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https://www.readbyqxmd.com/read/29679698/neurophysiological-and-neuroradiological-multimodal-approach-for-early-poor-outcome-prediction-after-cardiac-arrest
#1
Maenia Scarpino, Giovanni Lanzo, Francesco Lolli, Riccardo Carrai, Marco Moretti, Maddalena Spalletti, Morena Cozzolino, Adriano Peris, Aldo Amantini, Antonello Grippo
INTRODUCTION: Prognosticating outcome after cardiac arrest(CA) requires a multimodal approach. However, evidence regarding combinations of methods is limited. We evaluated whether the combination of electroencephalography(EEG), somatosensory evoked potentials(SEPs) and brain computed tomography(CT) could predict poor outcome. METHODS: We screened our database regarding patients successfully resuscitated after CA, for whom EEG, SEPs and brain CT were available within 24 hours...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679696/effect-of-neuromonitor-guided-titrated-care-on-brain-tissue-hypoxia-after-opioid-overdose-cardiac-arrest
#2
Jonathan Elmer, Katharyn L Flickinger, Maighdlin W Anderson, Allison Koller, Matthew Sundermann, Cameron Dezfulian, David O Okonkwo, Lori A Shutter, David Salcido, Clifton W Callaway, James J Menegazzi
INTRODUCTION: Brain tissue hypoxia may contribute to preventable secondary brain injury after cardiac arrest. We developed a porcine model of opioid overdose cardiac arrest and post-arrest care including invasive, multimodal neurological monitoring of regional brain physiology. We hypothesized brain tissue hypoxia is common with usual post-arrest care and can be prevented by modifying mean arterial pressure (MAP) and arterial oxygen concentration (PaO2 ). METHODS: We induced opioid overdose and cardiac arrest in sixteen swine, attempted resuscitation after 9 minutes of apnea, and randomized resuscitated animals to three alternating 6-hour blocks of standard or titrated care...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679694/the-introduction-of-a-rapid-response-system-in-acute-hospitals-a-pragmatic-stepped-wedge-cluster-randomised-controlled-trial
#3
Filip Haegdorens, Peter Van Bogaert, Ella Roelant, Koen De Meester, Marie Misselyn, Kristien Wouters, Koenraad G Monsieurs
AIM: Deterioration of hospitalised patients is often missed, misinterpreted, and mismanaged. Rapid Response Systems (RRSs) have been proposed to solve this problem. This study aimed to investigate the effect of an RRS on the incidence of unexpected death, cardiac arrest with cardiopulmonary resuscitation (CPR), and unplanned intensive care unit (ICU) admission. METHODS: We conducted a stepped wedge cluster randomised controlled trial including 14 Belgian acute care hospitals with two medical and two surgical wards each...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679693/bystander-witnessed-cardiac-arrest-is-associated-with-reported-agonal-breathing-and-leads-to-less-frequent-bystander-cpr
#4
P Brinkrolf, B Metelmann, C Scharte, A Zarbock, K Hahnenkamp, A Bohn
AIM: Although the importance of bystander cardiopulmonary resuscitation has been shown in multiple studies, the rate of bystander cardiopulmonary resuscitation is still relatively low in many countries. Little is known on bystanders' perceptions influencing the decision to start cardiopulmonary resuscitation. Our study aims to determine such factors. MATERIALS AND METHODS: Semi-structured telephone interviews with bystanders of out-of-hospital cardiac arrests between December 2014 and April 2016 were performed in a prospective manner...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679443/a-20-year-review-the-use-of-exception-from-informed-consent-and-waiver-of-informed-consent-in-emergency-research
#5
Lauren Klein, Johanna Moore, Michelle Biros
BACKGROUND: Due to the acuity and time sensitive needs of their clinical condition, patients presenting with certain emergent pathologies may lack capacity to provide meaningful prospective informed consent to participate in clinical research. For these reasons, these populations have often been excluded from research investigations. To mitigate this, regulations allowing Exception from Informed Consent (EFIC) (21 CFR 50.24) or Waiver of Informed Consent (WIC) (45 CFR 46.101) were developed in 1996...
