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Epinephrine in out of hospital arrest

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https://www.readbyqxmd.com/read/27771299/sodium-nitroprusside-enhanced-cardiopulmonary-resuscitation-improves-short-term-survival-in-a-porcine-model-of-ischemic-refractory-ventricular-fibrillation
#1
Demetris Yannopoulos, Jason A Bartos, Stephen A George, George Sideris, Sebastian Voicu, Brett Oestreich, Timothy Matsuura, Kadambari Shekar, Jennifer Rees, Tom P Aufderheide
INTRODUCTION: Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. HYPOTHESIS: SNPeCPR will increase short term (4-h) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model...
October 19, 2016: Resuscitation
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#2
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27618681/early-identification-of-patients-with-out-of-hospital-cardiac-arrest-with-no-chance-of-survival-and-consideration-for-organ-donation
#3
Patricia Jabre, Wulfran Bougouin, Florence Dumas, Pierre Carli, Corinne Antoine, Laurent Jacob, Benjamin Dahan, Frankie Beganton, Jean-Philippe Empana, Eloi Marijon, Nicole Karam, Alexandre Loupy, Carmen Lefaucheur, Daniel Jost, Alain Cariou, Frédéric Adnet, Thomas D Rea, Xavier Jouven
Background: In patients with out-of-hospital cardiac arrest (OHCA), care requirements can conflict with the need to promptly focus efforts on organ donation in patients who are pronounced dead. Objective: To evaluate objective criteria for identifying patients with OHCA with no chance of survival during the first minutes of cardiopulmonary resuscitation to enable prompt orientation toward organ donation. Design: Retrospective assessment using OHCA data from 2 registries and 1 trial...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27613359/favorable-neurological-outcomes-by-early-epinephrine-administration-within-19-minutes-after-emergency-medical-service-call-for-out-of-hospital-cardiac-arrest-patients
#4
H Tanaka, H Takyu, R Sagisaka, H Ueta, Toru Shirakawa, Tomoya Kinoshi, Hiroyuki Takahashi, Takashi Nakagawa, Syuji Shimazaki, M Ong Eng Hock
OBJECTIVE: To evaluate the time-independent effect of the early administration of epinephrine (EPI) on favorable neurological outcome (as CPC [cerebral performance category] 1-2) at 1 month in patients with out-of-hospital cardiac arrest. MATERIALS AND METHODS: A total of 119 639 witnessed cardiac arrest patients from 2008 to 2012 were eligible for this nationwide, prospective, population-based observational study. Patients were divided into EPI group (n = 20 420) and non-EPI group (n = 99 219)...
August 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27484224/endothelial-dysfunction-in-resuscitated-cardiac-arrest-endo-rca-safety-and-efficacy-of-low-dose-prostacyclin-administration-and-blood-pressure-target-in-addition-to-standard-therapy-as-compared-to-standard-therapy-alone-in-post-cardiac-arrest-syndrome-patients
#5
Anna Sina P Meyer, Sisse R Ostrowski, Jesper Kjaergaard, Pär I Johansson, Christian Hassager
BACKGROUND: Morbidity and mortality following initial survival of cardiac arrest remain high despite great efforts to improve resuscitation techniques and post-resuscitation care, in part due to the ischemia-reperfusion injury secondary to the restoration of the blood circulation. Patients resuscitated from cardiac arrest display evidence of endothelial injury and coagulopathy (hypocoagulability, hyperfibrinolysis), which in associated with poor outcome. Recent randomized controlled trials have revealed that treatment with infusion of prostacyclin reduces endothelial damage after major surgery and AMI...
2016: Trials
https://www.readbyqxmd.com/read/27411936/effect-of-prehospital-epinephrine-on-out-of-hospital-cardiac-arrest-a-report-from-the-national-out-of-hospital-cardiac-arrest-data-registry-in-japan-2011-2012
#6
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Takehiro Matsubara, Masataka Gunshin, Yutaka Kondo, Naoki Yahagi
PURPOSE: The effect of prehospital epinephrine on neurological outcome in out-of-hospital cardiac arrest (OHCA) is still controversial. We sought to determine whether prehospital epinephrine administration was associated with improved outcomes in adult OHCA. METHODS: A nationwide, population-based, propensity score-matched study of OHCA patients from January 1, 2011, to December 31, 2012, in Japan was conducted. We included adult OHCA patients treated by emergency medical service personnel without an excessive delay...
