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post resuscitation

Karthik Vishwanath, Rajan Gurjar, David Wolf, Suzannah Riccardi, Michael Duggan, David King
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation...
February 1, 2018: Biomedical Optics Express
Emily Andrew, Eric Mercier, Ziad Nehme, Stephen Bernard, Karen Smith
INTRODUCTION: Understanding the prognosis of elderly out-of-hospital cardiac arrest (OHCA) patients is vital to informing resuscitation and advanced care planning decisions. However, short-term outcomes such as survival to hospital discharge do not account for post-arrest quality of life. We describe the 12-month functional recovery and health-related quality of life (HR-QOL) of elderly OHCA survivors, including those arresting in aged care facilities. METHODS: We conducted a retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data for all OHCA survivors to hospital discharge aged ≥65 years between 1 January 2010 and 30 June 2016...
March 12, 2018: Resuscitation
Mitchell R Dyer, DaShawn Hickman, Norman Luc, Shannon Haldeman, Patricia Loughran, Christa Pawlwoski, Anirban Sen Gupta, Matthew D Neal
BACKGROUND: Clinical resuscitative treatment of traumatic hemorrhage involves transfusion of RBC, platelets and plasma in controlled ratios. However, use of such blood components, especially platelets, present many challenges including availability, portability, contamination risks, and short shelf-life, which limit the use of platelet transfusions outside of large trauma centers such as remote civilian hospitals and austere pre-hospital settings. This has prompted significant research in platelet substitutes that may resolve the above issues while providing platelet-mimetic hemostatic action...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Penny S Reynolds, Bernard J Fisher, Jacquelyn McCarter, Christopher Sweeney, Erika J Martin, Paul Middleton, Matthew Ellenberg, Evan Fowler, Donald F Brophy, Alpha A Fowler, Bruce D Spiess, Ramesh Natarajan
BACKGROUND: Coagulopathy and inflammation induced by hemorrhagic shock and traumatic injury are associated with increased mortality and morbidity. Vitamin C (VitC) is an antioxidant with potential protective effects on the pro-inflammatory and pro-coagulant pathways. We hypothesized that high-dose VitC administered as a supplement to fluid resuscitation would attenuate inflammation, coagulation dysfunction, and end-organ tissue damage in a swine model of polytrauma and hemorrhage. METHODS: Male Sinclair swine (n = 24; mean body weight 27 kg) were anesthetized, intubated, mechanically ventilated, and instrumented for physiological monitoring...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Konstantinos Karatolios, Georgios Chatzis, Birgit Markus, Ulrich Luesebrink, Holger Ahrens, Wolfgang Dersch, Susanne Betz, Birgit Ploeger, Elisabeth Boesl, William O'Neill, Clemens Kill, Bernhard Schieffer
AIMS: To compare survival outcomes of Impella support and medical treatment in patients with post-cardiac arrest cardiogenic shock related to acute myocardial infarction (AMI). METHODS: Retrospective single center study of patients resuscitated from out of hospital cardiac arrest (OHCA) due to AMI with post-cardiac arrest cardiogenic shock between September 2014 and September 2016. Patients were either assisted with Impella or received medical treatment only. Survival outcomes were compared using propensity score-matched analysis to account for differences in baseline characteristics between both groups...
March 6, 2018: Resuscitation
Brant M Wagener, Parker J Hu, Joo-Yeun Oh, Cilina A Evans, Jillian R Richter, Jaideep Honavar, Angela P Brandon, Judy Creighton, Shannon W Stephens, Charity Morgan, Randal O Dull, Marisa B Marques, Jeffrey D Kerby, Jean-Francois Pittet, Rakesh P Patel
BACKGROUND: Trauma is the leading cause of death and disability in patients aged 1-46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of organ injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood...
March 2018: PLoS Medicine
Justine Dol, Marsha Campbell-Yeo, Gail Tomblin Murphy, Megan Aston, Douglas McMillan, Brianna Richardson
OBJECTIVE: The objective of this review was to evaluate the impact of the Helping Babies Survive program on neonatal outcomes and healthcare provider knowledge and skills. INTRODUCTION: The Helping Babies Survive program consists of three modules: Helping Babies Breathe, Essential Care for Every Baby, and Essential Care for Small Babies. It was developed to reduce preventable newborn deaths through skill-based learning using simulation, learning exercises, and peer-to-peer training of healthcare providers in low-resource areas...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
Yexiang Sun, Chunyu Yuan, Xulin Chen, Fei Wang, Congsong Sun, Zhi Gao, Sheng Liu
OBJECTIVE: To investigate the effect of different concentrations of hypertonic saline solution (HS) on intestine injury in rats at the early stage of severe burn. METHODS: 104 adult healthy female Sprague-Dawley (SD) rats were randomly divided into five groups: sham group (n = 8), lactated Ringer solution (LR) group (n = 24) and 200, 300, 400 mmol/L HS group (HS200 group, HS300 group, HS400 group, all n = 24). All the rats in LR group and different concentrations of HS groups were scalded for 30% total body surface area (TBSA) with III degree, after immediately, the rats were given burn resuscitation therapy by LR or corresponding concentrations of HS through the tail vein...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Déborah Jaeger, Florence Dumas, Josephine Escutnaire, Sonia Sadoune, Adrien Lauvray, Carlos Elkhoury, Adrien Bassand, Nicolas Girerd, Pierre Yves Gueugniaud, Karim Tazarourte, Hervé Hubert, Alain Cariou, Tahar Chouihed
BACKGROUND: The survival rate of out-of-hospital cardiac arrest (OHCA) remains extremely low, generally under 10%. Post-resuscitation care, and particularly early coronary reperfusion, may improve this outcome. The main objective of the present study was to determine whether patients with immediate coronary angiography at hospital admission (CAA) had a better outcome than patients without immediate CAA. METHODS: This cohort analysis study was based on data extracted from the French National Cardiac Arrest registry (RéAC)...
