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https://www.readbyqxmd.com/read/28988724/antiarrhythmics-in-cardiac-arrest-a-systematic-review-and-meta-analysis
#1
REVIEW
Amelia Chowdhury, Brian Fernandes, Thomas M Melhuish, Leigh D White
INTRODUCTION: It is widely accepted that antiarrhythmics play a role in cardiopulmonary resuscitation (CPR) universally, but the absolute benefit of antiarrhythmic use and the drug of choice in advanced life support remains controversial. AIM: To perform a thorough, in-depth review and analysis of current literature to assess the efficacy of antiarrhythmics in advanced life support. MATERIAL AND METHODS: Two authors systematically searched through multiple bibliographic databases including CINAHL, SCOPUS, PubMed, Web of Science, Medline(Ovid) and the Cochrane Clinical Trials Registry...
August 23, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28910187/sternal-route-more-effective-than-tibial-route-for-intraosseous-amiodarone-administration-in-a-swine-model-of-ventricular-fibrillation
#2
James M Burgert, Andre Martinez, Mara O'Sullivan, Dawn Blouin, Audrey Long, Arthur D Johnson
OBJECTIVE: The pharmacokinetics of IO administered lipid soluble amiodarone during ventricular fibrillation (VF) with ongoing CPR are unknown. This study measured mean plasma concentration over 5 minutes, maximum plasma concentration (Cmax), and time to maximum concentration (Tmax) of amiodarone administered by the sternal IO (SIO), tibial IO (TIO), and IV routes in a swine model of VF with ongoing CPR. METHODS: Twenty-one Yorkshire-cross swine were randomly assigned to three groups: SIO, TIO, and IV...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-nonshockable-turned-shockable-out-of-hospital-cardiac-arrest-the-alps-study-amiodarone-lidocaine-or-placebo
#3
RANDOMIZED CONTROLLED TRIAL
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) commonly presents with nonshockable rhythms (asystole and pulseless electric activity). It is unknown whether antiarrhythmic drugs are safe and effective when nonshockable rhythms evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia [VF/VT]) during resuscitation. METHODS: Adults with nontraumatic OHCA, vascular access, and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine, or placebo by paramedics...
November 28, 2017: Circulation
https://www.readbyqxmd.com/read/28862480/national-characteristics-of-emergency-medical-services-responses-for-older-adults-in-the-united-states
#4
Hieu V Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E Jacobson, Jestin N Carlson, N Clay Mann, Henry E Wang
OBJECTIVE: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. METHODS: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses...
September 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28376849/effect-of-an-interactive-cardiopulmonary-resuscitation-assist-device-with-an-automated-external-defibrillator-synchronised-with-a-ventilator-on-the-cpr-performance-of-emergency-medical-service-staff-a-randomised-simulation-study
#5
RANDOMIZED CONTROLLED TRIAL
Rainer Nitzschke, Christoph Doehn, Jan F Kersten, Julian Blanz, Tobias J Kalwa, Norman A Scotti, Jens C Kubitz
BACKGROUND: The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. METHODS: We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design...
April 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28140440/the-effects-of-tibial-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-cardiac-arrest-procine-model
#6
Kathryn Hampton, Eric Wang, Jerome Ivan Argame, Tom Bateman, William Craig, Don Johnson
OBJECTIVE: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28098197/dantrolene-versus-amiodarone-for-cardiopulmonary-resuscitation-a-randomized-double-blinded-experimental-study
#7
Thomas Wiesmann, Dennik Freitag, Wolfgang Dersch, Daphne Eschbach, Marc Irqsusi, Thorsten Steinfeldt, Hinnerk Wulf, Carsten Feldmann
Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg(-1), dantrolene 2...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27412906/minnesota-resuscitation-consortium-s-advanced-perfusion-and-reperfusion-cardiac-life-support-strategy-for-out-of-hospital-refractory-ventricular-fibrillation
#8
Demetris Yannopoulos, Jason A Bartos, Cindy Martin, Ganesh Raveendran, Emil Missov, Marc Conterato, R J Frascone, Alexander Trembley, Kevin Sipprell, Ranjit John, Stephen George, Kathleen Carlson, Melissa E Brunsvold, Santiago Garcia, Tom P Aufderheide
BACKGROUND: In 2015, the Minnesota Resuscitation Consortium (MRC) implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory ventricular fibrillation/ventricular tachycardia (VF/VT). We report the outcomes of the initial 3-month period of operations. METHODS AND RESULTS: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol...
June 13, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27405926/the-cpr-outcomes-of-online-medical-video-instruction-versus-on-scene-medical-instruction-using-simulated-cardiac-arrest-stations
#9
Chaiyaporn Yuksen, Sorravit Sawatmongkornkul, Jarupol Tuangsirisup, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
BACKGROUND: Non-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures. There are limited data on the effects of telemedicine in cardiac arrest situations in the literature particularly in Asian settings. METHODS: This study was conducted by using two simulated cardiac arrest stations during the 2014 annual Thai national conference in emergency medicine...
