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https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#1
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#2
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28422817/incidence-and-implications-of-left-ventricular-distention-during-venoarterial-extracorporeal-membrane-oxygenation-support
#3
Lauren K Truby, Koji Takeda, Christine Mauro, Melana Yuzefpolskaya, Arthur R Garan, Ajay J Kirtane, Veli Topkara, Darryl Abrams, Daniel Brodie, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
Left ventricular distention (LVD) during venoarterial extracorporeal membrane oxygenation (VA-ECMO) support is increasingly recognized but seldom reported in the literature. The present study defined LVD as not present (LVD-); subclinical (LVD+, evidence of pulmonary edema on chest radiograph AND pulmonary artery diastolic blood pressure greater than 25 mmHg within the first 2 hours of ICU admission); or clinical (LVD++, need for decompression of the left ventricle immediately following VA-ECMO initiation)...
April 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28408618/national-policies-fostering-hospice-care-increased-hospice-utilization-and-reduced-the-invasiveness-of-end-of-life-care-for-cancer-patients
#4
Yu-Yun Shao, Emily Han-Chung Hsiue, Chih-Hung Hsu, Chien-An Yao, Ho-Min Chen, Mei-Shu Lai, Ann-Lii Cheng
BACKGROUND: In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies. METHODS: A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#5
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28396614/can-takotsubo-cardiomyopathy-be-diagnosed-by-autopsy-report-of-a-presumed-case-presenting-as-cardiac-rupture
#6
Andrew Mitchell, François Marquis
BACKGROUND: Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is myocardial rupture...
2017: BMC Clinical Pathology
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#7
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28385642/outcome-among-vf-vt-patients-in-the-linc-lucas-in-cardiac-arrest-trial-a-randomised-controlled-trial
#8
Bjarne Madsen Hardig, Erik Lindgren, Ollie Östlund, Johan Herlitz, Rolf Karlsten, Sten Rubertsson
INTRODUCTION: The LINC trial evaluated two ALS-CPR algorithms for OHCA patients, consisting of 3 minutes' mechanical chest compression (LUCAS) cycles with defibrillation attempt through compressions vs. 2 minutes' manual compressions with compression pause for defibrillation. The PARAMEDIC trial, using 2 minutes' algorithm found worse outcome for patients with initial VF/VT in the LUCAS group and they received more adrenalin compared to the manual group. We wanted to evaluate if these algorithms had any outcome effect for patients still in VF/VT after the initial defibrillation and how adrenalin timing impacted it...
April 3, 2017: Resuscitation
https://www.readbyqxmd.com/read/28381704/efficacy-of-precordial-percussion-pacing-assessed-in-a-cardiac-standstill-microminipig-model
#9
Takeshi Wada, Hiroshi Ohara, Yuji Nakamura, Xin Cao, Hiroko Izumi-Nakaseko, Kentaro Ando, Mitsuru Honda, Katsunori Yoshihara, Yuji Nakazato, Keith G Lurie, Atsushi Sugiyama
BACKGROUND: Potential cardiovascular benefits of precordial percussion pacing (PPP) during cardiac standstill are unknown.Methods and Results:A cardiac standstill model in amicrominipigwas created by inducing complete atrioventricular block with a catheter ablation technique (n=7). Next, the efficacy of cardiopulmonary resuscitation by standard chest compressions (S-CPR), PPP and ventricular electrical pacing in this model were analyzed in series (n=4). To assess the mechanism of PPP, a non-selective, stretch-activated channel blocker, amiloride, was administered during PPP (n=3)...
