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https://www.readbyqxmd.com/read/28202085/should-capnography-be-used-as-a-guide-for-choosing-a-ventilation-strategy-in-circulatory-shock-caused-by-severe-hypothermia-observational-case-series-study
#1
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Paweł Podsiadło, Mirosław Ziętkiewicz, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia can cause circulatory disturbances ranging from cardiac arrhythmias through circulatory shock to cardiac arrest. Severity of shock, pulmonary hypoperfusion and ventilation-perfusion mismatch are reflected by a discrepancy between measurements of CO2 levels in end-tidal air (EtCO2) and partial CO2 pressure in arterial blood (PaCO2). This disparity can pose a problem in the choice of an optimal ventilation strategy for accidental hypothermia victims, particularly in the prehospital period...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28198552/cortical-spreading-depolarizations-in-the-postresuscitation-period-in-a-cardiac-arrest-male-rat-model
#2
Frederik Boe Hansen, Niels Secher, Morten Skovgaard Jensen, Leif Østergaard, Else Tønnesen, Asger Granfeldt
Neurological injury develops over days following cardiac arrest (CA); however, the exact mechanisms remain unknown. After stroke or trauma, the progression of neurological injury is associated with cortical-spreading depolarizations (CSDs). The objective was to investigate whether CA and subsequent resuscitation in rats are associated with 1) the development of spontaneous negative direct current (DC) shifts indicative of CSDs, and 2) changes in artificially induced CSDs in the postresuscitation period. Male Sprague-Dawley rats were randomized into four groups: 1) CA 90, 2) Control 90, 3) CA 360, and 4) Control 360...
February 15, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28197046/outcome-of-noncardiac-surgical-patients-admitted-to-a-multidisciplinary-intensive-care-unit
#3
Pradeep Kumar, M K Renuka, M S Kalaiselvan, A S Arunkumar
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28185512/in-emergency-care-simulation-training-matters
#4
Neal Aplin
In a workplace emergency recently I was able to competently and confidently provide airway ventilation to a patient in cardiac arrest. Why? Because I had practised for such an eventuality during simulation training.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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
#5
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/28158980/early-exposure-to-hyperoxia-and-mortality-in-critically-ill-patients-with-severe-traumatic-injuries
#6
Derek W Russell, David R Janz, William L Emerson, Addison K May, Gordon R Bernard, Zhiguo Zhao, Tatsuki Koyama, Lorraine B Ware
BACKGROUND: Hyperoxia is common early in the course of resuscitation of critically ill patients. It has been associated with mortality in some, but not all, studies of cardiac arrest patients and other critically ill cohorts. Reasons for the inconsistency are unclear and may depend on unmeasured patient confounders, the timing and duration of hyperoxia, population characteristics, or the way that hyperoxia is defined and measured. We sought to determine whether, in a prospectively collected cohort of mechanically ventilated patients with traumatic injuries with and without head trauma, higher maximum partial pressure of arterial oxygen (PaO2) within 24 hours of admission would be associated with increased risk of in-hospital mortality...
February 3, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#7
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28127638/ecmo-in-cardiac-arrest-and%C3%A2-cardiogenic-shock
#8
L C Napp, C Kühn, J Bauersachs
Cardiogenic shock is an acute emergency, which is classically managed by medical support with inotropes or vasopressors and frequently requires invasive ventilation. However, both catecholamines and ventilation are associated with a worse prognosis, and many patients deteriorate despite all efforts. Mechanical circulatory support is increasingly considered to allow for recovery or to bridge until making a decision or definite treatment. Of all devices, extracorporeal membrane oxygenation (ECMO) is the most widely used...
February 2017: Herz
https://www.readbyqxmd.com/read/28116931/-at-what-age-can-children-perform-effective-cardiopulmonary-resuscitation-effectiveness-of-cardiopulmonary-resuscitation-skills-among-primary-school-children
#9
Bálint Bánfai, Attila Pandur, Emese Pék, Henrietta Csonka, József Betlehem
INTRODUCTION: In cardiac arrest life can be saved by bystanders. AIM: Our aim was to determine at what age can schoolchildren perform correct cardiopulmonary resuscitation. METHOD: 164 schoolchildren (age 7-14) were involved in the study. A basic life support training consisted of 45 minutes education in small groups (8-10 children). They were tested during a 2-minute-long continuous cardiopulmonary resuscitation scenario using the "AMBU CPR Software"...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28111195/endotracheal-tube-placement-confirmation-100-sensitivity-and-specificity-with-sustained-four-phase-capnographic-waveforms-in-a-cadaveric-experimental-model
#10
Salvatore Silvestri, Jay G Ladde, James F Brown, Jesus V Roa, Christopher Hunter, George A Ralls, Linda Papa
BACKGROUND: Waveform capnography is considered the gold standard for verification of proper endotracheal tube placement, but current guidelines caution that it is unreliable in low-perfusion states such as cardiac arrest. Recent case reports found that long-deceased cadavers can produce capnographic waveforms. The purpose of this study was to determine the predictive value of waveform capnography for endotracheal tube placement verification and detection of misplacement using a cadaveric experimental model...
