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https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#1
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29227899/cardiac-troponins-and-nt-probnp-in-the-forensic-setting-overview-of-sampling-site-postmortem-interval-cardiopulmonary-resuscitation-and-review-of-the-literature
#2
Cristian Palmiere, Camilla Tettamanti, Alessandro Bonsignore, Francesco De Stefano, Jessica Vanhaebost, Guillaume Rousseau, Maria Pia Scarpelli, Daniel Bardy
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16)...
November 27, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29227856/gastroduodenal-artery-aneurysm-post-traumatic-pancreatic-pseudocyst-drainage-an-interesting-case
#3
Mohammad Zarin, Sajid Ali, Abdul Majid, ZakaUllah Jan
BACKGROUND AND AIM: Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreatic surgery and thus prior recognition and prompt treatment is mandatory (Lee et al., 2009 [1]). We report a case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for traumatic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presented with melena one month post operatively...
December 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29226160/the-significance-of-changes-in-platelet-concentration-during-the-early-phase-after-severe-burn-injury-in-a-chinese-mass-casualty
#4
Beiming Shou, Junqiang Li, Chenqi Tang, Qian Tan, Dongfeng Zheng, Binwei Sun, Lanjun Nie, Hongwei Zhang, Yanan Jiang, Chunming Wang, Yanwen Wu
Background: Changes in platelet concentration are common in severe burn patients. Platelets play a key role in the course of disease. This study aims to explore the significance of platelet concentration during the course of the disease in victims of a mass burn casualty. Methods: A total of 180 patients were involved in the "8.2" Kunshan explosion accident in China. The examined data included age, gender, total burn area (% TBSA), third-degree burn area (% TBSA), and platelet concentration within the first 5 days after the burn injury...
2017: Burns and Trauma
https://www.readbyqxmd.com/read/29225746/comparison-of-the-impact-of-applications-of-targeted-transfusion-protocol-and-massive-transfusion-protocol-in-trauma-patients
#5
Shahram Paydar, Hosseinali Khalili, Golnar Sabetian, Behnam Dalfardi, Shahram Bolandparvaz, Mohammad Hadi Niakan, Hamidreza Abbasi, Donat R Spahn
Background: The current study assessed a recently developed resuscitation protocol for bleeding trauma patients called the Targeted Transfusion Protocol (TTP) and compared its results with those of the standard Massive Transfusion Protocol (MTP). Methods: Per capita utilization of blood products such as packed red blood cells (RBCs), fresh frozen plasma (FFP), and platelet concentrates was compared along with mortality rates during two 6-month periods, one in 2011 (when the standard MTP was followed) and another in 2014 (when the TTP was used)...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29224659/bronchial-artery-embolization-for-the-treatment-of-acute-hemoptysis
#6
M Cody O'Dell, Anne E Gill, C Matthew Hawkins
Massive hemoptysis is a life-threatening condition often defined as coughing up 300-600mL of blood in 24 hours in an adult, or >8mL/kg in 24 hours in a child. Although the definition is controversial, one should view massive hemoptysis as any volume of expectorated blood that can cause respiratory failure. This is because mortality in the setting of hemoptysis is usually associated with asphyxiation, rather than exsanguination. Massive hemoptysis accounts for only about 5% of cases of hemoptysis, but when treated conservatively, has a reported mortality rate between 50% and 85%...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#7
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29224237/major-haemorrhage-fatalities-in-the-australian-national-coronial-database
#8
Jacob S Gipson, Erica M Wood, Merrole F Cole-Sinclair, Zoe McQuilten, Neil Waters, Noel W Woodford
OBJECTIVE: The aim of the study is to describe the epidemiology of major bleeding fatalities. METHODS: A case series analysis of Australia's National Coronial Information System was conducted. Keywords were used to search for closed cases of major haemorrhage in the state of Victoria for the period 1 January 2009 to 31 December 2011. Coroners' findings, autopsy reports and police reports of cases were reviewed. Demographic data were extracted, and cases were assigned to a clinical bleeding context...
December 10, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#9
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29223601/early-coronary-angiography-and-percutaneous-coronary-intervention-are-associated-with-improved-outcomes-after-out-of-hospital-cardiac-arrest
#10
Jacob C Jentzer, Michael Scutella, Francis Pike, James Fitzgibbon, Nicholas M Krehel, Lindsay Kowalski, Clifton W Callaway, Jon C Rittenberger, Joshua C Reynolds, Gregory W Barsness, Cameron Dezfulian
AIM: Early coronary angiography (CAG) and percutaneous coronary intervention (PCI) are associated with better outcomes in subjects resuscitated from out-of-hospital cardiac arrest (OHCA). We sought to determine the relative contributions of early CAG and PCI to outcomes and adverse events after OHCA. METHODS: We analyzed 599 OHCA subjects from a prospective two-center registry. Hospital survival, functional outcomes and adverse events were compared between subjects undergoing early CAG (within 24h) with or without PCI and subjects not undergoing early CAG...
