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Epinephrine in out of hospital arrest

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https://www.readbyqxmd.com/read/29857945/epinephrine-administration-in-non-shockable-out-of-hospital-cardiac-arrest
#1
R Jouffroy, A Saade, P Alexandre, P Philippe, P Carli, B Vivien
BACKGROUND: Epinephrine is recommended for the treatment of non-shockable out of hospital cardiac arrest (OHCA) to obtain return of spontaneous circulation (ROSC). Epinephrine efficiency and safety remain under debate. OBJECTIVE: We propose to describe the association between the cumulative dose of epinephrine and the failure of ROSC during the first 30 min of advanced life support (ALS). METHODOLOGY: A retrospective observational cohort study using the Paris SAMU 75 registry including all non-traumatic OHCA...
May 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29804789/association-of-the-time-to-first-epinephrine-administration-and-outcomes-in-out-of-hospital-cardiac-arrest-sos-kanto-2012-study
#2
Yosuke Homma, Takashi Shiga, Hiraku Funakoshi, Dai Miyazaki, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Naohiro Yonemoto, Arino Yaguchi, Naoto Morimura
OBJECTIVE: This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms. METHODS: This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine...
May 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29519282/-profile-and-outcome-of-cardiopulmonary-resuscitation-after-sudden-cardiac-arrests-in-the-emergency-department-a-multicenter-prospective-observational-study
#3
Yingying Hu, Jun Xu, Huadong Zhu, Guoxiu Zhang, Feng Sun, Yazhi Zhang, Xuezhong Yu
OBJECTIVE: To investigate the status of cardiopulmonary resuscitation (CPR) in patients with sudden cardiac arrest (CA) in the emergency department. METHODS: A multicenter prospective observational study was conducted. The patients with CA admitted to 13 hospitals from 6 provinces in four different regions, including North China, Southern China, East China, Southwest China, from July 1st, 2015 to July 31st, 2017 were enrolled. A modified Utstein template was applied to collect clinical data, including general data, CA related data and prognosis, and primary outcome indicator was the return of spontaneous circulation (ROSC) rate, and the secondary outcome indicator was 28-day survival rate...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29511001/time-to-epinephrine-administration-and-survival-from-nonshockable-out-of-hospital-cardiac-arrest-among-children-and-adults
#4
Matthew Hansen, Robert H Schmicker, Craig D Newgard, Brian Grunau, Frank Scheuermeyer, Sheldon Cheskes, Veer Vithalani, Fuad Alnaji, Thomas Rea, Ahamed H Idris, Heather Herren, Jamie Hutchison, Mike Austin, Debra Egan, Mohamud Daya
BACKGROUND: Previous studies have demonstrated that earlier epinephrine administration is associated with improved survival from out-of-hospital cardiac arrest (OHCA) with shockable initial rhythms. However, the effect of epinephrine timing on patients with nonshockable initial rhythms is unclear. The objective of this study was to measure the association between time to epinephrine administration and survival in adults and children with emergency medical services (EMS)-treated OHCA with nonshockable initial rhythms...
May 8, 2018: Circulation
https://www.readbyqxmd.com/read/29425976/non-invasive-characterization-of-hemodynamics-in-adult-out-of-hospital-cardiac-arrest-patients-soon-after-return-of-spontaneous-circulation
#5
Joseph P Ornato, Tammy Nguyen, Peter Moffett, Stephen Miller, Michael J Vitto, David Evans, Alan Payne, Kathy Baker, Mary Schaeffer
BACKGROUND: Little is known about hemodynamics in adult, out-of-hospital (OHCA) patients following return of spontaneous circulation (ROSC). A 1994 study when "high-dose epinephrine" use was common showed consistently elevated systemic vascular resistance (SVR) lasting ≥6 h in 49 adult patients after return of spontaneous circulation (ROSC). STUDY AIM: To characterize hemodynamic abnormalities in adult OHCA patients soon after ROSC. Our hypothesis was that, unlike the consistently high SVR values reported when "high-dose" epinephrine was in common use, there would be a more heterogenous distribution of SVR values using current adrenergic therapy...
April 2018: Resuscitation
https://www.readbyqxmd.com/read/29413238/should-we-perform-an-immediate-coronary-angiogram-in-all-patients-after-cardiac-arrest-insights-from-a-large-french-registry
#6
Wulfran Bougouin, Florence Dumas, Nicole Karam, Carole Maupain, Eloi Marijon, Lionel Lamhaut, Daniel Jost, Guillaume Geri, Frankie Beganton, Olivier Varenne, Christian Spaulding, Xavier Jouven, Alain Cariou
OBJECTIVES: This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival. BACKGROUND: An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases. METHODS: From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France)...