April 4, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28380491/association-between-brain-and-kidney-near-infrared-spectroscopy-and-early-postresuscitation-mortality-in-asphyxiated-newborn-piglets
#10
Anne Lee Solevåg, Georg M Schmölzer, Britt Nakstad, Ola Didrik Saugstad, Po-Yin Cheung
BACKGROUND: Early outcome predictors after delivery room cardiopulmonary resuscitation (CPR) of asphyxiated newborns are needed. OBJECTIVES: To investigate if cerebral (rScO2) and renal (rSrO2) tissue oxygen saturation 30 min after return of spontaneous circulation (ROSC) are different between surviving versus nonsurviving piglets with asphyxia-induced cardiac arrest and CPR. Further, to investigate the relationship of rScO2 and rSrO2 to cardiac output (CO), blood pressure (BP), and biochemical variables 30 min and 4 h after ROSC...
April 6, 2017: Neonatology
https://www.readbyqxmd.com/read/28368387/retroelement-guided-protein-diversification-abounds-in-vast-lineages-of-bacteria-and-archaea
#11
Blair G Paul, David Burstein, Cindy J Castelle, Sumit Handa, Diego Arambula, Elizabeth Czornyj, Brian C Thomas, Partho Ghosh, Jeff F Miller, Jillian F Banfield, David L Valentine
Major radiations of enigmatic Bacteria and Archaea with large inventories of uncharacterized proteins are a striking feature of the Tree of Life(1-5). The processes that led to functional diversity in these lineages, which may contribute to a host-dependent lifestyle, are poorly understood. Here, we show that diversity-generating retroelements (DGRs), which guide site-specific protein hypervariability(6-8), are prominent features of genomically reduced organisms from the bacterial candidate phyla radiation (CPR) and as yet uncultivated phyla belonging to the DPANN (Diapherotrites, Parvarchaeota, Aenigmarchaeota, Nanoarchaeota and Nanohaloarchaea) archaeal superphylum...
April 3, 2017: Nature Microbiology
https://www.readbyqxmd.com/read/28355299/mild-hypothermia-alleviates-brain-oedema-and-blood-brain-barrier-disruption-by-attenuating-tight-junction-and-adherens-junction-breakdown-in-a-swine-model-of-cardiopulmonary-resuscitation
#12
Jiebin Li, Chunsheng Li, Wei Yuan, Junyuan Wu, Jie Li, Zhenhua Li, Yongzhen Zhao
Mild hypothermia improves survival and neurological recovery after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). However, the mechanism underlying this phenomenon is not fully elucidated. The aim of this study was to determine whether mild hypothermia alleviates early blood-brain barrier (BBB) disruption. We investigated the effects of mild hypothermia on neurologic outcome, survival rate, brain water content, BBB permeability and changes in tight junctions (TJs) and adherens junctions (AJs) after CA and CPR...
2017: PloS One
https://www.readbyqxmd.com/read/28353609/assessing-practical-skills-in-cardiopulmonary-resuscitation-discrepancy-between-standard-visual-evaluation-and-a-mechanical-feedback-device
#13
Baltasar Sánchez González, Laura Martínez, Manel Cerdà, Enrique Piacentini, Josep Trenado, Salvador Quintana
This paper aims to analyze agreement in the assessment of external chest compressions (ECC) by 3 human raters and dedicated feedback software.While 54 volunteer health workers (medical transport technicians), trained and experienced in cardiopulmonary resuscitation (CPR), performed a complete sequence of basic CPR maneuvers on a manikin incorporating feedback software (Laerdal PC v 4.2.1 Skill Reporting Software) (L), 3 expert CPR instructors (A, B, and C) visually assessed ECC, evaluating hand placement, compression depth, chest decompression, and rate...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28347320/life-threatening-massive-pulmonary-embolism-rescued-by-venoarterial-extracorporeal-membrane-oxygenation
#14
Fillipo Corsi, Guillaume Lebreton, Nicolas Bréchot, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Charles-Edouard Luyt, Pascal Leprince, Jean Chastre, Alain Combes, Matthieu Schmidt
BACKGROUND: Despite quick implementation of reperfusion therapies, a few patients with high-risk, acute, massive, pulmonary embolism (PE) remain highly hemodynamically unstable. Others have absolute contraindication to receive reperfusion therapies. Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) might lower their right ventricular overload, improve hemodynamic status, and restore tissue oxygenation. METHODS: ECMO-related complications and 90-day mortality were analyzed for 17 highly unstable, ECMO-treated, massive PE patients admitted to a tertiary-care center (2006-2015)...