December 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29222696/thrombomodulin-favors-leukocyte-microvesicle-fibrinolytic-activity-reduces-netosis-and-prevents-septic-shock-induced-coagulopathy-in-rats
#11
Julie Helms, Raphaël Clere-Jehl, Elsa Bianchini, Pierrick Le Borgne, Mélanie Burban, Fatiha Zobairi, Jean-Luc Diehl, Lelia Grunebaum, Florence Toti, Ferhat Meziani, Delphine Borgel
BACKGROUND: Septic shock-induced disseminated intravascular coagulation is responsible for increased occurrence of multiple organ dysfunction and mortality. Immunothrombosis-induced coagulopathy may contribute to hypercoagulability. We aimed at determining whether recombinant human thrombomodulin (rhTM) could control exaggerated immunothrombosis by studying procoagulant responses, fibrinolysis activity borne by microvesicles (MVs) and NETosis in septic shock. METHODS: In a septic shock model after a cecal ligation and puncture-induced peritonitis (H0), rats were treated with rhTM or a placebo at H18, resuscitated and monitored during 4 h...
December 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#12
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221300/comparison-of-continuous-compression-with-regular-ventilations-versus-30-2-compressions-ventilations-strategy-during-mechanical-cardiopulmonary-resuscitation-in-a-porcine-model-of-cardiac-arrest
#13
Zhengfei Yang, Qingyu Liu, Guanghui Zheng, Zhifeng Liu, Longyuan Jiang, Qing Lin, Rui Chen, Wanchun Tang
Background: A compression-ventilation (C:V) ratio of 30:2 is recommended for adult cardiopulmonary resuscitation (CPR) by the current American Heart Association (AHA) guidelines. However, continuous chest compression (CCC) is an alternative strategy for CPR that minimizes interruption especially when an advanced airway exists. In this study, we investigated the effects of 30:2 mechanical CPR when compared with CCC in combination with regular ventilation in a porcine model. Methods: Sixteen male domestic pigs weighing 39±2 kg were utilized...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220618/psychological-comfort-of-paramedics-with-field-death-pronouncement-a-national-asian-study-to-prepare-paramedics-for-field-termination-of-resuscitation
#14
Desmond R H Mao, Marcus E H Ong, Chungli Bang, Mohamed D T Salim, Yih Yng Ng, Desiree A Lie
OBJECTIVES: Paramedics' decision to terminate field resuscitation without a physician present may depend on personal and external factors. This study investigates factors associated with paramedic psychological comfort with termination of resuscitation (TOR) to inform future training. METHODS: We administered an anonymous survey to all practicing paramedics in a large urban Asian Emergency Medical Services system where formal TOR training had not yet been conducted and field TOR was not routinely applied...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29220603/evaluating-dispatch-assisted-cpr-using-the-cares-registry
#15
Manali Shah, Cherie Bartram, Kevin Irwin, Kimberly Vellano, Bryan McNally, Timothy Gallagher, Robert Swor
OBJECTIVES: Dispatch-assisted cardiopulmonary resuscitation (DA-CPR) has been shown to improve cardiac arrest survival. Recent literature has proposed dispatch metrics for provision of this intervention. Our objectives are to: use the Cardiac Arrest Registry to Enhance Survival (CARES) to compare current practice to proposed DA-CPR guidelines; describe barriers to DA-CPR; and assess the association of DA-CPR with out-of-hospital cardiac arrest (OHCA) survival. METHODS: We reviewed data from structured dispatch reviews of 911 OHCA calls from 1/1/14-12/31/15...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29220414/detection-of-spontaneous-pulse-using-the-acceleration-signals-acquired-from-cpr-feedback-sensor-in-a-porcine-model-of-cardiac-arrest
#16
Liang Wei, Gang Chen, Zhengfei Yang, Tao Yu, Weilun Quan, Yongqin Li
BACKGROUND: Reliable detection of return of spontaneous circulation with minimal interruptions of chest compressions is part of high-quality cardiopulmonary resuscitation (CPR) and routinely done by checking pulsation of carotid arteries. However, manual palpation was time-consuming and unreliable even if performed by expert clinicians. Therefore, automated accurate pulse detection with minimal interruptions of chest compression is highly desirable during cardiac arrest especially in out-of-hospital settings...
2017: PloS One
https://www.readbyqxmd.com/read/29220129/damage-control-resuscitation
#17
William Selde
No abstract text is available yet for this article.
April 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29220128/trauma-resuscitation-an-evidence-based-review-of-prehospital-traumatic-cardiac-arrest
#18
Matthew Chinn, M Riccardo Colella
No abstract text is available yet for this article.
April 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29219759/does-the-obesity-paradox-predict-functional-outcome-in-intracerebral-hemorrhage
#19
Neha S Dangayach, Harpreet Singh Grewal, Gian Marco De Marchis, Roberta K Sefcik, Rachel Bruce, Aarti Chhatlani, E Sander Connolly, M Cristina Falo, Sachin Agarwal, Jan Claassen, J Michael Schmidt, Stephan A Mayer
OBJECTIVE Being overweight or mildly obese has been associated with a decreased risk of death or hospitalization in patients with cardiovascular disease. Similarly, overweight patients admitted to an intensive care unit (ICU) have improved survival up to 1 year after admission. These counterintuitive observations are examples of the "obesity paradox." Does the obesity paradox exist in patients with intracerebral hemorrhage (ICH)? In this study the authors examined whether there was an association between obesity and functional outcome in patients with ICH...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29219627/non-oncotic-properties-of-albumin-a-multidisciplinary-vision-about-the-implications-for-critically-ill-patients
#20
Ricard Ferrer, Xavier Mateu, Emilio Maseda, Juan Carlos Yébenes, César Aldecoa, Candelaria De Haro, Juan Carlos Ruiz-Rodriguez, José Garnacho-Montero
Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients...
December 8, 2017: Expert Review of Clinical Pharmacology
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