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https://www.readbyqxmd.com/read/28198552/cortical-spreading-depolarizations-in-the-postresuscitation-period-in-a-cardiac-arrest-male-rat-model
#1
Frederik Boe Hansen, Niels Secher, Morten Skovgaard Jensen, Leif Østergaard, Else Tønnesen, Asger Granfeldt
Neurological injury develops over days following cardiac arrest (CA); however, the exact mechanisms remain unknown. After stroke or trauma, the progression of neurological injury is associated with cortical-spreading depolarizations (CSDs). The objective was to investigate whether CA and subsequent resuscitation in rats are associated with 1) the development of spontaneous negative direct current (DC) shifts indicative of CSDs, and 2) changes in artificially induced CSDs in the postresuscitation period. Male Sprague-Dawley rats were randomized into four groups: 1) CA 90, 2) Control 90, 3) CA 360, and 4) Control 360...
February 15, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28190437/neurology-of-cardiopulmonary-resuscitation
#2
M Mulder, R G Geocadin
This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28147413/cardiac-issues-in-cardiac-arrest
#3
Wulfran Bougouin, Alain Cariou
The prognosis of cardiac arrest (CA) remains poor, with a survival rate at hospital discharge between 6 and 10%. To improve this disappointing outcome, efforts are needed regarding each step in the chain of survival. In this review, the authors focus on cardiac issues, as the heart itself could be both a cause and a target in this setting. Acute myocardial infarction is very illustrative of this duality. As it is a frequent cause of CA, an early invasive strategy (through immediate coronary angiography) has been proposed by several teams and is now recommended in specific situations...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28141610/initiation-of-therapeutic-hypothermia-in-the-emergency-department-a-quality-improvement-project
#4
Cody Yochum, Rose Utley
Therapeutic hypothermia (TH) postresuscitation has been recommended by the American Heart Association (AHA) since 2005. Early initiation of TH and fast achievement of goal temperatures have been associated with better neurological outcomes. The objective of this study was to evaluate the effectiveness of a specific TH protocol for the emergency department (ED) in increasing ED use of TH and decreasing the time from return of spontaneous circulation (ROSC) to initiation of cooling measures. An ED protocol for TH as recommended by the AHA was implemented...
January 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28098670/understanding-therapeutic-hypothermia
#5
Christian S Yacono, Stephanie Eider
Therapeutic hypothermia is a relatively new protocol that can improve patients' chances of favorable neurologic outcomes after cardiac arrest. However, implementation rates remain low nationwide. This article describes recommendations for and benefits of therapeutic hypothermia in postresuscitation care.
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#6
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27987397/prophylactic-versus-clinically-driven-antibiotics-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-a-randomized-pilot-study
#7
Suada Filekovic Ribaric, Matjaz Turel, Rihard Knafelj, Vojka Gorjup, Rade Stanic, Primoz Gradisek, Ognjen Cerovic, Tomislav Mirkovic, Marko Noc
AIM: To investigate benefits of prophylactic antibiotics in comatose survivors of out-of-hospital cardiac arrest (OHCA). METHODS: Patients without evidence of tracheobronchial aspiration on admission bronchoscopy were randomized to prophylactic Amoxicillin-Clavulanic acid 1.2g every 8h (P) or clinically-driven antibiotics (C) administered if signs of infection developed during initial 7days of intensive care unit (ICU) stay. RESULTS: Among 83 patients enrolled between September 2013 and February 2015, tracheobronchial aspiration was documented in 23 (28%)...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27966313/neurological-outcome-after-cardiac-arrest-a-prospective-study-of-the-predictive-ability-of-prognostic-biomarkers-neuron-specific-enolase-glial-fibrillary-acidic-protein-s-100b-and-procalcitonin
#8
Gülay Ok, Demet Aydın, Koray Erbüyün, Canan Gürsoy, Fatma Taneli, Sema Bilge, Gönül Dinç Horasan
