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Epinephrine in out of hospital arrest

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https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#1
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28402986/no-small-matter-pediatric-resuscitation
#2
Taylor McCormick, Kevin McVaney, Paul E Pepe
PURPOSE OF REVIEW: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied...
April 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28395982/cardiopulmonary-resuscitation-of-out-of-hospital-traumatic-cardiac-arrest-in-qatar-a-nationwide-population-based-study
#3
Furqan B Irfan, Rafael Consunji, Ayman El-Menyar, Pooja George, Ruben Peralta, Hassan Al-Thani, Stephen Hodges Thomas, Guillaume Alinier, Ashfaq Shuaib, Jassim Al-Suwaidi, Rajvir Singh, Maaret Castren, Peter A Cameron, Therese Djarv
BACKGROUND: Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar. METHODS: An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA)...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28288774/intravenous-vs-intraosseous-access-and-return-of-spontaneous-circulation-during-out-of-hospital-cardiac-arrest
#4
COMPARATIVE STUDY
Brian Clemency, Kaori Tanaka, Paul May, Johanna Innes, Sara Zagroba, Jacqueline Blaszak, David Hostler, Derek Cooney, Kevin McGee, Heather Lindstrom
INTRODUCTION: Guidelines endorse intravenous (IV) and intraosseous (IO) medication administration for cardiac arrest treatment. Limited clinical evidence supports this recommendation. A multiagency, retrospective study was performed to determine the association between parenteral access type and return of spontaneous circulation (ROSC) in out of hospital cardiac arrest. METHODS: This was a structured, retrospective chart review of emergency medical services (EMS) records from three agencies...
February 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28276880/effectiveness-of-prehospital-epinephrine-administration-in-improving-long-term-outcomes-of-witnessed-out-of-hospital-cardiac-arrest-patients-with-initial-non-shockable-rhythms
#5
Jun Tomio, Shinji Nakahara, Hideto Takahashi, Masao Ichikawa, Masamichi Nishida, Naoto Morimura, Tetsuya Sakamoto
OBJECTIVE: We evaluated the association between prehospital epinephrine administration by emergency medical services (EMS) and the long-term outcomes of out-of-hospital cardiac arrest (OHCA) with initial pulseless electrical activity (PEA) or asystole. METHODS: We conducted a controlled, propensity-matched, retrospective cohort study by using Japan's nationwide OHCA registry database. We studied 110,239 bystander-witnessed OHCA patients aged 15-94 years with initial non-shockable rhythms registered between January 2008 and December 2012...
February 7, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28274812/pediatric-cardiac-arrest-due-to-drowning-and-other-respiratory-etiologies-neurobehavioral-outcomes-in-initially-comatose-children
#6
Beth S Slomine, Vinay M Nadkarni, James R Christensen, Faye S Silverstein, Russell Telford, Alexis Topjian, Joshua D Koch, Jill Sweney, Ericka L Fink, Mudit Mathur, Richard Holubkov, J Michael Dean, Frank W Moler
AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28185923/factors-associated-with-the-outcome-of-out-of-hospital-cardiopulmonary-arrest-among-people-over-80-years-old-in-japan
#7
Takashi Nagata, Takeru Abe, Manabu Hasegawa, Akihito Hagihara
AIM: To determine if termination of resuscitation should be considered for older individuals, we sought to identify factors associated with clinical outcome following out-of-hospital cardiac arrest (OHCA) in people ≥80 years old and over. METHODS: A prospective, population-based, observational study was conducted for ≥80-year-old individuals who experienced out-of-hospital cardiac arrest and to whom resuscitation was provided by emergency responders between January 1, 2005 and December 31, 2012 (n=377,577)...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28102532/time-to-epinephrine-in-out-of-hospital-cardiac-arrest-a-retrospective-analysis-of-intraosseous-versus-intravenous-access
#8
Elliot M Ross, Julian Mapp, Chetan Kharod, David A Wampler, Christopher Velasquez, David A Miramontes
INTRODUCTION: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. METHODS: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28087097/quick-epinephrine-administration-induces-favorable-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients
#9
H Ueta, H Tanaka, S Tanaka, R Sagisaka, H Takyu
OBJECTIVE: This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month. METHODOLOGY: A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16min after 119 called and adrenaline was then administered within 22min of after contact. PATIENTS DIVIDED INTO TWO GROUPS: Patients were contacted within 8min of the 119 call (n=6956), and were contacted between 8 and 16min after the call (n=6370)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27942569/data-for-outcomes-of-acute-hospital-administration-of-amiodarone-and-or-lidocaine-in-shockable-patients-presenting-with-out-of-hospital-cardiac-arrest
#10
Chien-Hua Huang, Ping-Hsun Yu, Min-Shan Tsai, Po-Ya Chuang, Tzung-Dau Wang, Chih-Yen Chiang, Wei-Tien Chang, Matthew Huei-Ming Ma, Chao-Hsiun Tang, Wen-Jone Chen
The data presented in this article are related to the research article entitled "Acute Hospital Administration of Amiodarone and/or Lidocaine in Shockable Patients Presenting with Out-of-hospital Cardiac Arrest: A Nationwide Cohort Study" (C.H. Huang, P.H. Yu, M.S. Tsai et al., 2016) [1]. The data contains the information of co-morbidities coding from ICD-9 CM codes and specific difference in requirement between medical centers and non-medical centers in resuscitation. Univariate and multivariate logistic regression analysis for factors related to the outcome of survival to ICU admission and survival to hospital discharge are included in the data set...
February 2017: Data in Brief
https://www.readbyqxmd.com/read/27771299/sodium-nitroprusside-enhanced-cardiopulmonary-resuscitation-improves-short-term-survival-in-a-porcine-model-of-ischemic-refractory-ventricular-fibrillation
#11
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...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#12
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
#13
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-ems-call-for-out-of-hospital-cardiac-arrest-patients
#14
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)...
December 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
#15
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...
August 2, 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
#16
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
#17
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
#18
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
#19
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
#20
REVIEW
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
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