March 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28322600/renal-mitochondrial-response-to-low-temperature-in-non-hibernating-and-hibernating-species
#15
George J Dugbartey, Maarten C Hardenberg, Wendelinde F Kok, Ate Boerema, Hannah V Carey, James Staples, Robert H Henning, Hjalmar Bouma
SIGNIFICANCE: Therapeutic hypothermia is commonly applied to limit ischemic injury in organ transplantation, during cardiac and brain surgery and after cardiopulmonary resuscitation. In these procedures, the kidneys are particularly at risk for ischemia/reperfusion injury (IRI), likely due to their high rate of metabolism. Although hypothermia mitigates ischemic kidney injury, it is not a panacea. Residual mitochondrial failure is thought to be a key event triggering loss of cellular homeostasis, and potentially cell death...
March 21, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28291665/cardiac-arrest-in-acute-myocardial-infarction-concept-of-circulatory-support-with-mechanical-chest-compression-and-impella-to-facilitate-percutaneous-coronary-intervention
#16
Kaleab N Asrress, Maciej Marciniak, Natalia Briceno, Divaka Perera
Cardiogenic shock in the context of acute ST-elevation myocardial infarction (STEMI) remains a challenge to manage and results in significant mortality and morbidity, cardiac arrest in this setting even more so. The increase in myocardial oxygen demand and consumption with the use of inotropes is recognised as increasing mortality. Alternatives include the intra-aortic balloon pump (IABP), which has yet to be shown to improve outcomes, and extracorporeal membrane oxygenation (ECMO), which requires super-specialised techniques not widely available...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28288575/lactobacillus-derived-extracellular-vesicles-enhance-host-immune-responses-against-vancomycin-resistant-enterococci
#17
Ming Li, Kiho Lee, Min Hsu, Gerard Nau, Eleftherios Mylonakis, Bharat Ramratnam
BACKGROUND: Probiotic bacteria are known to modulate host immune responses against various pathogens. Recently, extracellular vesicles (EVs) have emerged as potentially important mediators of host-pathogen interactions. In this study, we explored the role of L. plantarum derived EVs in modulating host responses to vancomycin-resistant Enterococcus faecium (VRE) using both Caenorhabditis elegans and human cells. RESULTS: Our previous work has shown that probiotic conditioning C...
March 14, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#18
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28274560/antithrombin-iii-is-associated-with-acute-liver-failure-in-patients-with-end-stage-heart-failure-undergoing-mechanical-circulatory-support
#19
Judith Hoefer, Hanno Ulmer, Juliane Kilo, Raimund Margreiter, Michael Grimm, Peter Mair, Elfriede Ruttmann
OBJECTIVE: There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. METHODS: A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28265880/study-design-and-rationale-of-a-multicenter-open-labeled-randomized-controlled-trial-comparing-midazolam-versus-morphine-in-acute-pulmonary-edema-mimo-trial
#20
Alberto Dominguez-Rodriguez, Guillermo Burillo-Putze, Maria Del Mar Garcia-Saiz, Ana Aldea-Perona, Magali González-Colaço Harmand, Oscar Mirò, Pedro Abreu-Gonzalez
PURPOSE: Morphine has been used for several decades in cases of acute pulmonary edema (APE) due to the anxiolytic and vasodilatory properties of the drug. The non-specific depression of the central nervous system is probably the most significant factor for the changes in hemodynamics in APE. Retrospective studies have shown both negative and neutral effects in patients with APE and therefore some authors have suggested benzodiazepines as an alternative treatment. The use of intravenous morphine in the treatment of APE remains controversial...
March 7, 2017: Cardiovascular Drugs and Therapy
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