March 5, 2018: Resuscitation
Scott D Casey, Bryn E Mumma
BACKGROUND: Sex, race, and insurance status are associated with treatment and outcomes in several cardiovascular diseases. These disparities, however, have not been well-studied in out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Our objective was to evaluate the association of patient sex, race, and insurance status with hospital treatments and outcomes following OHCA. METHODS: We studied adult patients in the 2011-2015 California Office of Statewide Health Planning and Development (OSHPD) Patient Discharge Database with a "present on admission" diagnosis of cardiac arrest (ICD-9-CM 427...
March 5, 2018: Resuscitation
Grace Koo, Neha Goyal, Jeanne M DeCara, Roberto M Lang, Karima Addetia
Good-quality chest compressions improve outcomes in cardiac arrest. While manual chest compressions are suboptimal in this regard, the LUCAS device has been shown to improve the effectiveness of chest compressions during cardiopulmonary resuscitation (CPR). The complication rate associated with mechanical CPR, however, has not been adequately studied. Limited evidence suggests no difference in internal injury between manual and mechanical CPR. We report the case of a patient on anticoagulation who developed a mediastinal hematoma post mechanical CPR and on whom subtle findings on initial echocardiography could have alerted the clinician to this complication early during the clinical course...
March 6, 2018: Echocardiography
Xinyue Gao, Qiang Tao, Xun Zhou, WeiFu Lei
PURPOSE: To compare the effects of fluid resuscitation with lactated Ringer's solution (LR) and saline-based 6% hydroxyethyl starch 130/0.4 (HES) on the inflammatory response and oxidative stress in the small intestine as well as on bacterial translocation to the liver. METHODS: Sprague-Dawley rats were subjected to blood pressure-controlled hemorrhagic shock and then resuscitated with LR or HES. At 1, 3, 6, 12, and 24 hr after resuscitation, liver tissues were collected to count the bacterial colonies, and small intestines were harvested to analyze the levels of inflammatory (TNF-α and HO-1) and oxidative stress (MPO) mediators as well as the intestinal injury by immunohistochemistry, colorimetry and hematoxylin & eosin staining, respectively...
March 6, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Anwarul Haque, Zehra Dhanani, Amin Ali, Basit Salam, Qalab Abbas, Gohar Javed, Humaira Jurair
BACKGROUND: The Rotterdam Score (RS) on CT head is a new evolving clinical tool as a predictor of mortality in Traumatic Brain Injury (TBI). The objective of this study is to assess the outcome of children with TBI admitted in paediatric intensive care unit (PICU) of a tertiary-care, university hospital by using RS. METHODS: This was a prospective observational study conducted on children (age: 1mo -16yr) with TBI admitted in PICU of Aga Khan University Hospital from 2013 to 2016...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Ward Eertmans, Cornelia Genbrugge, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans, Cathy De Deyne
BACKGROUND: We investigated the ability of bispectral index (BIS) monitoring to predict poor neurological outcome in out-of-hospital cardiac arrest (OHCA) patients fully treated according to guidelines. RESULTS: In this prospective, observational study, 77 successfully resuscitated OHCA patients were enrolled in whom BIS, suppression ratio (SR) and electromyographic (EMG) values were continuously monitored during the first 36 h after the initiation of targeted temperature management at 33 °C...
March 2, 2018: Annals of Intensive Care
Drayton A Hammond, Laura Baumgartner, Craig Cooper, Elisabeth Donahey, Serena A Harris, Jessica M Mercer, Mandy Morris, Mona K Patel, Angela M Plewa-Rusiecki, Alia A Poore, Ryan Szaniawski, Deanna Horner
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized...
February 26, 2018: Journal of Critical Care
Joseph H Pitcher, John Dziodzio, Joshua Keller, Teresa May, Richard R Riker, David B Seder
BACKGROUND: Hypotension, hyperglycemia, dysoxia, and dyscarbia may contribute to reperfusion injury, and each is independently associated with poor outcome (PO) after cardiac arrest. We investigated whether the combined effects of these physiological derangements are associated with cardiac arrest outcomes. METHODS: This institutional review board-approved retrospective cohort study included consecutive resuscitated cardiac arrest patients that received targeted temperature management at Maine Medical Center from 2013 to 2015...
February 28, 2018: Neurocritical Care
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
Christopher W White, Simon J Messer, Stephen R Large, Jennifer Conway, Daniel H Kim, Demetrios J Kutsogiannis, Jayan Nagendran, Darren H Freed
Cardiac transplantation has become limited by a critical shortage of suitable organs from brain-dead donors. Reports describing the successful clinical transplantation of hearts donated after circulatory death (DCD) have recently emerged. Hearts from DCD donors suffer significant ischemic injury prior to organ procurement; therefore, the traditional approach to the transplantation of hearts from brain-dead donors is not applicable to the DCD context. Advances in our understanding of ischemic post-conditioning have facilitated the development of DCD heart resuscitation strategies that can be used to minimize ischemia-reperfusion injury at the time of organ procurement...
2018: Frontiers in Cardiovascular Medicine
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
Kaan Yusufoğlu, Mehmet Özgür Erdoğan, İsmail Tayfur, Mustafa Ahmet Afacan, Şahin Çolak
Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines...
February 23, 2018: Turkish Journal of Medical Sciences
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