BACKGROUND/AIM: Factors affecting neurological outcome and the usefulness of neuron-specific enolase (NSE), S-100B, glial fibrillary acidic protein (GFAP), and procalcitonin (PCT) in predicting neurological outcomes were assessed in patients who survived at least 24 h after cardiopulmonary resuscitation (CPR). MATERIALS AND METHODS: Thirty successfully resuscitated cardiac arrest patients were included in this prospective clinical study. The initial cardiac arrest rhythm, duration of CPR, return of spontaneous circulation time, administered doses of adrenaline, base excess, blood sugar, and hemodynamic parameters were recorded...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27866109/magnitude-of-temperature-elevation-is-associated-with-neurologic-and-survival-outcomes-in-resuscitated-cardiac-arrest-patients-with-postrewarming-pyrexia
#9
Anne V Grossestreuer, David F Gaieski, Michael W Donnino, Douglas J Wiebe, Benjamin S Abella
PURPOSE: Avoidance of pyrexia is recommended in resuscitation guidelines, including after treatment with targeted temperature management (TTM). Which aspects of postresuscitation pyrexia are harmful and modifiable have not been conclusively determined. MATERIALS AND METHODS: This retrospective multicenter registry study collected serial temperatures during 72 hours postrewarming to assess the relationship between 3 aspects of pyrexia (maximum temperature, pyrexia duration, timing of first pyrexia) and neurologic outcome (primary) and survival (secondary) at hospital discharge...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27847811/effect-of-erythropoietin-on-postresuscitation-renal-function-in-a-swine-model-of-ventricular-fibrillation
#10
Charalampos Pantazopoulos, Nicoletta Iacovidou, Evangelia Kouskouni, Paraskevi Pliatsika, Apostolos Papalois, Georgios Kaparos, Dimitrios Barouxis, Panagiotis Vasileiou, Pavlos Lelovas, Olympia Kotsilianou, Ioannis Pantazopoulos, Georgios Gkiokas, Clara Garosa, Gavino Faa, Theodoros Xanthos
Purpose. To investigate the effect of EPO administration on postresuscitation renal function. Methods. Twenty-four female Landrace/Large-White piglets aged 10-15 weeks with average weight of 19 ± 2 kg were randomly assigned to 2 different groups of 12 subjects each. After the end of an 8-minute ventricular fibrillation, the control group (Group C) received saline as placebo, whereas the EPO group (Group E) received EPO 5000 U/kg. The animals were resuscitated according to the 2010 European Resuscitation Council Guidelines for Resuscitation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27802958/the-evolving-paradigm-of-individualized-postresuscitation-care-after-cardiac-arrest
#11
REVIEW
David B Seder, Christine Lord, David J Gagnon
The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27768665/lack-of-species-specific-difference-in-pulmonary-function-when-using-mouse-versus-human-plasma-in-a-mouse-model-of-hemorrhagic-shock
#12
Zhanglong Peng, Shibani Pati, Magali J Fontaine, Kelly Hall, Anthony V Herrera, Rosemary A Kozar
BACKGROUND: Clinical studies have demonstrated that the early and empiric use of plasma improves survival after hemorrhagic shock. We have demonstrated in rodent models of hemorrhagic shock that resuscitation with plasma is protective to the lungs compared with lactated Ringer's solution. As our long-term objective is to determine the molecular mechanisms that modulate plasma's protective effects in injured bleeding patients, we have used human plasma in a mouse model of hemorrhagic shock...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27714400/-technical-assist-devices-perspectives-and-new-developments
#13
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...
November 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27648441/diazoxide-attenuates-postresuscitation-brain-injury-in-a-rat-model-of-asphyxial-cardiac-arrest-by-opening-mitochondrial-atp-sensitive-potassium-channels
#14
Haidong Wu, Peng Wang, Yi Li, Manhui Wu, Jiali Lin, Zitong Huang
Objective. We investigated whether and how diazoxide can attenuate brain injury after cardiopulmonary resuscitation (CPR) by selective opening of mitochondrial ATP-sensitive potassium (mitoKATP) channels. Methods. Adult male Sprague-Dawley rats with induced cerebral ischemia (n = 10 per group) received an intraperitoneal injection of 0.1% dimethyl sulfoxide (1 mL; vehicle group), diazoxide (10 mg/kg; DZ group), or diazoxide (10 mg/kg) plus 5-hydroxydecanoate (5 mg/kg; DZ + 5-HD group) 30 min after CPR...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27644095/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest
#15
REVIEW
Julianna Jung
Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm...