July 12, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27296956/sex-differences-in-the-prehospital-management-of-out-of-hospital-cardiac-arrest
#10
Bryn E Mumma, Temur Umarov
BACKGROUND: Sex differences exist in the diagnosis and treatment of several cardiovascular diseases. Our objective was to determine whether sex differences exist in the use of guideline-recommended treatments in out-of-hospital cardiac arrest (OHCA). METHODS: We included adult patients with non-traumatic OHCA treated by emergency medical services (EMS) in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed (ROC PRIMED) database during 2007-2009...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/26145169/nifekalant-versus-amiodarone-in-the-treatment-of-cardiac-arrest-an-experimental-study-in-a-swine-model-of-prolonged-ventricular-fibrillation
#11
COMPARATIVE STUDY
George Karlis, Nicoletta Iacovidou, Pavlos Lelovas, Panagiota Niforopoulou, Apostolos Papalois, Ioanna Siafaka, Spyros Mentzelopoulos, Theodoros Xanthos
PURPOSE: The purpose of the experiment was to compare the effects of nifekalant and amiodarone on the return of spontaneous circulation (ROSC), survival, as well as on the hemodynamic parameters in a swine model of prolonged ventricular fibrillation (VF). METHODS: After 8 min of untreated VF, bolus doses of epinephrine (adrenaline) and either nifekalant, or amiodarone, or saline (n = 10 per group), were administered after randomization. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration and defibrillation was attempted 2 min later...
2015: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/25033747/use-of-esmolol-after-failure-of-standard-cardiopulmonary-resuscitation-to-treat-patients-with-refractory-ventricular-fibrillation
#12
Brian E Driver, Guillaume Debaty, David W Plummer, Stephen W Smith
INTRODUCTION: We compare the outcomes for patients who received esmolol to those who did not receive esmolol during refractory ventricular fibrillation (RVF) in the emergency department (ED). METHODS: A retrospective investigation in an urban academic ED of patients between January 2011 and January 2014 of patients with out-of-hospital or ED cardiac arrest (CA) with an initial rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT) who received at least three defibrillation attempts, 300mg of amiodarone, and 3mg of adrenaline, and who remained in CA upon ED arrival...
October 2014: Resuscitation
https://www.readbyqxmd.com/read/24854308/resuscitation-with-amiodarone-increases-survival-after-hemorrhage-and-ventricular-fibrillation-in-pigs
#13
Frank Zoerner, Egidijus Semenas
UNLABELLED: Supplemental digital content is available in the text. BACKGROUND: The aim of this experimental study was to compare survival and hemodynamic effects of a low-dose amiodarone and vasopressin compared with vasopressin in hypovolemic cardiac arrest model in piglets. METHODS: Eighteen anesthetized male piglets (with a weight of 25.3 [1.8] kg) were bled approximately 30% of the total blood volume via the femoral artery to a mean arterial blood pressure of 35 mm Hg in a 15-minute period...
June 2014: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/24766974/resuscitation-outcomes-consortium-amiodarone-lidocaine-or-placebo-study-roc-alps-rationale-and-methodology-behind-an-out-of-hospital-cardiac-arrest-antiarrhythmic-drug-trial
#14
RANDOMIZED CONTROLLED TRIAL
Peter J Kudenchuk, Siobhan P Brown, Mohamud Daya, Laurie J Morrison, Brian E Grunau, Tom Rea, Tom Aufderheide, Judy Powell, Brian Leroux, Christian Vaillancourt, Jonathan Larsen, Lynn Wittwer, M Riccardo Colella, Shannon W Stephens, Mark Gamber, Debra Egan, Paul Dorian
BACKGROUND: Despite their wide use, whether antiarrhythmic drugs improve survival after out-of-hospital cardiac arrest (OHCA) is not known. The ROC-ALPS is evaluating the effectiveness of these drugs for OHCA due to shock-refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/VT). METHODS: ALPS will randomize 3,000 adults across North America with nontraumatic OHCA, persistent or recurring VF/VT after ≥1 shock, and established vascular access to receive up to 450 mg amiodarone, 180 mg lidocaine, or placebo in the field using a double-blind protocol, along with standard resuscitation measures...
