included in the biomarker substudy...
October 1, 2016: American Journal of Cardiology
Wei Gu, Qian Zhang, Chun-Sheng Li
OBJECTIVE: To investigate whether Shen-Fu Injection (, SFI) reduces post-resuscitation immune dysfunction in a porcine model of cardiac arrest by modulating apoptosis of regulatory T lymphocytes (Treg) in the spleen. METHODS: After 8-min untreated ventricular fibrillation and 2-min basic life support, 24 pigs were divided into 3 groups with a random number table, i.e. SFI group, epinephrine (EP) group, and saline (SA) group (8 in each group), which received central venous injection of SFI (1...
September 2016: Chinese Journal of Integrative Medicine
Scott T Youngquist, Atman P Shah, John P Rosborough, James T Niemann
Most resuscitated victims of out-of-hospital cardiac arrest who survive to hospital expire due to the postresuscitation syndrome. This syndrome is characterized by a sepsis-like proinflammatory state. The objective of this investigation was to determine whether a relationship exists between the rise of tumor necrosis factor (TNF), a proinflammatory cytokine, following return of spontaneous circulation (ROSC), and early postarrest survival in a clinically relevant animal model of spontaneous ventricular fibrillation (VF)...
October 2016: Journal of Interferon & Cytokine Research
J Zwingmann, R Lefering, M Feucht, N P Südkamp, P C Strohm, T Hammer
BACKGROUND: Data of the TraumaRegister DGU® were analyzed to derive survival rates, neurological outcome and prognostic factors of patients who had suffered traumatic cardiac arrest in the early treatment phase. METHODS: The database of the TraumaRegister DGU® from 2002 to 2013 was analyzed. The main focus of this survey was on different time points of performed resuscitation. Descriptive and multivariate analyses (logistic regression) were performed with the neurological outcome (Glasgow Outcome Scale) and survival rate as the target variable...
2016: Critical Care: the Official Journal of the Critical Care Forum
Tomoya Hirose, Tadahiko Shiozaki, Junji Nomura, Yasuto Hamada, Keiichi Sato, Kazuya Katsura, Naoki Ehara, Akinori Wakai, Kentaro Shimizu, Mitsuo Ohnishi, Sumito Hayashida, Daikai Sadamitsu, Takeshi Shimazu
BACKGROUND: In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the pre-hospital setting. METHODS: We recently developed a portable rSO2 monitor that is small (170 × 100 × 50 mm in size and 600 g in weight) enough to carry in pre-hospital settings...
2016: BMC Research Notes
Yecheng Liu, Zhuang Tian, Chunhua Yu, Joseph Walline, Jun Xu, Huadong Zhu, Xuezhong Yu
BACKGROUND: Although the cardiac pump and the thoracic pump are the two main theories, the actual mechanisms of blood flow during Cardiopulmonary Resuscitation (CPR) in humans are still unclear. The aim of this study was to explore the relationship between the pump mechanism and time after cardiac arrest. METHODS AND RESULTS: 20 patients with non-traumatic cardiac arrest were enrolled in this study. Transesophageal two-dimensional and pulse-doppler echocardiography were used during CPR...
November 15, 2016: International Journal of Cardiology
Joerg C Schefold, Nora Fritschi, Gerhard Fusch, Aldin Bahonjic, Wolfram Doehner, Stephan von Haehling, Rene Pschowski, Christian Storm, Tim Schroeder
BACKGROUND/AIMS: Temperature control improves neurological prognosis in comatose cardiac arrest (CA) survivors. Previous reports demonstrate that most affected patients show signs of significant systemic inflammation. In an effort to better characterize potential temperature-related effects on key inflammatory pathways, we investigate the course of Tryptophan (Trp) levels, Tryptophan catabolites (including kynurenines) and indoleamine-2,3-dioxygenase (IDO)-activity in post CA patients...
October 2016: Resuscitation
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