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https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#1
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28202293/therapeutic-hypothermia-attenuates-brain-edema-in-a-pig-model-of-cardiac-arrest-possible-role-of-the-angiopoietin-tie-2-system
#2
Jiebin Li, ChunSheng Li, Wei Yuan, JunYuan Wu, Jie Li, ZhenHua Li, YongZhen Zhao
OBJECTIVE: This study aimed to clarify whether therapeutic hypothermia protects against cerebral edema following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in a porcine model via regulating the angiopoietin-Tie-2 ligand-receptor system. METHODS: Male pigs were randomized into the therapeutic hypothermia group, the normothermia group or the sham control group. CA was induced in pigs by untreated ventricular fibrillation for 8min. Brain edema was determined by measuring the cerebral cortical water content at 24h after the return of spontaneous circulation (ROSC)...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28194680/parental-knowledge-of-cardiovascular-screening-and-prevention-of-sudden-cardiac-arrest-in-youth-athletes
#3
Madison A Wagener, Alex B Diamond, Ashley Rowatt Karpinos
Sudden cardiac arrest (SCA) is the leading cause of death in youth athletes. Survival from out- of-hospital SCA depends on prompt initiation of cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED). This study evaluated parental knowledge, experience, and attitudes related to cardiovascular screening, SCA, and CPR/AED use in youth athletes and made comparisons between parents who are employed in healthcare and parents who are not employed in healthcare. We conducted a cross-sectional survey to evaluate knowledge, experiences, and attitudes of 91 parents of youth athletes who attended a community-based cardiovascular screening event...
February 13, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28194478/-diagnostic-investigation-in-emergency-medicine-why-case-history-is-crucial
#4
M Mirus, A R Heller
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28190798/age-specific-differences-in-the-duration-of-prehospital-cardiopulmonary-resuscitation-administered-by-emergency-medical-service-providers-necessary-to-achieve-favorable-neurological-outcome-after-out-of-hospital-cardiac-arrest
#5
Akira Funada, Yoshikazu Goto, Hayato Tada, Ryota Teramoto, Masaya Shimojima, Kenshi Hayashi, Masakazu Yamagishi
BACKGROUND: The appropriate duration of prehospital cardiopulmonary resuscitation (CPR)administered by emergency medical service (EMS) providers for patients with out-of-hospital cardiac arrest (OHCA) necessary to achieve 1-month survival with favorable neurological outcome (Cerebral Performance Category 1 or 2, CPC 1-2) is unclear and could differ by age.Methods and Results:We analyzed the records of 35,709 adult OHCA patients with return of spontaneous circulation (ROSC) before hospital arrival in a prospectively recorded Japanese registry between 2011 and 2014...
February 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28187532/testicular-sperm-aspiration-tesa-for-infertile-couples-with-severe-or-complete-asthenozoospermia
#6
A H Al-Malki, K Alrabeeah, E Mondou, V Brochu-Lafontaine, S Phillips, A Zini
The aim of the study was to evaluate reproductive outcomes in a cohort of infertile couples with severe and complete asthenozoospermia undergoing TESA (testicular sperm aspiration) with ICSI. We conducted a retrospective study of 28 couples with complete or severe asthenozoospermia who underwent TESA between January 2010 and December 2015. We compared TESA-ICSI outcomes of these couples to ejaculate ICSI outcomes of 40 couples with severe asthenozoospermia treated during the same time period at our institution...
February 10, 2017: Andrology
https://www.readbyqxmd.com/read/28187154/comparison-of-different-inspiratory-triggering-settings-in-automated-ventilators-during-cardiopulmonary-resuscitation-in-a-porcine-model
#7
Dingyu Tan, Jun Xu, Shihuan Shao, Yangyang Fu, Feng Sun, Yazhi Zhang, Yingying Hu, Joseph Walline, Huadong Zhu, Xuezhong Yu
BACKGROUND: Mechanical ventilation via automated in-hospital ventilators is quite common during cardiopulmonary resuscitation. It is not known whether different inspiratory triggering sensitivity settings of ordinary ventilators have different effects on actual ventilation, gas exchange and hemodynamics during resuscitation. METHODS: 18 pigs enrolled in this study were anaesthetized and intubated. Continuous chest compressions and mechanical ventilation (volume-controlled mode, 100% O2, respiratory rate 10/min, and tidal volumes 10ml/kg) were performed after 3 minutes of ventricular fibrillation...
