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Return of spontaneous circulation

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https://www.readbyqxmd.com/read/28328788/early-presence-of-sleep-spindles-on-electroencephalography-is-associated-with-good-outcome-after-pediatric-cardiac-arrest
#1
Laurence Ducharme-Crevier, Craig A Press, Jonathan E Kurz, Michele G Mills, Joshua L Goldstein, Mark S Wainwright
OBJECTIVES: The role of sleep architecture as a biomarker for prognostication after resuscitation from cardiac arrest in children hospitalized in an ICU remains poorly defined. We sought to investigate the association between features of normal sleep architecture in children after cardiac arrest and a favorable neurologic outcome at 6 months. DESIGN: Retrospective review of medical records and continuous electroencephalography monitoring. SETTING: Cardiac and PICU of a tertiary children's hospital...
March 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28328299/early-left-ventricular-ejection-fraction-as-a-predictor-of-survival-after-cardiac-arrest
#2
Barry Burstein, Dev Jayaraman, Regina Husa
Although echocardiograms are frequently performed within 24 h of sudden cardiac death, the utility of left ventricular ejection fraction (LVEF) to predict survival is unknown. In this is single center retrospective cohort study of patients admitted to the intensive care unit or coronary care unit after in-hospital or out-of-hospital sudden cardiac death, LVEF <40% was not a significant predictor of survival at 30 days or hospital discharge. ABSTRACT Background: Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest...
March 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/28314170/-pseudo-subarachnoid-hemorrhage-sign-on-early-brain-computed-tomography-in-out-of-hospital-cardiac-arrest-survivors-receiving-targeted-temperature-management
#3
Byung Kook Lee, Youn-Jung Kim, Seung Mok Ryoo, Su Jin Kim, Dong Hun Lee, Kyung Woon Jeung, Won Young Kim
PURPOSE: Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. MATERIALS AND METHODS: We retrospectively evaluated the registries of 2 tertiary hospitals, identifying 836 adult (≥18 years) patients achieving return of spontaneous circulation after out-of-hospital cardiac arrest...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28302139/targeted-temperature-management-in-cardiac-arrest-survival-evaluated-by-propensity-score-matching
#4
Eirik A Buanes, Karl O Hufthammer, Jørund Langørgen, Anne-Berit Guttormsen, Jon-Kenneth Heltne
BACKGROUND: Targeted temperature management in cardiac arrest was introduced following evidence of increased survival from two controlled trials published in 2002. We wanted to investigate whether the introduction of targeted temperature management to clinical practice had increased the survival of cardiac arrest patients at Haukeland University Hospital, Norway. METHODS: We included 336 unresponsive patients admitted to the emergency department between December 2003 and December 2008 with return of spontaneous circulation following out-of-hospital cardiac arrest in the analysis...
March 16, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28288774/intravenous-vs-intraosseous-access-and-return-of-spontaneous-circulation-during-out-of-hospital-cardiac-arrest
#5
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/28285032/the-association-between-physician-turnover-the-july-effect-and-survival-after-in-hospital-cardiac-arrest
#6
Laura Myers, Bassem Mikhael, Paul Currier, Katherine Berg, Anupam Jena, Michael Donnino, Lars W Andersen
IMPORTANCE: The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. OBJECTIVE: As a surrogate for physician turnover, we used a multivariable difference-in-difference approach to determine if there was a difference in outcomes between May and July in teaching versus non-teaching hospitals. DESIGN: We used prospectively collected observational data from United States hospitals participating in the Get With The Guidelines(®)-Resuscitation registry...
