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https://www.readbyqxmd.com/read/27887820/real-time-tidal-volume-feedback-guides-optimal-ventilation-during-simulated-cardiopulmonary-resuscitation
#1
Kyoung Min You, Chiwon Lee, Woon Yong Kwon, Jung Chan Lee, Gil Joon Suh, Kyung Su Kim, Min Ji Park, Sungwan Kim
PURPOSE: We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR). BASIC PROCEDURES: We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes. We conducted a randomized, crossover, manikin-simulation study in which 14 participants were randomly divided into a control (without tidal volume feedback, n = 7) and a TVD group (with real-time tidal volume feedback, n = 7) and underwent manikin simulation...
November 4, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886777/characteristics-of-patients-who-are-not-resuscitated-in-out-of-hospital-cardiac-arrests-and-opportunities-to-improve-community-response-to-cardiac-arrest
#2
S Rajagopal, C R Kaye, R Lall, C D Deakin, S Gates, H Pocock, T Quinn, N Rees, M Smyth, G D Perkins
AIM: This study explores why resuscitation is withheld when emergency medical staff arrive at the scene of a cardiac arrest and identifies modifiable factors associated with this decision. METHODS: This is a secondary analysis of unselected patients who sustained an out of hospital cardiac arrest attended by ambulance vehicles participating in a randomized controlled trial of a mechanical chest compression device (PARAMEDIC trial). Patients were categorized as 'non-resuscitation' patients if there was a do-not-attempt-cardiopulmonary-resuscitation (DNACPR) order, signs unequivocally associated with death or resuscitation was deemed futile (15min had elapsed since collapse with no bystander-CPR and asystole recorded on EMS arrival)...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27864126/the-use-of-life-sustaining-procedures-in-the-last-month-of-life-is-associated-with-more-depressive-symptoms-in-surviving-spouses
#3
Katherine A Ornstein, Melissa D Aldridge, Melissa M Garrido, Rebecca Gorges, Evan Bollens-Lund, Albert L Siu, Kenneth M Langa, Amy S Kelley
CONTEXT: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression. OBJECTIVE: To determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses. METHODS: We used data from the Health and Retirement Study, a longitudinal survey of U...
November 15, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27856490/prevalence-and-contents-of-advance-directives-of-patients-with-esrd-receiving-dialysis
#4
Molly A Feely, Daniel Hildebrandt, Jithinraj Edakkanambeth Varayil, Paul S Mueller
BACKGROUND AND OBJECTIVES: ESRD requiring dialysis is associated with increased morbidity and mortality rates, including increased rates of cognitive impairment, compared with the general population. About one quarter of patients receiving dialysis choose to discontinue dialysis at the end of life. Advance directives are intended to give providers and surrogates instruction on managing medical decision making, including end of life situations. The prevalence of advance directives is low among patients receiving dialysis...
November 17, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27849657/long-term-follow-up-on-health-related-quality-of-life-after-mechanical-circulatory-support-in-children
#5
Thilo P K Fleck, Georg Dangel, Felix Bächle, Christoph Benk, Jochen Grohmann, Johannes Kroll, Matthias Siepe, Rene Höhn, Janbernd Kirschner, Friedhelm Beyersdorf, Brigitte Stiller
OBJECTIVE: The objective of this study was to evaluate health-related quality of life in long-term survivors of mechanical circulatory support after acute cardiopulmonary failure. DESIGN: Prospective follow-up study. SETTING: Single-institutional in a center for congenital heart disease and pediatric cardiology. PATIENTS: Fifty patients who underwent 58 mechanical circulatory support therapies in our institution from 2001 to 2012...