October 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27362855/targeted-temperature-management-after-pediatric-cardiac-arrest-due-to-drowning-outcomes-and-complications
#7
Frank W Moler, Jamie S Hutchison, Vinay M Nadkarni, Faye S Silverstein, Kathleen L Meert, Richard Holubkov, Kent Page, Beth S Slomine, James R Christensen, J Michael Dean
OBJECTIVE: To describe outcomes and complications in the drowning subgroup from the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Exploratory post hoc cohort analysis. SETTING: Twenty-four PICUs. PATIENTS: Pediatric drowning cases. INTERVENTIONS: Therapeutic hypothermia versus therapeutic normothermia. MEASUREMENTS AND MAIN RESULTS: An exploratory study of pediatric drowning from the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital trial was conducted...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27224446/impaired-biological-response-to-aspirin-in-therapeutic-hypothermia-comatose-patients-resuscitated-from-out-of-hospital-cardiac-arrest
#8
Jean-François Llitjos, Georgios Sideris, Sebastian Voicu, Claire Bal Dit Sollier, Nicolas Deye, Bruno Megarbane, Ludovic Drouet, Patrick Henry, Jean-Guillaume Dillinger
AIM OF THE STUDY: Acute coronary syndrome is one of the main causes of out-of-hospital cardiac arrest (OHCA). OHCA patients are particularly exposed to high platelet reactivity (HPR) under aspirin (ASA) treatment. The aim was to evaluate HPR-ASA in therapeutic hypothermia comatose patients resuscitated from OHCA. METHODS AND RESULTS: Twenty-two consecutive patients with OHCA of cardiac origin were prospectively included after therapeutic hypothermia and randomized to receive ASA 100mg per day, either intravenously (n=13) or orally via a gastric tube (n=9)...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/27131438/emergency-percutaneous-coronary-intervention-in-post-cardiac-arrest-patients-without-st-segment-elevation%C3%A2-pattern-insights-from-the-procat-ii-registry
#9
Florence Dumas, Wulfran Bougouin, Guillaume Geri, Lionel Lamhaut, Julien Rosencher, Frédéric Pène, Jean-Daniel Chiche, Olivier Varenne, Pierre Carli, Xavier Jouven, Jean-Paul Mira, Christian Spaulding, Alain Cariou
OBJECTIVES: In a large cohort of out-of-hospital cardiac arrest (OHCA) patients without ST-segment elevation (STE), the study assessed the relationship between the use of an early invasive strategy and patient outcome. BACKGROUND: Emergent coronary angiogram (CAG) and reperfusion are currently a standard of care in patients resuscitated from an OHCA with ST-segment elevation (STE). However, using a similar invasive strategy is still debated in patients without STE...
May 23, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27099380/bet-2-usefulness-of-epinephrine-in-out-of-hospital-cardiac-arrest
#10
Megan E Evans, Todd Chassee
A short-cut review was carried out to establish whether prehospital adrenaline affects long-term morbidity or mortality after out-of-hospital cardiac arrest. Fifty-five papers were found using the reported search. Of these, three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that while epinephrine used as an adjunctive treatment during out-of-hospital cardiac arrest (OHCA) may improve return of spontaneous circulation (ROSC) and survival to hospital, it does not improve survival to discharge or neurological outcome...
May 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27077941/double-sequential-external-defibrillation-and-survival-from-out-of-hospital-cardiac-arrest-a-case-report
#11
Martin Johnston, Sheldon Cheskes, Garry Ross, P Richard Verbeek
BACKGROUND: Patients who present in ventricular fibrillation are typically treated with cardiopulmonary resuscitation (CPR), epinephrine, antiarrhythmic medications, and defibrillation. Although these therapies have shown to be effective, some patients remain in a shockable rhythm. Double sequential external defibrillation has been described as a viable option for patients in refractory ventricular fibrillation. OBJECTIVE: To describe the innovative use of two defibrillators used to deliver double sequential external defibrillation by paramedics in a case of refractory ventricular fibrillation resulting in prehospital return of spontaneous circulation and survival to hospital discharge with good neurologic function...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27057834/epidemiology-risk-factors-and-outcomes-of-out-of-hospital-cardiac-arrest-caused-by-stroke-a-population-based-study
#12
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Toshiki Sera, Kent Doi, Naoki Yahagi
Limited information is available regarding stroke-related out-of-hospital cardiac arrest (OHCA). We aimed to assess the clinical characteristics of stroke-related OHCA and to identify the factors associated with patient outcomes.We conducted a nationwide population-based study of adult OHCA patients in Japan from January 1, 2006 to December 31, 2009. We examined the epidemiology, risk factors, and outcomes of stroke-related OHCA compared with cardiogenic OHCA. The primary outcome was neurologically favorable survival...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27015217/impact-of-different-initial-epinephrine-treatment-time-points-on-the-early-postresuscitative-hemodynamic-status-of-children-with-traumatic-out-of-hospital-cardiac-arrest
#13
MULTICENTER STUDY
Yan-Ren Lin, Yuan-Jhen Syue, Waradee Buddhakosai, Huai-En Lu, Chin-Fu Chang, Chih-Yu Chang, Cheng Hsu Chen, Wen-Liang Chen, Chao-Jui Li
The postresuscitative hemodynamic status of children with traumatic out-of-hospital cardiac arrest (OHCA) might be impacted by the early administration of epinephrine, but this topic has not been well addressed. The aim of this study was to analyze the early postresuscitative hemodynamics, survival, and neurologic outcome according to different time points of first epinephrine treatment among children with traumatic OHCA.Information on 388 children who presented to the emergency departments of 3 medical centers and who were treated with epinephrine for traumatic OHCA during the study period (2003-2012) was retrospectively collected...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26944563/association-of-initial-rhythm-with-neurologically-favorable-survival-in-non-shockable-out-of-hospital-cardiac-arrest-without-a-bystander-witness-or-bystander-cardiopulmonary-resuscitation
#14
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Takehiro Matsubara, Kent Doi, Yoichi Kitsuta, Susumu Nakajima, Naoki Yahagi
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) has a predominantly non-shockable rhythm. Non-shockable rhythm, and the absence of a bystander witness or bystander cardiopulmonary resuscitation (CPR) are associated with poor outcomes. However, the association between the type of non-shockable rhythm and outcomes is not well known. OBJECTIVE: To examine the association between the initial rhythm and neurologically favorable outcomes after non-shockable OHCA without a bystander witness or bystander CPR...