April 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29679187/growth-a-journey-from-experience-to-higher-perception-among-iranian-muslim-cpr-survivors
#6
Seyed Hamid Seyed Bagheri, Masoud Rayyani, Sedigheh Iranmanesh, Mahlagha Dehghan, Batool Tirgari, Seyed Habibollah Hosseini
Several studies have been conducted among cardiopulmonary resuscitation (CPR) survivors. Some studies have shown that positive and negative experiences coexist. Emotional distress and psychopathology in CPR survivors are related to the urgent need to make growth. Understanding the meaning of CPR survivors' lived experiences of growth may facilitate their growth. The aim of the study was to illuminate the meaning of CPR survivor's lived experiences of growth in southeast Iran. A qualitative design using a phenomenological hermeneutic approach influenced by Ricoeur was used in 12 CPR survivors...
April 20, 2018: Journal of Religion and Health
https://www.readbyqxmd.com/read/29679134/aphallia-a-review-to-standardize-management
#7
REVIEW
Tarryn Gabler, Robyn Charlton, Jerome Loveland, Ellen Mapunda
Congenital aphallia is a rare anomaly with little supporting literature and controversial management. The aim of this review is to assess the most recent literature with a focus on staged management of these cases. We performed a PubMed search of all English literature in the past 10 years using the term aphallia. Twenty-three articles were identified of which six were excluded. A further three papers meeting our criteria were found in the references to papers initially identified. We found that management can be staged in three phases: short, intermediate and long-term...
April 20, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29678921/a-repeating-sulfated-galactan-motif-resuscitates-dormant-micrococcus-luteus
#8
Thomas Böttcher, Dávid Szamosvári, Jon Clardy
Only a small fraction of bacteria can autonomously initiate growth on agar plates. Non-growing bacteria typically enter a metabolically inactive dormant state and require specific chemical trigger factors or signals to exit this state and resume growth. Micrococcus luteus has become a model organism for this important yet poorly understood phenomenon. So far, only few resuscitation signals have been described and all of them are produced endogenously by bacterial species. We report the discovery of a novel type of resuscitation signal that allows M...
April 20, 2018: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29678294/association-between-body-mass-index-and-clinical-outcomes-of-patients-after-cardiac-arrest-and-resuscitation-a-meta-analysis
#9
REVIEW
Ye Ma, Lili Huang, Lu Zhang, Hai Yu, Bin Liu
BACKGROUND: Obesity as one of the risk factors for cardiovascular diseases increases mortality in general population. Several clinical studies investigated clinical outcomes in patients with different body mass index (BMI) after cardiac arrest (CA). Controversial data regarding BMI on clinical outcomes in those patients exist in those studies. Therefore, we conducted a meta-analysis to evaluate the effect of BMI on survival condition and neurological prognosis in those patients. METHODS: We searched Pubmed, Embase, Ovid/Medline and EBM reviews databases for relational studies investigating the association between BMI and clinical outcomes of patients after CA...
April 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#10
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#11
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29676952/associations-between-patient-characteristics-and-a-new-early-do-not-attempt-resuscitation-order-after-intracerebral-hemorrhage
#12
Jessica McFarlin, Claire E Hailey, Wenjing Qi, Peter G Kranz, Weiping Sun, Wei Sun, Marisa Gray, Kon Kam King Nicolas, Daniel T Laskowitz, Michael L James
BACKGROUND: Decisions to limit care, including use of a do-not-resuscitate (DNR) order, are associated with increased risk of death after intracerebral hemorrhage (ICH). Given the value that patient surrogates place on the physician's perception of prognosis, understanding prognostic indicators that influence clinical judgment of outcomes is critical. OBJECTIVE: The purpose of this study was to understand the patient variables and comorbid illnesses associated with DNR orders placed on patients within 72 hours after ICH...
April 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29676777/do-not-resuscitate-orders-in-older-adults-during-hospitalization-a-propensity-score-matched-analysis
#13
Karishma Patel, Liron Sinvani, Vidhi Patel, Andrzej Kozikowski, Christopher Smilios, Meredith Akerman, Kinga Kiszko, Sutapa Maiti, Negin Hajizadeh, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: To explore the effect of the presence and timing of a do-not-resuscitate (DNR) order on short-term clinical outcomes, including mortality. DESIGN: Retrospective cohort study with propensity score matching to enable direct comparison of DNR and no-DNR groups. SETTING: Large, academic tertiary-care center. PARTICIPANTS: Hospitalized medical patients aged 65 and older. MEASUREMENTS: Primary outcome was in-hospital mortality...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29676615/walter-b-cannon-s-world-war-i-experience-treatment-of-traumatic-shock-then-and-now
#14
Kathy L Ryan
Walter B. Cannon (1871-1945), perhaps America's preeminent physiologist, volunteered for service with the Army Expeditionary Force (AEF) during World War I. He initially served with Base Hospital No. 5, a unit made up of Harvard clinicians, before moving forward to the front lines to serve at a casualty clearing station run by the British. During his time there, he performed research on wounded soldiers to understand the nature and causes of traumatic shock. Subsequently, Cannon performed animal experimentation on the causes of traumatic shock in the London laboratory of Dr...