October 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/27625237/is-intracranial-pressure-monitoring-useful-in-children-with-severe-traumatic-brain-injury
#16
Sekar Arunkumar, Bhagavatula Indira Devi, Dhaval Shukla, Madhusudhan Reddy
BACKGROUND: Intracranial pressure monitoring (ICP) is considered as optional for management of severe traumatic brain injury (TBI) in children. AIMS: This study was performed to determine whether ICP monitoring is beneficial in the managing severe TBI in children. SETTINGS AND DESIGN: Neurosurgical intensive care unit (ICU) of a tertiary care referral center; prospective observational study. MATERIALS AND METHODS: Children aged 16 years or less with severe TBI defined as "postresuscitation Glasgow Coma Scale (GCS) score of 8 or less admitted to an ICU" were enrolled...
September 2016: Neurology India
https://www.readbyqxmd.com/read/27607559/high-serum-tumor-necrosis-factor-levels-in-the-early-post-cardiac-arrest-period-are-associated-with-poor-short-term-survival-in-a-swine-model-of-ventricular-fibrillation
#17
Scott T Youngquist, Atman P Shah, John P Rosborough, James T Niemann
Most resuscitated victims of out-of-hospital cardiac arrest who survive to hospital expire due to the postresuscitation syndrome. This syndrome is characterized by a sepsis-like proinflammatory state. The objective of this investigation was to determine whether a relationship exists between the rise of tumor necrosis factor (TNF), a proinflammatory cytokine, following return of spontaneous circulation (ROSC), and early postarrest survival in a clinically relevant animal model of spontaneous ventricular fibrillation (VF)...
October 2016: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/27597811/assessment-of-postresuscitation-volume-status-by-bioimpedance-analysis-in-patients-with-sepsis-in-the-intensive-care-unit-a-pilot-observational-study
#18
Bram Rochwerg, Jason H Cheung, Christine M Ribic, Faraz Lalji, France J Clarke, Susheel Gantareddy, Nischal Ranganath, Aziz Walele, Ellen McDonald, Maureen O Meade, Deborah J Cook, Trevor T Wilkieson, Catherine M Clase, Peter J Margetts, Azim S Gangji
Background. Bioimpedance analysis (BIA) is a novel method of assessing a patient's volume status. Objective. We sought to determine the feasibility of using vector length (VL), derived from bioimpedance analysis (BIA), in the assessment of postresuscitation volume status in intensive care unit (ICU) patients with sepsis. Method. This was a prospective observational single-center study. Our primary outcome was feasibility. Secondary clinical outcomes included ventilator status and acute kidney injury. Proof of concept was sought by correlating baseline VL measurements with other known measures of volume status...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27449068/captopril-improves-postresuscitation-hemodynamics-protective-against-pulmonary-embolism-by-activating-the-ace2-ang-1-7-mas-axis
#19
Hong-Li Xiao, Chun-Sheng Li, Lian-Xing Zhao, Jun Yang, Nan Tong, Le An, Qi-Tong Liu
Acute pulmonary embolism (APE) has a very high mortality rate, especially at cardiac arrest and even after the return of spontaneous circulation (ROSC). This study investigated the protective effect of the angiotensin-converting enzyme (ACE) inhibitor captopril on postresuscitation hemodynamics, in a porcine model of cardiac arrest established by APE. Twenty-nine Beijing Landrace pigs were infused with an autologous thrombus leading to cardiac arrest and subjected to standard cardiopulmonary resuscitation and thrombolysis...
November 2016: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/27424212/edaravone-improves-survival-and-neurological-outcomes-after-cpr-in-a-ventricular-fibrillation-model-of-rats
#20
Tao Qin, Ling-Yan Lei, Nuo Li, Fangying Ruan Shi, Meng-Hua Chen, Lu Xie
OBJECTIVE: Overproduction of free radicals is a main factor contributing to cerebral injury after cardiac arrest (CA)/cardiopulmonary resuscitation (CPR). We sought to evaluate the impact of edaravone on the survival and neurological outcomes after CA/CPR in rats. METHODS: Rats were subjected to CA following CPR. For survival study, the rats with restoration of spontaneous circulation (ROSC) were randomly allocated to one of the two groups (edaravone and saline group, n=20/each group) to received Edaravone (3 mg/kg) or normal saline...
October 2016: American Journal of Emergency Medicine
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