2017: PloS One
https://www.readbyqxmd.com/read/28176385/financial-and-clinical-outcomes-of-extracorporeal-mechanical-support
#8
Ryan Chiu, Eric Pillado, Sohail Sareh, Kim De La Cruz, Richard J Shemin, Peyman Benharash
BACKGROUND: Over the past decade, extracorporeal mechanical support (ECMO) has been increasingly utilized in respiratory failure and cardiogenic shock. There is a need for assessing clinical and financial outcomes of ECMO use. This study presents our institution's experience with veno-arterial ECMO (VA-ECMO) over a 9-year period. METHODS: A retrospective review of our institution's ECMO database identified patients undergoing VA-ECMO between 2005 and 2013 (N = 150)...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28175939/good-neurological-outcome-after-accidental-hyopthermia-presenting-with-asytole
#9
I Eckert, P Imboden, P Paal, J Koppenberg
A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming...
February 7, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28173814/the-human-oocyte-preservation-experience-hope-registry-evaluation-of-cryopreservation-techniques-and-oocyte-source-on-outcomes
#10
Zsolt Peter Nagy, Robert E Anderson, Eve C Feinberg, Brooke Hayward, Mary C Mahony
BACKGROUND: This prospective, Phase IV, multicenter, observational registry of assisted reproductive technology clinics in the USA studied outcomes of first cycles using thawed/warmed cryopreserved (by slow-freezing/vitrification) oocytes (autologous or donor). METHODS: Patients were followed up through implantation, clinical pregnancy, and birth outcomes. The main outcome measure was live birth rate (LBR), defined as the ratio of live births to oocytes thawed/warmed minus the number of embryos cryopreserved for each cycle, averaged over all thawing cycles...
February 7, 2017: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#11
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28164442/odense-pharmacoepidemiological-database-oped-a-review-of-use-and-content
#12
Jesper Hallas, Maja Hellfritzsch, Morten Rix, Morten Olesen, Mette Reilev, Anton Pottegård
The Odense University Pharmacoepidemiological Database (OPED) is a prescription database established in 1990 by the University of Southern Denmark, covering reimbursed prescriptions from the county of Funen in Denmark and the region of Southern Denmark (1.2 million inhabitants). It is still active and thereby has more than 25 years' of continuous coverage. In this MiniReview, we review its history, content, quality, coverage, governance and some of its uses. OPED's data include the Danish Civil Registration Number (CPR), which enables unambiguous linkage with virtually all other health-related registers in Denmark...
February 5, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28161214/consciousness-induced-during-cardiopulmonary-resuscitation-an-observational-study
#13
Alexander Olaussen, Ziad Nehme, Matthew Shepherd, Paul A Jennings, Stephen Bernard, Biswadev Mitra, Karen Smith
BACKGROUND: Cardiopulmonary resuscitation-induced consciousness (CPRIC) is a phenomenon that has been described in only a handful of case reports. In this study, we aimed to describe CPRIC in out-of-hospital cardiac arrest (OHCA) patients and determine its association with survival outcomes. METHODS: Retrospective study of registry-based data from Victoria, Australia between January 2008 and December 2014. Adult OHCA patients treated by emergency medical services (EMS) were included...
February 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28159528/therapeutic-hypothermia-may-improve-neurological-outcomes-in-extracorporeal-life-support-for-adult-cardiac-arrest
#14
Philip Y K Pang, Gillian H L Wee, Ming Jie Huang, Anne E E Hoo, Ismail Mohamed Tahir Sheriff, See Lim Lim, Teing Ee Tan, Yee Jim Loh, Victor T T Chao, Jia Lin Soon, Ka Lee Kerk, Zakir Hussain Abdul Salam, Yoong Kong Sin, Chong Hee Lim
BACKGROUND: Limited data exists on patients receiving therapeutic hypothermia during extracorporeal life support (ECLS). We investigated outcomes and prognostic factors in these patients. METHODS: A retrospective review was conducted for 225 consecutive adult patients treated with ECLS between July 2003 and January 2016. Extracorporeal life support was initiated for refractory cardiac arrest (>10 mins) in 79 patients (35.1%). Patient demographics, ECLS-related complications, in-hospital mortality and neurological outcomes were analysed...