November 15, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27846895/development-and-validation-of-a-prehospital-prediction-model-for-acute-traumatic-coagulopathy
#6
Ithan D Peltan, Ali Rowhani-Rahbar, Lisa K Vande Vusse, Ellen Caldwell, Thomas D Rea, Ronald V Maier, Timothy R Watkins
BACKGROUND: Acute traumatic coagulopathy (ATC) is a syndrome of early, endogenous clotting dysfunction that afflicts up to 30% of severely injured patients, signaling an increased likelihood of all-cause and hemorrhage-associated mortality. To aid identification of patients within the likely therapeutic window for ATC and facilitate study of its mechanisms and targeted treatment, we developed and validated a prehospital ATC prediction model. METHODS: Construction of a parsimonious multivariable logistic regression model predicting ATC - defined as an admission international normalized ratio >1...
November 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27826709/risk-factors-for-cardiac-arrest-or-mechanical-circulatory-support-in-children-with-fulminant-myocarditis
#7
Joseph R Casadonte, Mjaye L Mazwi, Katheryn E Gambetta, Hannah L Palac, Mary E McBride, Osama M Eltayeb, Michael C Monge, Carl L Backer, John M Costello
In children with fulminant myocarditis (FM), we sought to describe presenting characteristics and clinical outcomes, and identify risk factors for cardiac arrest and mechanical circulatory support (MCS). A retrospective review of patients with FM admitted at our institution between January 1, 2004, and June 31, 2015, was performed. We compared characteristics and outcomes of FM patients who received cardiopulmonary resuscitation (CPR) and/or were placed on MCS (CPR/MCS group) to those who did not develop these outcomes (Control group)...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27810565/frequency-and-predictors-of-acute-hospitalization-before-death-in-patients-with-glioblastoma
#8
Eli L Diamond, Katherine S Panageas, Alexis Dallara, Ariel Pollock, Allison J Applebaum, Alan C Carver, Elena Pentsova, Lisa M DeAngelis, Holly G Prigerson
CONTEXT: Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life (EOL) are almost invariably a matter of "when," not a matter of "if". Optimizing symptom management and quality of life in later stages of disease is of the utmost priority. OBJECTIVES: To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM. METHODS: Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission...
October 31, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27809884/diffuse-persistent-pulmonary-interstitial-emphysema-secondary-to-mechanical-ventilation-in-bronchiolitis
#9
Blanca Toledo Del Castillo, Isabel Gordillo, Elena Rubio García, Sarah Nicole Fernández Lafever, Rafael Gonzalez Cortés, Javier Urbano Villaescusa, Jorge López González, María José Solana García, Jesús López-Herce Cid
BACKGROUND: Persistent interstitial pulmonary emphysema (PIE) is a rare disease and it is even more uncommon in full-term infants, like our patient. When conservative management is not successful, surgical treatment should be considered. In our case, ECMO support was iniciated to keep the patient ventilated in order to allow the lung to heal using lung protection strategies. CASE PRESENTATION: We report an 18-day-old male infant with bronchiolitis that required mechanical ventilation with high positive airway pressures due to severe respiratory insufficiency...
November 3, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27789242/observed-long-term-mortality-after-18-000-person-years-among-survivors-in-a-large-regional-drowning-registry
#10
Joshua C Reynolds, Erica A Michiels, Mojdeh Nasiri, Mathew J Reeves, Linda Quan
AIM: Long-term outcomes beyond one year after non-fatal drowning are uncharacterized. We estimated long-term mortality and identified prognostic factors in a large, population-based cohort. METHODS: Population-based prospective cohort study (1974-1996) of Western Washington Drowning Registry (WWDR) subjects surviving the index drowning through hospital discharge. Primary outcome was all-cause mortality through 2012. We tabulated Utstein-style exposure variables, estimated Kaplan-Meier curves, and identified prognostic factors with Cox proportional hazard modeling...
October 24, 2016: Resuscitation
https://www.readbyqxmd.com/read/27785135/determinants-of-unfavorable-prognosis-for-out-of-hospital-sudden-cardiac-arrest-in-bielsko-biala-district
#11
Dariusz Gach, Jolanta U Nowak, Łukasz J Krzych
INTRODUCTION: The prognosis in out-of-hospital sudden cardiac arrest (OHCA) remains unfavorable and depends on a number of demographic and clinical variables, the reversibility of its causes and its mechanisms. AIM: To investigate the risk factors of prehospital death in patients with OHCA in Bielsko County. MATERIAL AND METHODS: The study analyzed all dispatch cards of the National Emergency Medical Services (EMS) teams in Bielsko-Biala for the year 2013 (n = 23 400)...
