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https://www.readbyqxmd.com/read/28334809/subcutaneous-emphysema-of-scalp-following-resuscitation-in-a-neonate
#1
Avinash Dhaware, Sandeep Kadam, Sanjay Patole
BACKGROUND: Neonatal subcutaneous emphysema of scalp (SES) with air leaks is rare. Case characteristics: Neonate presented with SES in addition to pneumothorax and pneumomediastinum. OBSERVATION: SES resolved after the chest was drained to treat pneumothorax. OUTCOME: Neonate made full recovery. CONCLUSION: Neonatal SES may be associated with air leaks post-resuscitation, which has not been reported.
February 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28328299/early-left-ventricular-ejection-fraction-as-a-predictor-of-survival-after-cardiac-arrest
#2
Barry Burstein, Dev Jayaraman, Regina Husa
Although echocardiograms are frequently performed within 24 h of sudden cardiac death, the utility of left ventricular ejection fraction (LVEF) to predict survival is unknown. In this is single center retrospective cohort study of patients admitted to the intensive care unit or coronary care unit after in-hospital or out-of-hospital sudden cardiac death, LVEF <40% was not a significant predictor of survival at 30 days or hospital discharge. ABSTRACT Background: Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest...
March 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/28326313/lung-volume-recruitment-acutely-increases-respiratory-system-compliance-in-individuals-with-severe-respiratory-muscle-weakness
#3
Yannick Molgat-Seon, Liam M Hannan, Paolo B Dominelli, Carli M Peters, Renee J Fougere, Douglas A McKim, A William Sheel, Jeremy D Road
The aim of the present study was to determine whether lung volume recruitment (LVR) acutely increases respiratory system compliance (Crs) in individuals with severe respiratory muscle weakness (RMW). Individuals with RMW resulting from neuromuscular disease or quadriplegia (n=12) and healthy controls (n=12) underwent pulmonary function testing and the measurement of Crs at baseline, immediately after, 1 h after and 2 h after a single standardised session of LVR. The LVR session involved 10 consecutive supramaximal lung inflations with a manual resuscitation bag to the highest tolerable mouth pressure or a maximum of 50 cmH2O...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#4
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28320747/association-of-cardiovascular-health-with-subclinical-disease-and-incident-events-the-multi-ethnic-study-of-atherosclerosis
#5
Tamar S Polonsky, Hongyan Ning, Martha L Daviglus, Kiang Liu, Gregory L Burke, Mary Cushman, John Eng, Aaron R Folsom, Pamela L Lutsey, Jennifer A Nettleton, Wendy S Post, Ralph L Sacco, Moyses Szklo, Donald M Lloyd-Jones
BACKGROUND: Few adults have ideal cardiovascular health (CVH). We studied associations of an overall CVH score with subclinical cardiovascular disease and events. We assessed whether associations varied by race/ethnicity. METHODS AND RESULTS: Among 5961 participants in the Multi-Ethnic Study of Atherosclerosis, components of CVH were measured at baseline, 2000-2002: systolic blood pressure, total cholesterol, fasting glucose, smoking, physical activity, diet, and body mass index...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28315727/increasing-or-fluctuating-bispectral-index-values-during-post-resuscitation-targeted-temperature-management-can-predict-clinical-seizures-after-rewarming
#6
Kanae Ochiai, Atsushi Shiraishi, Yasuhiro Otomo, Yuuichi Koido, Takashi Kanemura, Masato Honma
AIM: To investigate whether an increasing bispectral index (BIS) value during targeted temperature management (TTM) correlates with increased clinical seizures after TTM or worse neurological prognoses after TTM. METHODS: We performed a retrospective prognostication study of patients who were treated with TTM after recovery of spontaneous circulation from cardiac arrest at a tertiary care hospital. We recorded the BIS regularly during TTM and calculated the correlations of the mean BIS values, standard deviations of the BIS values, and linear regression coefficient of the trend of the BIS values over time as index tests...
March 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28306590/the-use-of-dipyrone-in-the-icu-is-associated-with-acute-kidney-injury-a-retrospective-cohort-analysis
#7
Thomas Stueber, Laura Buessecker, Andreas Leffler, Hans-Jörg Gillmann
BACKGROUND: Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely understood. Although dipyrone effects on renal vasodilator prostaglandin synthesis are documented, little is known about its potential renal side effects, especially in the critical care environment...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#8
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28300030/hemispheric-polymicrogyria-and-neonatal-seizures-a-potentially-life-threatening-combination
#9
Paula M Brna, A Simon Harvey, Richard J Leventer
Polymicrogyria (PMG) is a heterogeneous malformation of cortical development characterized by excessive gyration and abnormal cortical lamination. Typically, bilateral forms have more severe developmental delay and early-onset epilepsy, but the full spectrum of severity remains ill-defined. We report two cases of right hemispheric PMG and neonatal-onset, drug-resistant seizures culminating in early death. Case 1 began having seizures on Day 1 of life that intensified in severity and proved resistant to numerous antiepileptic drugs...