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#7
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29305926/lower-dose-epinephrine-administration-and-out-of-hospital-cardiac-arrest-outcomes
#8
Cameron A Fisk, Michele Olsufka, Lihua Yin, Andrew M McCoy, Andrew J Latimer, Charles Maynard, Graham Nichol, Jonathan Larsen, Leonard A Cobb, Michael R Sayre
BACKGROUND: International guidelines recommend administration of 1 mg of intravenous epinephrine every 3-5 min during cardiac arrest. The optimal dose of epinephrine is not known. We evaluated the association of reduced frequency and dose of epinephrine with survival after out-of-hospital cardiac arrest (OHCA). METHODS: Included were patients with non-traumatic OHCA treated by advanced life support (ALS) providers from January 1, 2008 to June 30, 2016. During the before period, providers were instructed to give epinephrine 1 mg intravenously at 4 min followed by additional 1 mg doses every eight minutes to patients with OHCA with a shockable rhythm and 1 mg doses every two minutes to patients with a non-shockable rhythm (higher dose)...
March 2018: Resuscitation
https://www.readbyqxmd.com/read/29206063/age-discrimination-in-out-of-hospital-cardiac-arrest-care-a-case-control-study
#9
Eric Wiel, Christophe Di Pompéo, Nicolas Segal, Gérald Luc, Jean-Baptiste Marc, Carine Vanderstraeten, Carlos El Khoury, Joséphine Escutnaire, Karim Tazarourte, Pierre-Yves Gueugniaud, Hervé Hubert
BACKGROUND: Although some studies have questioned whether cardiopulmonary resuscitation (CPR) in older people could be futile, age is not considered an essential out-of-hospital cardiac arrest (OHCA) prognostic factor. However, in the daily clinical practice of mobile medical teams (MMTs), age seems to be an important factor affecting OHCA care. AIMS: The purpose of this study was to compare OHCA care and outcomes between young patients (<65 years old) and older patients...
December 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29197833/prehospital-intravenous-access-for-survival-from-out-of-hospital-cardiac-arrest-propensity-score-matched-analyses-from-a-population-based-cohort-study-in-osaka-japan
#10
Tomoko Fujii, Tetsuhisa Kitamura, Kentaro Kajino, Kosuke Kiyohara, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takashi Kawamura, Taku Iwami
OBJECTIVES: Prehospital intravenous access is a common intervention for patients with out-of-hospital cardiac arrest (OHCA). We aimed to assess the effectiveness of prehospital intravenous access and subsequent epinephrine administration on outcomes among OHCA patients. METHODS: We conducted a prospective cohort study of patients with OHCA from non-traumatic causes aged ≥18 years in Osaka, Japan from January 2005 through December 2012. The primary outcome was 1-month survival with favourable neurological outcome defined as a cerebral performance category of 1 or 2...
December 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/29036580/time-to-epinephrine-and-survival-after-paediatric-out-of-hospital-cardiac-arrest
#11
Tatsuma Fukuda, Yutaka Kondo, Kei Hayashida, Hiroshi Sekiguchi, Ichiro Kukita
Aims: Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results: This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry...
July 11, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28983759/myocardial-dysfunction-after-out-of-hospital-cardiac-arrest-predictors-and-prognostic-implications
#12
Yuan Yao, Nicholas James Johnson, Sarah Muirhead Perman, Vimal Ramjee, Anne Victoria Grossestreuer, David Foster Gaieski
We aim to determine the incidence of early myocardial dysfunction after out-of-hospital cardiac arrest, risk factors associated with its development, and association with outcome. A retrospective chart review was performed among consecutive out-of-hospital cardiac arrest (OHCA) patients who underwent echocardiography within 24 h of return of spontaneous circulation at three urban teaching hospitals. Our primary outcome is early myocardial dysfunction, defined as a left ventricular ejection fraction < 40% on initial echocardiogram...