June 1, 2018: Advances in Physiology Education
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#15
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29675055/shifting-paradigm-from-no-code-and-do-not-resuscitate-to-goals-of-care-policies
#16
Yaseen M Arabi, Abdulla A Al-Sayyari, Mohamed S Al Moamary
Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of No Code or DNR orders have led to delivery of poorer care to some patients. Several experts have called for a change in the current approach. The new approach, Goals of Care paradigm, aims to contextualize the decisions about resuscitation and advanced life support within the overall plan of care, focusing on choices of treatments to be given rather than specifically on treatments not to be given...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29674406/spontaneous-rupture-of-seminoma-in-undescended-testis-with-hemoperitoneum-a-rare-presentation
#17
Deepak Kumar Diwakar, Nikita Wadhwani, Ravi Shekhar Pradhan, Ravi Prakash Verma
Cryptorchidism is associated with increased risk of malignancy and infertility. We present a case of a 30-year-old man who presented to the Emergency Department of our tertiary care hospital with spontaneous intra-abdominal rupture of the seminoma in undescended testis with hemoperitoneum. This is a rare presentation of seminoma and emphasises the importance of scrotal examination in young men presenting with acute abdomen. Surgical management is the definitive treatment and should be instituted as soon as possible, after appropriate resuscitation...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29674365/protocol-of-a-multicenter-international-randomized-controlled-manikin-study-on-different-protocols-of-cardiopulmonary-resuscitation-for-laypeople-mani-cpr
#18
Enrico Baldi, Enrico Contri, Roman Burkart, Paola Borrelli, Ottavia Eleonora Ferraro, Michela Tonani, Amedeo Cutuli, Daniele Bertaia, Pasquale Iozzo, Caroline Tinguely, Daniel Lopez, Susi Boldarin, Claudio Deiuri, Sandrine Dénéréaz, Yves Dénéréaz, Michael Terrapon, Christian Tami, Cinzia Cereda, Alberto Somaschini, Stefano Cornara, Andrea Cortegiani
INTRODUCTION: Out-of-hospital cardiac arrest is one of the leading causes of death in industrialised countries. Survival depends on prompt identification of cardiac arrest and on the quality and timing of cardiopulmonary resuscitation (CPR) and defibrillation. For laypeople, there has been a growing interest on hands-only CPR, meaning continuous chest compression without interruption to perform ventilations. It has been demonstrated that intentional interruptions in hands-only CPR can increase its quality...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674328/catastrophic-circulatory-collapse-after-inadvertent-subcutaneous-injection-of-treprostinil
#19
John J Radosevich, Mohan Dutt, Jeremy Feldman
PURPOSE: A case of life-threatening cardiovascular collapse after inadvertent subcutaneous injection of undiluted treprostinil is reported. SUMMARY: A 29-year-old, 76-kg woman with group 1 pulmonary arterial hypertension managed with subcutaneous treprostinil infusion arrived at the emergency department (ED) with headache, nausea, vomiting, and a syncopal episode. Her vital signs were stable on presentation. Admission orders were placed, and the appropriate 3-mL syringe containing 7...
April 19, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29672984/views-of-cancer-patients-regarding-cardiopulmonary-resuscitation-in-greece
#20
N Miaris, E Samantas, I Siafaka, E Logothetis, N Iacovidou, A Chalkias, T Xanthos
Cardiopulmonary resuscitation (CPR) in patients with cancer is an ethical issue of worldwide interest. A questionnaire-based study was carried out in a Greek oncology hospital aiming to explore the attitude of Greek cancer patients towards CPR. Overall, 200 patients (94 male, 106 female) of a mean age of 62.8 years took part in the study. Only 42 (21%) patients indicated that they knew what CPR really involves and only 20 (10%) patients thought that CPR has serious side effects, while the mean estimated in-hospital CPR survival rate to hospital discharge was 56...
April 19, 2018: European Journal of Cancer Care
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