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https://www.readbyqxmd.com/read/29331682/post-mortem-tryptase-cut-off-level-for-anaphylactic-death
#1
R Tse, C X Wong, K Kesha, J Garland, Y Tran, S Anne, H Elstub, A D Cala, C Palmiere, K L Patchett
Serum mast cell tryptase is used to support the diagnosis of anaphylaxis. The recommended clinical cut-off for total tryptase (<11.4μg/L) appears unsuitable in the post mortem setting due to largely unknown processes which result in significantly elevated levels in these samples. Consequently there is no widely accepted tryptase cut-off level for diagnosing an anaphylactic death. This 5-year retrospective study compared total tryptase levels in post mortem femoral blood in anaphylactic deaths and control...
December 28, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29331650/echocardiographic-patterns-of-postresuscitation-myocardial-dysfunction
#2
Kyoung-Chul Cha, Hyung Il Kim, Oh Hyun Kim, Yong Sung Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
BACKGROUND: Postresuscitation myocardial dysfunction (PRMD) can develop after successful resuscitation from cardiac arrest. However, echocardiographic patterns of PRMD remain unknown. This study aimed to investigate PRMD manifestations with serial echocardiography during the post-cardiac arrest period. METHODS: We enrolled non-traumatic out-of-hospital cardiac arrest patients older than 19 years who underwent successful cardiopulmonary resuscitation (CPR). We excluded patients with myocardial infarction or pre-existing cardiac disease, including heart failure or myocardial disease...
January 11, 2018: Resuscitation
https://www.readbyqxmd.com/read/29325421/effects-of-underwater-bubble-cpap-on-very-low-birth-weight-preterm-newborns-in-the-delivery-room-and-after-transport-to-the-neonatal-intensive-care-unit
#3
Vera Lucia Barros Abelenda, Tania Cristina Oliveira Valente, Cirlene Lima Marinho, Agnaldo José Lopes
The development of less invasive ventilatory strategies in very-low-birth-weight (VLBW) preterm newborns has been a growing concern in recent decades. This study aimed to measure differences in the clinical progression of preterm newborns using two distinct periods in a university hospital: before and after using underwater bubble continuous positive airway pressure (ubCPAP). This is a retrospective study of VLBW preterm newborns with gestational ages less than or equal to 32 weeks admitted to the neonatal intensive care unit...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29323705/the-protective-effects-of-distal-ischemic-treatment-on-apoptosis-and-mitochondrial-permeability-in-the-hippocampus-after-cardiopulmonary-resuscitation
#4
Xiang Zhou, Liu Yong, Yang Huang, ShuiBo Zhu, XiaoYang Song, BiXi Li, Jian Zhu, HaiBo Wang
BACKGROUND: Apoptosis and mitochondrial dysfunction are the main cause of neurological injury after cardiopulmonary resuscitation (CPR). However, the effects of distal ischemic treatments on ischemia-induced apoptosis are rarely studied, and the mechanism by which mitochondrial dysfunction contributes to CPR still unclear. METHODS: A rat model of distal ischemia was established by clipping the right femoral artery. Rats were divided into blank, model, pre-distal ischemic treatment, per-treatment, and post-treatment groups...
January 11, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29323039/neuronal-injury-and-tumor-necrosis-factor-alpha-immunoreactivity-in-the-rat-hippocampus-in-the-early-period-of-asphyxia-induced-cardiac-arrest-under-normothermia
#5
Hyun-Jin Tae, Il Jun Kang, Tae-Kyeong Lee, Jeong Hwi Cho, Jae-Chul Lee, Myoung Cheol Shin, Yoon Sung Kim, Jun Hwi Cho, Jong-Dai Kim, Ji Hyeon Ahn, Joon Ha Park, In-Shik Kim, Hyang-Ah Lee, Yang Hee Kim, Moo-Ho Won, Young Joo Lee
Low survival rate occurs in patients who initially experience a spontaneous return of circulation after cardiac arrest (CA). In this study, we induced asphyxial CA in adult male Sprague-Daley rats, maintained their body temperature at 37 ± 0.5°C, and then observed the survival rate during the post-resuscitation phase. We examined neuronal damage in the hippocampus using cresyl violet (CV) and Fluore-Jade B (F-J B) staining, and pro-inflammatory response using ionized calcium-binding adapter molecule 1 (Iba-1), glial fibrillary acidic protein (GFAP), and tumor necrosis factor-alpha (TNF-α) immunohistochemistry in the hippocampus after asphyxial CA in rats under normothermia...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29317350/duration-of-cardiopulmonary-resuscitation-in-patients-without-prehospital-return-of-spontaneous-circulation-after-out-of-hospital-cardiac-arrest-results-from-a-severity-stratification-analysis