October 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28911510/long-term-prognostic-value-of-gasping-during-out-of-hospital-cardiac%C3%A2-arrest
#13
RANDOMIZED CONTROLLED TRIAL
Guillaume Debaty, Jose Labarere, Ralph J Frascone, Marvin A Wayne, Robert A Swor, Brian D Mahoney, Robert M Domeier, Michael L Olinger, Brian J O'Neil, Demetris Yannopoulos, Tom P Aufderheide, Keith G Lurie
BACKGROUND: Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR). OBJECTIVES: This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes. METHODS: The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health-funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28836556/epinephrine-in-out-of-hospital-cardiac-arrest-helpful-or-harmful
#14
REVIEW
Huan Shao, Chun-Sheng Li
OBJECTIVE: Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest. The evidence for the use of adrenaline in out-of-hospital cardiac arrest (OHCA) and in-hospital resuscitation is inconclusive. We conducted a systematic review on the clinical efficacy of adrenaline in adult OHCA patients to evaluate whether epinephrine provides any overall benefit for patients. DATA SOURCES: The EMBASE and PubMed databases were searched with the key words "epinephrine," "cardiac arrest," and variations of these terms...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28821366/safety-events-in-pediatric-out-of-hospital-cardiac-arrest
#15
Matt Hansen, Carl Eriksson, Barbara Skarica, Garth Meckler, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to explore the types of patient safety events that take place during pediatric out-of-hospital cardiac arrest resuscitation. METHODS: Retrospective medical record review from a single large urban EMS system of EMS-treated pediatric (<18years of age) out-of-hospital cardiac arrests (OHCA) occurring between 2008 and 2011. A chart review tool was developed for this project and each chart was reviewed by a multidisciplinary review panel...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28754320/efficacy-of-vasopressin-epinephrine-compared-to-epinephrine-alone-for-out-of-hospital-cardiac-arrest-patients-a-systematic-review-and-meta-analysis
#16
REVIEW
Qiang Zhang, Bo Liu, Lianxing Zhao, Zhijiang Qi, Huan Shao, Le An, Chunsheng Li
OBJECTIVE: The aim of this study was to conduct a meta-analysis to evaluate the efficacy of vasopressin-epinephrine compared to epinephrine alone in patients who suffered out-of-hospital cardiac arrest (OHCA). METHODS: Relevant studies up to February 2017 were identified by searching in PubMed, EMBASE, the Cochrane Library, Wanfang for randomized controlled trials(RCTs) assigning adults with cardiac arrest to treatment with vasopressin-epinephrine (VEgroup) vs adrenaline (epinephrine) alone (E group)...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28737594/identifying-risk-for-acute-kidney-injury-in-infants-and-children-following-cardiac-arrest
#17
MULTICENTER STUDY
Tara M Neumayr, Jeff Gill, Julie C Fitzgerald, Avihu Z Gazit, Jose A Pineda, Robert A Berg, J Michael Dean, Frank W Moler, Allan Doctor
OBJECTIVES: Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest. DESIGN: Retrospective analysis of a public access dataset. SETTING: Fifteen children's hospitals associated with the Pediatric Emergency Care Applied Research Network. PATIENTS: Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004...
October 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28698134/effects-of-advanced-life-support-on-patients-who-suffered-cardiac-arrest-outside-of-hospital-and-were-defibrillated
#18
Akihito Hagihara, Daisuke Onozuka, Takashi Nagata, Manabu Hasegawa
BACKGROUND: The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood. METHODS: This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed...
January 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28476480/mortality-in-patients-resuscitated-from-out-of-hospital-cardiac-arrest-based-on-automated-blood-cell-count-and-neutrophil-lymphocyte-ratio-at-admission
#19
Christoph Weiser, Michael Schwameis, Fritz Sterz, Harald Herkner, Irene M Lang, Ilse Schwarzinger, Alexander O Spiel
INTRODUCTION: The neutrophil lymphocyte ratio(NLR) is a marker of systemic inflammation. We hypothesized that admission NLR is related to mortality and that epinephrine application during resuscitation influences NLR in patients after successful resuscitation from out of hospital cardiac arrest (OHCA). METHODS: This retrospective cohort study is based on a registry including all OHCA patients who had a presumed cardiac cause of cardiac arrest and achieved sustained ROSC prior to admission between 2005 and 2014...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/28473275/effects-of-repeated-epinephrine-administration-and-administer-timing-on-witnessed-out-of-hospital-cardiac-arrest-patients
#20
R Sagisaka, H Tanaka, H Takyu, H Ueta, S Tanaka
BACKGROUND: Repeated administration of epinephrine is associated with unfavorable cerebral outcome after out-of-hospital cardiac arrests (OHCA), but the timing of epinephrine administration has not been considered. AIM: The aim of the study was to analyze the effects of repeated epinephrine administration after OHCA on favorable cerebral function coded by cerebral performance categories (CPC 1-2). METHODS: A nationwide, retrospective, population-based observational study was conducted by using Utstein-style data between 2010 and 2012 in Japan...
October 2017: American Journal of Emergency Medicine
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