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27774445/ecls-in-pediatric-cardiac-patients
#12
Matteo Di Nardo, Graeme MacLaren, Marco Marano, Corrado Cecchetti, Paola Bernaschi, Antonio Amodeo
Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27763916/hemodynamic-instability-following-airway-spray-cryotherapy
#13
Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27761759/caring-for-critically-ill-oldest-old-patients-a-clinical-review
#14
Nicola Vargas, Loredana Tibullo, Emanuela Landi, Giovanni Carifi, Alfonso Pirone, Antonio Pippo, Immacolata Alviggi, Renato Tizzano, Elisa Salsano, Francesco Di Grezia, Maria Vargas
Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity...
October 19, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27760561/acute-transfusion-related-abdominal-injury-in-trauma-patients-a-case-report
#15
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27756513/cardiopulmonary-resuscitation-using-the-lifeline-arm-mechanical-chest-compression-device-a-randomized-crossover-manikin-trial
#16
Lukasz Szarpak, Zenon Truszewski, Lukasz Czyzewski, Michael Frass, Oliver Robak
INTRODUCTION: European Resuscitation Council as well as American Heart Association guidelines for cardiopulmonary resuscitation (CPR) stress the importance of uninterrupted and effective chest compressions (CCs). Manual CPR decreases in quality of CCs over time because of fatigue which impacts outcome. We report the first study with the Lifeline ARM automated CC device for providing uninterrupted CCs. METHODS: Seventy-eight paramedics participated in this randomized, crossover, manikin trial...
October 7, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27725100/fulminant-myocarditis-as-a-primary-manifestation-of-h1n1-infection-a-first-reported-case-from-serbia
#17
Goran Davidović, Stefan Simović, Slobodanka Mitrović, Violeta Irić-Ćupić, Vladimir Miloradović
A 19-year-old male was admitted to our clinic with a diagnosis of suspected acute pericarditis and acute coronary syndrome. The initial diagnostics at our clinic revealed fulminant myocarditis. Twenty-four hours after admission, the patient's condition deteriorated, and he required mechanical ventilation and cardiopulmonary resuscitation. Unfortunately, the patient died. Clinical course, postmortem pathohistological findings and virus serology indicated that an H1N1 viral caused fulminant myocarditis and was the primary manifestation...
May 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27714400/-technical-assist-devices-perspectives-and-new-developments
#18
C Wallmüller, P Stratil, A Schober
The development of technical assist devices in the context of cardiopulmonary resuscitation (CPR) reaches back to the early roots of modern resuscitation research. This article covers the subjects of extracorporeal CPR (ECPR), including extracorporeal life support (ECLS), emergency ECLS (EECLS) and mechanical resuscitation devices. Specifically, the potential use of active compression-decompression CPR (ACD-CPR), impedance threshold devices (ITD) and capnography as additional measures during resuscitation are described in detail...
October 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27701901/increased-cognitive-problem-reporting-after-information-about-chemotherapy-induced-cognitive-decline-the-moderating-role-of-stigma-consciousness
#19
Wendy W Jacobs, Enny H H J Das, Sanne S B Schagen
OBJECTIVE: Information about treatment side effects can increase their occurrence; breast cancer (BC) patients showed increased cognitive problem reporting (CPR) and decreased memory performance after information about cognitive side effects. The current study extends previous research on Adverse Information Effects (AIE) by investigating (a) risk factors, (b) underlying mechanisms, and (c) an intervention to reduce AIE. DESIGN: In an online experiment, 175 female BC patients were randomly assigned to one of three conditions...
October 4, 2016: Psychology & Health
https://www.readbyqxmd.com/read/27694796/mild-hypothermia-protects-pigs-gastric-mucosa-after-cardiopulmonary-resuscitation-via-inhibiting-interleukin-6-il-6-production
#20
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
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