#6
Akira Funada, Yoshikazu Goto, Hayato Tada, Ryota Teramoto, Masaya Shimojima, Kenshi Hayashi, Masa-Aki Kawashiri, Masakazu Yamagishi
BACKGROUND: The relationship between duration of cardiopulmonary resuscitation (CPR) and post-arrest outcomes based on severity stratification in out-of-hospital cardiac arrest (OHCA) patients without prehospital return of spontaneous circulation (ROSC) remains unclear. METHODS: We analysed 420,959 adult patients without prehospital ROSC in the All-Japan OHCA registry for 4 years. Prehospital CPR duration was defined as the time from CPR initiation by emergency medical service (EMS) providers to hospital arrival...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29317348/paediatric-in-hospital-cardiac-arrest-factors-associated-with-survival-and-neurobehavioural-outcome-one-year-later
#7
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, John Berger, George Ofori-Amanfo, Christopher J L Newth, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate clinical characteristics associated with 12-month survival and neurobehavioural function among children recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital trial. METHODS: Children (n = 329) with in-hospital cardiac arrest who received chest compressions for ≥2 minutes, were comatose, and required mechanical ventilation after return of circulation were included. Neurobehavioural function was assessed using the Vineland Adaptive Behaviour Scale, second edition (VABS-II) at baseline (reflecting pre-arrest status) and 12 months post-arrest...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29315458/implementation-and-effectiveness-of-a-video-based-debriefing-programme-for-neonatal-resuscitation
#8
C Skåre, T E Calisch, E Saeter, T Rajka, A M Boldingh, B Nakstad, D E Niles, J Kramer-Johansen, T M Olasveengen
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29312849/do-not-resuscitate-status-as-an-independent-risk-factor-for-patients-undergoing-surgery-for-hip-fracture
#9
Ethan Y Brovman, Andrew J Pisansky, Anair Beverly, Angela M Bader, Richard D Urman
AIM: To determine morbidity and mortality in hip fracture patients and also to assess for any independent associations between Do-Not-Resuscitate (DNR) status and increased post-operative morbidity and mortality in patients undergoing surgical repair of hip fractures. METHODS: We conducted a propensity score matched retrospective analysis using de-identified data from the American College of Surgeons' National Surgical Quality Improvement Project (ACS NSQIP) for all patients undergoing hip fracture surgery over a 7 year period in hospitals across the United States enrolled in the ACS NSQIP with and without DNR status...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29301757/prior-medications-and-the-cardiovascular-benefits-from-combination-angiotensin-converting-enzyme-inhibition-plus-calcium-channel-blockade-among-high-risk-hypertensive-patients
#10
Robert D Brook, Niko Kaciroti, George Bakris, Björn Dahlöf, Bertram Pitt, Eric Velazquez, Michael Weber, Dion H Zappe, Tsushung Hau, Kenneth A Jamerson
BACKGROUND: The ACCOMPLISH (Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension) trial demonstrated that combination therapy using amlodipine, rather than hydrochlorothiazide, in conjunction with benazepril provided greater cardiovascular risk reduction among high-risk hypertensive patients. Few trials have evaluated the effect of prior antihypertensive therapy used among participants on the study outcomes. METHODS AND RESULTS: In a post hoc observational analysis, we examined the characteristics of the drug regimens taken before trial enrollment in the context of the primary composite outcome (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, resuscitation after sudden cardiac death, and coronary revascularization)...