March 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28280734/saving-the-on-scene-time-for-out-of-hospital-cardiac-arrest-patients-the-registered-nurses-role-and-performance-in-emergency-medical-service-teams
#7
Ming-Wei Lin, Che-Yu Wu, Chih-Long Pan, Zhong Tian, Jyh-Horng Wen, Jet-Chau Wen
For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28279312/the-role-of-post-resuscitation-electrocardiogram%C3%A2-in-patients-with%C3%A2-st-segment%C3%A2-changes-in-the-immediate%C3%A2-post-cardiac-arrest-period
#8
Youn-Jung Kim, Sun-Yang Min, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Hui Jai Lee, Jonghwan Shin, Byuk Sung Ko, Shin Ahn, Gi-Byoung Nam, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. BACKGROUND: The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28270248/the-resuscitative-and-pharmacokinetic-effects-of-humeral-intraosseous-vasopressin-in-a-swine-model-of-ventricular-fibrillation
#9
James M Burgert, Arthur D Johnson, Jose Garcia-Blanco, Lawrence V Fulton, Michael J Loughren
Introduction The American Heart Association (AHA; Dallas, Texas USA) and European Resuscitation Council (Niel, Belgium) cardiac arrest (CA) guidelines recommend the intraosseous (IO) route when intravenous (IV) access cannot be obtained. Vasopressin has been used as an alternative to epinephrine to treat ventricular fibrillation (VF). Hypothesis/Problem Limited data exist on the pharmacokinetics and resuscitative effects of vasopressin administered by the humeral IO (HIO) route for treatment of VF. The purpose of this study was to evaluate the effects of HIO and IV vasopressin, on the occurrence, odds, and time of return of spontaneous circulation (ROSC) and pharmacokinetic measures in a swine model of VF...
March 8, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28268187/initial-arterial-carbon-dioxide-tension-is-associated-with-neurological-outcome-after-resuscitation-from-cardiac-arrest
#10
Molly L Tolins, Daniel J Henning, David F Gaieski, Anne V Grossestreuer, Alison Jaworski, Nicholas J Johnson
STUDY OBJECTIVES: To determine the relationships between partial pressure of arterial carbon dioxide (PaCO2), prescribed minute ventilation (MV), and neurologic outcome in patients resuscitated from cardiac arrest. METHODS: This was a retrospective cohort study utilizing a multicenter database of adult patients with return of spontaneous circulation (ROSC) after cardiac arrest. The primary outcome was neurologic status at hospital discharge, defined by Cerebral Performance Category (CPC) score: CPC 1-2 was favorable, CPC 3-5 was poor...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28263791/accuracy-of-point-of-care-focused-echocardiography-in-predicting-outcome-of-resuscitation-in-cardiac-arrest-patients-a-systematic-review-and-meta-analysis
#11
REVIEW
Po-Yang Tsou, Jeantte Kurbedin, Yueh-Sheng Chen, Eric H Chou, Meng-Tse Gabriel Lee, Matthew Chien-Hung Lee, Matthew Huei-Ming Ma, Shyr-Chyr Chen, Chien-Chang Lee
OBJECTIVE: We aim to summarize current evidence on the value of Point-of-Care (POC) focused echocardiography in the assessment of short-term survival in patients with cardiac arrest. METHODS: PubMed and EMBASE were searched from inception to July 2016 for eligible studies that evaluated the utility of POC echocardiography in patients with cardiac arrest. Modified QUADAS was used to appraise the quality of included studies. A random-effect bivariate model and a hierarchical summary receiving operating curve were used to summarize the performance characteristics of focused echocardiography...
March 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28253519/reliability-of-pulse-oximetry-during-progressive-hypoxia-cardiopulmonary-resuscitation-and-recovery-in-a-piglet-model-of-neonatal-hypoxic-cardiac-arrest
#12
Mohammad Ahmad Hassan, Claudia Weber, Markus Waitz, Li Huang, Helmut D Hummler, Marc Robin Mendler
BACKGROUND: Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. OBJECTIVE: To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during progressive hypoxia, cardiac arrest, cardiopulmonary resuscitation (CPR), and after return of spontaneous circulation (ROSC). METHODS: Thirty-three newborn piglets were exposed to hypoxia until asystole occurred and then resuscitated until ROSC...