March 14, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28286831/predictive-factors-of-survival-and-6-month-favorable-outcome-of-very-severe-head-trauma-patients-a-historical-cohort-study
#10
Karin Vathanalaoha, Thakul Oearsakul, Thara Tunthanathip
INTRODUCTION: Very severe head trauma cases, defined as Glasgow Coma Scale (GCS) scores of less than 6, have a higher mortality rate and poorer outcome. The purpose of this study was to recognize factors associated with survival and 6-month favorable outcome of very severe head trauma patients presenting to emergency department. METHODS: In this historical cohort study, the authors retrospectively reviewed medical records of head trauma patients who were admitted to the emergency department with post-resuscitation GCS scores of less than 6...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285861/cardioprotective-effect-of-nicorandil-against-myocardial-injury-following-cardiac-arrest-in-swine
#11
Li-Ning Liang, Xia Zhong, Yi Zhou, Zhi-Qiang Hou, Hao-Ran Hu, Fang-Fang Zhu, Ji-Bin Chen, Xian-Fei Ji, De-Ya Shang
INTRODUCTION: Nicorandil, a vasodilatory drug used to treat angina, was reported to protect against myocardial ischemia-reperfusion injury in various animal models. However, its cardioprotective action following cardiac arrest is unknown. We examined the cardioprotective effects of nicorandil in a porcine model of cardiac arrest and resuscitation. METHODS: Ventricular fibrillation was induced electrically for 4min in anesthetized domestic swine, followed by cardiopulmonary resuscitation...
March 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285322/intensive-care-medicine-research-agenda-on-cardiac-arrest
#12
REVIEW
Jerry P Nolan, Robert A Berg, Stephen Bernard, Bentley J Bobrow, Clifton W Callaway, Tobias Cronberg, Rudolph W Koster, Peter J Kudenchuk, Graham Nichol, Gavin D Perkins, Tom D Rea, Claudio Sandroni, Jasmeet Soar, Kjetil Sunde, Alain Cariou
Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)-requiring mechanical ventilation and sedation-and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care...
March 11, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28279695/categorization-of-survival-and-death-after-cardiac-arrest
#13
E A Matthews, J Magid-Bernstein, A Presciutti, A Rodriguez, D Roh, S Park, J Claassen, S Agarwal
BACKGROUND: Most cardiac arrest (CA) patients remain comatose post-resuscitation, prompting goals-of-care (GOC) conversations. The impact of these conversations on patient outcomes has not been well described. METHODS: Patients (n=385) treated for CA in Columbia University ICUs between 2008-2015 were retrospectively categorized into various modes of survival and death based on documented GOC discussions. Patients were deemed "medically unstable" if there was evidence of hemodynamic instability at the time of discussion...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28279312/the-role-of-post-resuscitation-electrocardiogram%C3%A2-in-patients-with%C3%A2-st-segment%C3%A2-changes-in-the-immediate%C3%A2-post-cardiac-arrest-period
#14
Youn-Jung Kim, Sun-Yang Min, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Hui Jai Lee, Jonghwan Shin, Byuk Sung Ko, Shin Ahn, Gi-Byoung Nam, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. BACKGROUND: The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#15
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28271120/code-status-reconciliation-to-improve-identification-and-documentation-of-code-status-in-electronic-health-records
#16
Viral G Jain, Peter J Greco, David C Kaelber
BACKGROUND: Code status (CS) of a patient (part of their end-of-life wishes) can be critical information in healthcare delivery, which can change over time, especially at transitions of care. Although electronic health record (EHR) tools exist for medication reconciliation across transitions of care, much less attention is given to CS, and standard EHR tools have not been implemented for CS reconciliation (CSR). Lack of CSR creates significant potential patient safety and quality of life issues...
March 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28270248/the-resuscitative-and-pharmacokinetic-effects-of-humeral-intraosseous-vasopressin-in-a-swine-model-of-ventricular-fibrillation
#17
James M Burgert, Arthur D Johnson, Jose Garcia-Blanco, Lawrence V Fulton, Michael J Loughren
Introduction The American Heart Association (AHA; Dallas, Texas USA) and European Resuscitation Council (Niel, Belgium) cardiac arrest (CA) guidelines recommend the intraosseous (IO) route when intravenous (IV) access cannot be obtained. Vasopressin has been used as an alternative to epinephrine to treat ventricular fibrillation (VF). Hypothesis/Problem Limited data exist on the pharmacokinetics and resuscitative effects of vasopressin administered by the humeral IO (HIO) route for treatment of VF. The purpose of this study was to evaluate the effects of HIO and IV vasopressin, on the occurrence, odds, and time of return of spontaneous circulation (ROSC) and pharmacokinetic measures in a swine model of VF...
March 8, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#18
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28263789/pediatric-extracorporeal-cardiopulmonary-resuscitation-during-nights-and-weekends
#19
Christopher R Burke, Titus Chan, Thomas V Brogan, D Michael McMullan
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is a lifesaving rescue therapy for patients with refractory cardiac arrest. Previous studies suggest that maintaining a 24/7 in-house surgical team may reduce ECPR initiation time and improve survival in adult patients. However, an association between cardiac arrest occurring during off-hours and ECPR outcome has not been established in children. METHODS: This is a single institution, retrospective review of all pediatric patients who received ECPR from December 2008 to August 2015...
March 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28256813/intraspinal-administration-of-morphine-hydrochloride-combined-with-low-doses-of-bupivacaine-in-hemorrhoidectomy-a-clinical-randomised-trial
#20
Manuel Ruiz-Castro, Marta San José Santos, Antonio Rodríguez-Miguel, Francisco J de Abajo Iglesias
BACKGROUND: Intrathecal local anesthetics, associated or not to opioids, is commonplace in anorectal surgery, but it is unknown which is the option with the best risk-benefit ratio. The main aim was to assess whether the combination of morphine (50 mcg) with low-dose bupivacaine (3 mg) in an intradural solution has a better analgesic short-term effect than bupivacaine alone at standard doses (5 mg) in hemorrhoidectomy. METHODS: 66 patients of any sex were randomly assigned to two alternative treatments and 63 patients were considered valid for analysis...
March 3, 2017: Minerva Anestesiologica
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