January 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#11
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29297385/tailoring-nutrition-therapy-to-illness-and-recovery
#12
REVIEW
Paul E Wischmeyer
Without doubt, in medicine as in life, one size does not fit all. We do not administer the same drug or dose to every patient at all times, so why then would we live under the illusion that we should give the same nutrition at all times in the continuum of critical illness? We have long lived under the assumption that critical illness and trauma lead to a consistent early increase in metabolic/caloric need, the so-called "hypermetabolism" of critical illness. What if this is incorrect? Recent data indicate that early underfeeding of calories (trophic feeding) may have benefits and may require consideration in well-nourished patients...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29283290/real-time-quantitative-monitoring-of-cerebral-blood-flow-by-laser-speckle-contrast-imaging-after-cardiac-arrest-with-targeted-temperature-management
#13
Junyun He, Hongyang Lu, Leanne Young, Ruoxian Deng, Daniel Callow, Shanbao Tong, Xiaofeng Jia
Brain injury is the main cause of mortality and morbidity after cardiac arrest (CA). Changes in cerebral blood flow (CBF) after reperfusion are associated with brain injury and recovery. To characterize the relative CBF (rCBF) after CA, 14 rats underwent 7 min asphyxia-CA and were randomly treated with 6 h post-resuscitation normothermic (36.5-37.5℃) or hypothermic- (3-234℃) targeted temperature management (TTM) (N = 7). rCBF was monitored by a laser speckle contrast imaging (LSCI) technique. Brain recovery was evaluated by neurologic deficit score (NDS) and quantitative EEG - information quantity (qEEG-IQ)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29283091/the-management-of-rectal-bleeding-following-transrectal-prostate-biopsy-a-review-of-the-current-literature
#14
Mark R Quinlan, Bolton D Damien, Rowan G Casey
INTRODUCTION: Since the advent of prostate-specific antigen (PSA)-based testing, transrectal ultrasound (TRUS)-guided prostate biopsy has become a standard part of the diagnostic pathway for prostate cancer (PCa). Rectal bleeding is one of the common side effects of this transrectal route. While rectal bleeding is usually mild and self-limiting, it can be life-threatening. In this article, we examine rectal bleeding post TRUS-guided prostate biopsy and explore the literature to evaluate techniques and strategies aimed at preventing and managing this common and important complication...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29280985/pediatric-hypothermic-submersion-injury-and-protective-factors-associated-with-optimal-outcome-a-case-report-and-literature-review
#15
Daniel Kriz, Juan Piantino, Devin Fields, Cydni Williams
Drowning is the 3rd leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children. Submersion injuries with cardiac arrest can lead to long-term neurologic morbidity. Severe hypothermic submersion injuries have complex treatment courses and survivors have variable neurocognitive outcomes. We describe the course of a hypothermic submersion injury in a 6-year-old previously healthy boy. The description includes premorbid and post-injury neurocognitive functioning...
December 27, 2017: Children
https://www.readbyqxmd.com/read/29280927/hydrogen-inhalation-is-superior-to-mild-hypothermia-for-improving-neurological-outcome-and-survival-in-a-cardiac-arrest-model-of-spontaneously-hypertensive-rat
#16
Gang Chen, Bihua Chen, Chenxi Dai, Jianjie Wang, Juan Wang, Yuanyuan Huang, Yongqin Li
BACKGROUND: Post-cardiac arrest syndrome is the consequence of whole-body ischemia-reperfusion events that lead to multiple organ failure and eventually to death. Recent animal studies demonstrated that inhalation of hydrogen greatly mitigates post-resuscitation myocardial dysfunction and brain injury. However, the influence of underlying heart disease on the efficacy of hydrogen is still unknown. In the present study, we investigated the effects of hydrogen inhalation on neurological outcome and survival in a cardiac arrest model of spontaneously hypertensive rat (SHR)...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29279637/an-interventional-quality-improvement-study-to-assess-the-compliance-to-cardiopulmonary-resuscitation-documentation-in-an-indian-teaching-hospital
#17
Viraj Nevrekar, Prasan Kumar Panda, Naveet Wig, R M Pandey, Praveen Agarwal, Ashutosh Biswas
Background: Cardiopulmonary resuscitation (CPR) should be performed as per the international guidelines; however, compliance to these guidelines is difficult to assess. This study was conducted to determine the compliance to American Heart Association (2010) guideline on CPR documentation by among resident physicians before and after resident training (two arms). Methods: This pre-postinterventional quality improvement study was conducted in a referral center, North India...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#18
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29278526/the-effects-of-flipped-learning-for-bystander-cardiopulmonary-resuscitation-on-undergraduate-medical-students
#19
Taizo Nakanishi, Tadahiro Goto, Taketsune Kobuchi, Tetsuya Kimura, Hiroyuki Hayashi, Yasuharu Tokuda
Objectives: To compare bystander cardiopulmonary resuscitation skills retention between conventional learning and flipped learning for first-year medical students. Methods: A post-test only control group design. A total of 108 participants were randomly assigned to either the conventional learning or flipped learning. The primary outcome measures of time to the first chest compression and the number of total chest compressions during a 2-minute test period 6 month after the training were assessed with the Mann-Whitney U test...
December 22, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/29276031/in-a-bed-or-on-the-floor-the-effect-of-realistic-hospital-resuscitation-training-a-randomised-controlled-trial
#20
Troels Mygind-Klausen, André Jæger, Camilla Hansen, Rasmus Aagaard, Lise Qvirin Krogh, Mette Amalie Nebsbjerg, Kristian Krogh, Bo Løfgren
INTRODUCTION: In-hospital cardiac arrest has a poor prognosis and often occurs in patients lying in a hospital bed. A bed mattress is a soft compressible surface that may decrease cardiopulmonary resuscitation (CPR) quality. Often hospital CPR training is performed with a manikin on the floor. AIM: To study CPR quality following realistic CPR training with a manikin in a bed compared with one on the floor. METHODS: We conducted a randomised controlled study...
December 13, 2017: American Journal of Emergency Medicine
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