March 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#13
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#14
Anne-Laure Constant, Nicolas Mongardon, Quentin Morelot, Nicolas Pichon, David Grimaldi, Lauriane Bordenave, Alexis Soummer, Bertrand Sauneuf, Sybille Merceron, Sylvie Ricome, Benoit Misset, Cedric Bruel, David Schnell, Julie Boisramé-Helms, Etienne Dubuisson, Jennifer Brunet, Sigismond Lasocki, Pierrick Cronier, Belaid Bouhemad, Serge Carreira, Emmanuelle Begot, Benoit Vandenbunder, Gilles Dhonneur, Philippe Jullien, Matthieu Resche-Rigon, Jean-Pierre Bedos, Claire Montlahuc, Stephane Legriel
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67...
April 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28214793/evaluation-of-timing-and-route-of-epinephrine-in-a-neonatal-model-of-asphyxial-arrest
#15
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, William J Jusko, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Myra H Wyckoff, Satyan Lakshminrusimha
BACKGROUND: Epinephrine administered by low umbilical venous catheter (UVC) or endotracheal tube (ETT) is indicated in neonates who fail to respond to positive pressure ventilation and chest compressions at birth. Pharmacokinetics of ETT epinephrine via fluid-filled lungs or UVC epinephrine in the presence of fetal shunts is unknown. We hypothesized that epinephrine administered by ETT or low UVC results in plasma epinephrine concentrations and rates of return of spontaneous circulation (ROSC) similar to right atrial (RA) epinephrine...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#16
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28202420/out-of-hospital-cardiac-arrest-ohca-attended-by-mobile-emergency-teams-with-a-physician-on-board-results-of-the-spanish-ohca-registry-oshcar
#17
Fernando Rosell-Ortiz, Xavier Escalada-Roig, Patricia Fernández Del Valle, Luis Sánchez-Santos, José M Navalpotro-Pascual, Alfredo Echarri-Sucunza, José M Adsuar-Quesada, Isabel Ceniceros-Rozalén, José I Ruiz-Azpiazu, Karlos Ibarguren-Olalde, Nuria López-Cabeza, María V Mier-Ruiz, Enrique Martín-Sánchez, Marta Martínez Del Valle, Guadalupe Inza-Muñoz, Juan A Cordero Torres, María J García-Ochoa, José A Cortés-Ramas, Raúl Canabal-Berlanga, Rafael Zoyo López-Navarro, Juan B López-Messa, Javier García Del Águila, Daniel Alonso-Moreno, Carmen Pozo-Pérez, José Bravo-Castello, Natividad Ramos-García, Ignacio Gómez-Larrosa, Francisco J Mellado-Vergel
Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by 19 public EMS in Spain, covering the period from 1-October 2013 to 30-October 2014. RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence 18...
February 13, 2017: Resuscitation
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
#18
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/28202258/sudden-cardiac-death-and-coronary-disease-in-the-young-a-nationwide-cohort-study-in-denmark
#19
Sára Zachariasardóttir, Bjarke Risgaard, Frederik Nybye Ågesen, Reza Jabbari, Charlotte Glinge, Ole Ingemann-Hansen, Gyda Lolk Ottesen, Jørgen Lange Thomsen, Stig Haunsø, Jytte Banner, Bo Gregers Winkel, Jacob Tfelt-Hansen
BACKGROUND: Sudden cardiac death caused by coronary artery disease (CAD-SCD) is the most frequent cause of SCD in persons <50years. The aim of this study was to examine differences in clinical characteristics and autopsy findings of the heart among 18-35 and 36-49year old CAD-SCD cases. METHODS: We have previously identified all sudden cardiac deaths in Denmark through review of death certificates and autopsy reports including all deaths between 2000 and 2006 in individuals aged 18-35years and all deaths between 2007 and 2009 in individuals aged 18-49years...
January 28, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#20
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
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