January 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28156594/patterns-of-intensity-of-end-of-life-care-for-adolescents-and-young-adults-with-cancer-a-population-based-study
#15
Elysia Marie Alvarez, Olga Saynina, Lee Sanders, Smita Bhatia, Lisa J Chamberlain
: 132 Background: Cancer is the leading cause of non-accidental death amongst adolescents and young adults (AYA), aged 15-39, in the U.S. It is critical to understand end of life (EOL) care of AYA cancer decedents, including use of medically intense interventions like intubation. Although desired by some, most patients prefer a natural death. We sought to determine rates of medically intense interventions at end of life for AYA cancer decedents and associated factors. METHODS: Using the California Office of Statewide Health Planning and Development private administrative database linked to death certificates, we performed a retrospective population based analysis of patients aged 15-39 with cancer who died between 2000-2010...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156572/end-of-life-care-decisions-using-korean-advance-directives-among-cancer-patient-caregiver-dyads
#16
Shinmi Kim, JinShil Kim
: 11 Background: The Korean advance directives (K-ADs) consist of a value statement, treatment directives (cardiopulmonary resuscitation [CPR], preferences for artificial ventilation, tube feeding, and hospice care). K-ADs can facilitate a patient's decision-making for end-of-life (EOL) care. This study aims to examine the extent to which patient-caregiver dyads agreed on decisions for EOL care using the K-ADs. METHODS: Using a descriptive study design, 81 cancer patients were invited to participate...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28150278/the-quality-of-a-newly-developed-infant-chest-compression-method-applied-by-paramedics-a-randomized-crossover-manikin-trial
#17
Jacek Smereka, Mariusz Kasinski, Adam Smereka, Jerzy Robert Ładny, Łukasz Szarpak
BACKGROUND: The etiology of sudden cardiac arrest in infants is different from that in adults, with respiratory failure, sudden infant death syndrome, and drowning being the primary causes in the former. According to the European Resuscitation Council (ERC) and American Heart Association (AHA) recommendations, the quality of chest compressions (CC) is a key element affecting the effectiveness of cardiopulmonary resuscitation (CPR). The current ERC and AHA guidelines recommend the 'two-finger technique' (TFT) or 'two-thumb encircling hands technique' (TTHT) for external CCs during infant CPR...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28148473/a-mobile-device-app-to-reduce-time-to-drug-delivery-and-medication-errors-during-simulated-pediatric-cardiopulmonary-resuscitation-a-randomized-controlled-trial
#18
Johan N Siebert, Frederic Ehrler, Christophe Combescure, Laurence Lacroix, Kevin Haddad, Oliver Sanchez, Alain Gervaix, Christian Lovis, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusion is both complex and time-consuming, placing children at higher risk than adults for medication errors. Following an evidence-based ergonomic-driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
February 1, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28147415/improving-survival-after-cardiac-arrest
#19
Conrad Arnfinn Bjørshol, Eldar Søreide
Each year, approximately half a million people suffer out-of-hospital cardiac arrest (CA) in Europe: The majority die. Survival after CA varies greatly between regions and countries. The authors give an overview of the important elements necessary to promote improved survival after CA as a function of the chain of survival and formula for survival concepts. The chain of survival incorporates bystanders (who identify warning symptoms, call the emergency dispatch center, initiate cardiopulmonary resuscitation [CPR]), dispatchers (who identify CA, and instruct and reassure the caller), first responders (who provide high-quality CPR, early defibrillation), paramedics and other prehospital care providers (who continue high-quality CPR, and provide timely defibrillation and advanced life support, transport to CA center), and hospitals (targeted temperature management, percutaneous coronary intervention, delayed prognostication)...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28147268/autonomous-camkii-activity-as-a-drug-target-for-histological-and-functional-neuroprotection-after-resuscitation-from-cardiac-arrest
#20
Guiying Deng, James E Orfila, Robert M Dietz, Myriam Moreno-Garcia, Krista M Rodgers, Steve J Coultrap, Nidia Quillinan, Richard J Traystman, K Ulrich Bayer, Paco S Herson
The Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) is a major mediator of physiological glutamate signaling, but its role in pathological glutamate signaling (excitotoxicity) remains less clear, with indications for both neuro-toxic and neuro-protective functions. Here, the role of CaMKII in ischemic injury is assessed utilizing our mouse model of cardiac arrest and cardiopulmonary resuscitation (CA/CPR). CaMKII inhibition (with tatCN21 or tatCN19o) at clinically relevant time points (30 min after resuscitation) greatly reduces neuronal injury...
January 31, 2017: Cell Reports
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