May 2014: American Heart Journal
https://www.readbyqxmd.com/read/24698471/outcomes-by-rescue-shock-number-during-the-metabolic-phase-of-porcine-ventricular-fibrillation-resuscitation
#15
Ryan A Coute, Timothy J Mader, Lawrence D Sherman
BACKGROUND: Optimal resuscitation duration before the first rescue shock (RS) to maximize the probability of success after prolonged ventricular fibrillation (VF) cardiac arrest remains unknown. The purpose of this study was to determine the occurrence of return of spontaneous circulation (ROSC) and survival by RS attempt after 12 minutes of untreated VF. METHODS: This was a secondary analysis of prospectively collected data from an institutional animal care and use committee-approved protocol...
June 2014: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24580085/adrenaline-increases-blood-brain-barrier-permeability-after-haemorrhagic-cardiac-arrest-in-immature-pigs
#16
E Semenas, H S Sharma, L Wiklund
BACKGROUND: Adrenaline (ADR) and vasopressin (VAS) are used as vasopressors during cardiopulmonary resuscitation. Data regarding their effects on blood-brain barrier (BBB) integrity and neuronal damage are lacking. We hypothesised that VAS given during cardiopulmonary resuscitation (CPR) after haemorrhagic circulatory arrest will preserve BBB integrity better than ADR. METHODS: Twenty-one anaesthetised sexually immature male piglets (with a weight of 24.3 ± 1.3 kg) were bled 35% via femoral artery to a mean arterial blood pressure of 25 mmHg in the period of 15 min...
May 2014: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/24463222/hypertonic-saline-infusion-during-resuscitation-from-out-of-hospital-cardiac-arrest-a-matched-pair-study-from-the-german-resuscitation-registry
#17
Christopher Hahn, Martin Breil, Jens Christian Schewe, Martin Messelken, Stefan Rauch, Jan Thorsten Gräsner, Jan Wnent, Stephan Seewald, Andreas Bohn, Matthias Fischer
AIM: Survival rates after out-of-hospital-cardiac-arrest (OHCA) differ widely between EMS systems. Since hypertonic saline appears to improve long-term outcome after OHCA, some local EMS systems have included it in their treatment protocols for OHCA. Our first aim was to give a quality review of one of these protocols. Our second aim was to assess whether short-term survival improves when hypertonic saline is used in resuscitation after OHCA. METHODS: Matched pairs were identified for the independent "return of spontaneous circulation (ROSC) after cardiac arrest" (RACA) score variables and for use of ACD-CPR, adrenaline, and amiodarone from the German Resuscitation Registry (GRR) for January 2000 to March 2011...
May 2014: Resuscitation
https://www.readbyqxmd.com/read/24462025/double-simultaneous-defibrillators-for-refractory-ventricular-fibrillation
#18
Benjamin W Leacock
BACKGROUND: Out-of-hospital cardiac arrest is a leading cause of death in the United States. Ventricular fibrillation (VF) is the most common initial rhythm after cardiac arrest. OBJECTIVE: To describe a novel approach to the patient with intractable VF after cardiac arrest. CASE REPORT: A 51-year old man presented in cardiac arrest after a ST-elevation myocardial infarction. He remained in VF despite receiving typical therapy including cardiopulmonary resuscitation, amiodarone, lidocaine, epinephrine, and five attempts at defibrillation with 200 J using a biphasic defibrillator...
April 2014: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24361455/outcomes-associated-with-amiodarone-and-lidocaine-in-the-treatment-of-in-hospital-pediatric-cardiac-arrest-with-pulseless-ventricular-tachycardia-or-ventricular-fibrillation
#19
Santiago O Valdes, Aaron J Donoghue, Derek B Hoyme, Rachel Hammond, Marc D Berg, Robert A Berg, Ricardo A Samson
AIM: To determine the association between amiodarone and lidocaine and outcomes in children with cardiac arrest with pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF). BACKGROUND: Current AHA guidelines for CPR and emergency cardiovascular care recommend amiodarone for cardiac arrest in children associated with shock refractory pVT/VF, based on a single pediatric study and extrapolation from adult data. METHODS: Retrospective cohort study from the Get With the Guidelines-Resuscitation database for in-patient cardiac arrest...
March 2014: Resuscitation
https://www.readbyqxmd.com/read/24341695/effects-of-early-amiodarone-administration-during-and-immediately-after-cardiopulmonary-resuscitation-in-a-swine-model
#20
G Karlis, N Iacovidou, P Lelovas, P Niforopoulou, A Zacharioudaki, A Papalois, K Sunde, P A Steen, T Xanthos
BACKGROUND: Aim of this experimental study was to compare haemodynamic effects and outcome with early administration of amiodarone and adrenaline vs. adrenaline alone in pigs with prolonged ventricular fibrillation (VF). METHODS: After 8 min of untreated VF arrest, bolus doses were administered of adrenaline (0.02 mg/kg) and either amiodarone (5 mg/kg) or saline (n = 8 per group) after randomisation. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration, and defibrillation was attempted 2 min later...
January 2014: Acta Anaesthesiologica Scandinavica
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