January 19, 2017: Resuscitation
https://www.readbyqxmd.com/read/28108054/acute-respiratory-compromise-in-the-emergency-department-a-description-and-analysis-of-3571-events-from-the-get-with-the-guidelines-resuscitation%C3%A2-registry
#11
Carl Mathias Karlsson, Michael W Donnino, Hans Kirkegaard, Michael N Cocchi, Maureen Chase, Lars W Andersen
BACKGROUND: Respiratory events requiring the use of assisted ventilation are relatively common in the emergency department (ED), and can be associated with substantial morbidity and mortality. OBJECTIVE: The aim of this study was to describe and elucidate patient and event characteristics associated with mortality and progression to cardiac arrest in ED patients with acute respiratory compromise. METHODS: Data were obtained from the multicenter Get With the Guidelines-Resuscitation® registry...
January 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28098197/dantrolene-versus-amiodarone-for-cardiopulmonary-resuscitation-a-randomized-double-blinded-experimental-study
#12
Thomas Wiesmann, Dennik Freitag, Wolfgang Dersch, Daphne Eschbach, Marc Irqsusi, Thorsten Steinfeldt, Hinnerk Wulf, Carsten Feldmann
Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg(-1), dantrolene 2...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#13
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28078762/competence-in-the-use-of-supraglottic-airways-by-australian-surf-lifesavers-for-cardiac-arrest-ventilation-in-a-manikin
#14
Lachlan Holbery-Morgan, Cara Angel, Michelle Murphy, James Carew, Finn Douglas, Robert Murphy, Natalie Hood, Andrew Rechtman, Christopher Scarff, Nicholas Simpson, Andrew Stewardson, Daniel Steinfort, Sam Radford, Ned Douglas, Douglas Johnson
OBJECTIVES: Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation. METHODS: The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#15
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28051284/analysis-of-out-of-hospital-cardiac-arrest-in-croatia-survival-bystander-cardiopulmonary-resuscitation-and-impact-of-physician-s-experience-on-cardiac-arrest-management-a-single-center-observational-study
#16
Anita Lukić, Ileana Lulić, Dinka Lulić, Zoran Ognjanović, Davorin Cerovečki, Siniša Telebar, Ivica Mašić
AIM: To analyze the initial rhythm, bystander cardiopulmonary resuscitation (CPR) rate, and survival after out-of-hospital cardiac arrests (OHCA) in Varaľdin County (Croatia), and to investigate whether physician's inexperience in emergency medical services (EMS) has an impact on resuscitation management. METHODS: We reviewed clinical records and Revised Utstein cardiac arrest forms of all out-of-hospital resuscitations performed by EMS Varaľdin (EMSVz), Croatia, from 2007-2013...
December 31, 2016: Croatian Medical Journal
https://www.readbyqxmd.com/read/28045326/non-occlusive-mesenteric-ischaemia-in-out-of-hospital-cardiac-arrest-survivors
#17
Raphael Wurm, Anna Cho, Henrike Arfsten, Raphael van Tulder, Christian Wallmüller, Philipp Steininger, Fritz Sterz, Kristina Tendl, Csilla Balassy, Klaus Distelmaier, Martin Hülsmann, Gottfried Heinz, Christopher Adlbrecht
BACKGROUND AND AIM OF THE STUDY: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28045012/cardiopulmonary-resuscitation-knowledge-among-nursing-students-a-questionnaire-study
#18
Mutlu Vural, Mustafa Feridun Koşar, Orhan Kerimoğlu, Fatih Kızkapan, Serdar Kahyaoğlu, Sevil Tuğrul, Hasan Burak İşleyen
OBJECTIVE: Nurses are usually first witnesses to in-hospital sudden cardiac arrests. Training of nurses has an impact on the efficiency and outcome of cardiopulmonary resuscitation (CPR), and thus, assessment of CPR knowledge among undergraduate nurses is very important to improve training program. METHODS: The questionnaire comprised of three parts about CPR knowledge: the first dealing with general questions to understand the importance of CPR in clinical practice; the second comprising the main goal and accuracy of CPR intervention; and the last consisting of questions targeting the indications, methods, and effectiveness of CPR...
December 28, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28032304/l-carnitine-reduces-susceptibility-to-bupivacaine-induced-cardiotoxicity-an-experimental-study-in-rats
#19
Gail K Wong, Carolyne Pehora, Mark W Crawford
BACKGROUND: The primary aim of this study was to evaluate the effect of acute administration of L-carnitine 100 mg·kg(-1) iv on susceptibility to bupivacaine-induced cardiotoxicity in rats. METHODS: In the first of two experiments, L-carnitine 100 mg·kg(-1) iv (n = 10) or saline iv (n = 10) was administered to anesthetized and mechanically ventilated Sprague-Dawley rats following which an infusion of bupivacaine 2.0 mg·kg(-1)·min(-1) iv was given until asystole occurred...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28011292/utilization-of-palliative-care-services-for-cardiac-arrest-patients-undergoing-therapeutic-hypothermia-a-retrospective-analysis
#20
Emily K Zern, Michael N Young, Taylor Triana, Meng Xu, Benjamin Holmes, Nyal Borges, John A McPherson, Mohana B Karlekar
BACKGROUND: Palliative care (PC) services are integral to the care of patients with advanced medical illnesses. Given the significant morbidity and mortality associated with cardiac arrest, we sought to measure the use and impact of PC in the care of patients treated with therapeutic hypothermia (TH). METHODS: We conducted a retrospective study of 317 consecutive patients undergoing TH after cardiac arrest. We compared intensive care unit (ICU) characteristics and clinical outcomes of subjects who received PC consultation (n=125) to those who did not (n=192)...
December 21, 2016: Resuscitation
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