May 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/26689353/cardiorespiratory-arrest-in-children-out-of-hospital
#15
Kristina Krmpotic, Hilary Writer
INTRODUCTION: Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children per year in resource-rich countries, with two-thirds of arrests occurring in children under 18 months of age. Approximately 45% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia. METHODS AND OUTCOMES: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview)...
2015: Clinical Evidence
https://www.readbyqxmd.com/read/26585517/prehospital-intravenous-epinephrine-may-boost-survival-of-patients-with-traumatic-cardiac-arrest-a-retrospective-cohort-study
#16
Wen-Chu Chiang, Shi-Yi Chen, Patrick Chow-In Ko, Ming-Ju Hsieh, Hui-Chih Wang, Edward Pei-Chuan Huang, Chih-Wei Yang, Kah-Meng Chong, Wei-Ting Chen, Shey-Ying Chen, Matthew Huei-Ming Ma
BACKGROUND: Prehospital resuscitation for patients with major trauma emphasizes a load-and-go principle. For traumatic cardiac arrest (TCA) patients, the administration of vasopressors remains under debate. This study evaluated the effectiveness of epinephrine in the prehospital setting for patients with TCA. METHODS: We conducted a retrospective cohort study using a prospectively collected registry for out-of-hospital cardiac arrest in Taipei. Enrollees were ≥18 years of age with TCA...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26529432/blinded-evaluation-of-combination-drug-therapy-for-prolonged-ventricular-fibrillation-using-a-swine-model-of-sudden-cardiac-arrest
#17
Timothy J Mader, Ryan A Coute, Adam R Kellogg, Brian H Nathanson
Despite experimental evidence supporting the use of resuscitation drugs in the treatment of sudden cardiac arrest (CA), there are no good human clinical data to support the decades-old practice of giving these medications during out-of-hospital CA resuscitation. We hypothesized that the lack of efficacy in clinical practice in ventricular fibrillation (VF) is the failure-based manner in which resuscitation drugs have historically been administered (one at a time interspersed with chest compressions and a defibrillation attempt, giving the next only if the previous one was ineffective)...
May 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26307453/the-time-dependent-association-of-adrenaline-administration-and-survival-from-out-of-hospital-cardiac-arrest
#18
MULTICENTER STUDY
Gordon A Ewy, Bentley J Bobrow, Vatsal Chikani, Arthur B Sanders, Charles W Otto, Daniel W Spaite, Karl B Kern
BACKGROUND: Recommended for decades, the therapeutic value of adrenaline (epinephrine) in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) is controversial. PURPOSE: To investigate the possible time-dependent outcomes associated with adrenaline administration by Emergency Medical Services personnel (EMS). METHODS: A retrospective analysis of prospectively collected data from a near statewide cardiac resuscitation database between 1 January 2005 and 30 November 2013...
November 2015: Resuscitation
https://www.readbyqxmd.com/read/26110059/effects-of-prehospital-epinephrine-administration-on-neurological-outcomes-in-patients-with-out-of-hospital-cardiac-arrest
#19
Yuichi Ono, Mineji Hayakawa, Takeshi Wada, Atsushi Sawamura, Satoshi Gando
BACKGROUND: To determine if the effects of epinephrine administration on the outcome of out-of-hospital cardiac arrest (OHCA), patients are associated with the duration of cardiopulmonary resuscitation (CPR) performed by Emergency Medical Service (EMS) personnel. METHODS: This retrospective, nonrandomized, observational analysis used the All-Japan Utstein Registry, a prospective, nationwide population-based registry of all OHCA patients transported to the hospital by EMS staff as the data source...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/25928051/the-number-of-prehospital-defibrillation-shocks-and-1-month-survival-in-patients-with-out-of-hospital-cardiac-arrest
#20
Manabu Hasegawa, Takeru Abe, Takashi Nagata, Daisuke Onozuka, Akihito Hagihara
BACKGROUND: The relationship between the number of pre-hospital defibrillation shocks and treatment outcome in patients with out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation (VF) is unknown currently. We examined the association between the number of pre-hospitalization defibrillation shocks and 1-month survival in OHCA patients. METHODS: We conducted a prospective observational study using national registry data obtained from patients with OHCA between January 1, 2009 and December 31, 2012 in Japan...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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