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Return of spontaneous circulation

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https://www.readbyqxmd.com/read/29157790/improving-the-neurological-prognosis-following-ohca-using-real-time-evaluation-of-cerebral-tissue-oxygenation-a-case-report
#1
Yasuaki Koyama, Yoshiaki Inoue, Shuhei Hisago, Aiki Marushima, Keiichi Hagiya, Yuichiro Yamasaki, Yuki Enomoto, Nobutake Shimojo, Satoru Kawano, Taro Mizutani
BACKGROUND: The neurological prognosis is poor for patients suffering from out-of-hospital cardiac arrest (OHCA), in the absence of bystander cardio pulmonary resuscitation (CPR), and showing asystole as the initial waveform. However, such patients have the potential of resuming social activity if cerebral tissue oxygen saturation can be preserved. CASE PRESENTATION: We recently encountered a 60-year-old man who had suffered an OHCA in the absence of bystander CPR, and who successfully resumed complete social activity despite initial asystole and requiring at least 75min of chest compressions before return of spontaneous circulation (ROSC)...
November 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29146493/predicting-rosc-in-out-of-hospital-cardiac-arrest-using-expiratory-carbon-dioxide-concentration-is-trend-detection-instead-of-absolute-threshold-values-the-key
#2
Peter Brinkrolf, Matthias Borowski, Camilla Metelmann, Roman-Patrik Lukas, Laura Pidde-Küllenberg, Andreas Bohn
AIM: Guidelines recommend detecting return of spontaneous circulation (ROSC) by a rising concentration of carbon dioxide in the exhalation air. As CO2 is influenced by numerous factors, no absolute cut-off values of CO2 to detect ROSC are agreed on so far. As trends in CO2 might be less affected by influencing factors, we investigated an approach which is based on detecting CO2-trends in real-time. METHODS: We conducted a retrospective case-control study on 169 CO2 time series from out of hospital cardiac arrests resuscitated by Muenster City Ambulance-Service, Germany...
November 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/29146024/effect-of-serum-albumin-concentration-on-neurological-outcome-after-out-of-hospital-cardiac-arrest-from-the-critical-comprehensive-registry-of-intensive-cares-for-ohca-survival-study-in-osaka-japan
#3
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takeshi Shimazu, Takashi Kawamura, Tetsuhisa Kitamura
The aim of this study was to assess whether serum albumin concentration upon hospital arrival had prognostic indications on out-of-hospital cardiac arrest (OHCA). This prospective, multicenter observational study conducted in Osaka, Japan (the CRITICAL [Comprehensive Registry of Intensive Cares for OHCA Survival] study), enrolled all patients with consecutive OHCA transported to 14 participating institutions. We included adult patients aged ≥18 years with nontraumatic OHCA who achieved return of spontaneous circulation and whose serum albumin concentration was available from July 2012 to December 2014...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29131707/plasma-neutrophil-gelatinase-associated-lipocalin-measured-immediately-after-restoration-of-spontaneous-circulation-predicts-acute-kidney-injury-in-cardiac-arrest-survivors-who-underwent-therapeutic-hypothermia
#4
Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Yong Hun Jung, Sung Min Lee, Jung Soo Park, Kyung Woon Jeung
Early diagnosis of acute kidney injury (AKI) after cardiac arrest (CA) is challenging. We aimed to identify the diagnostic and prognostic performance of neutrophil gelatinase-associated lipocalin (NGAL) for AKI and its clinical outcomes. A retrospective observational study, involving adult comatose CA survivors treated with therapeutic hypothermia between May 2013 and December 2016, was conducted. AKI was classified according to the guidelines of Kidney Disease Improving Global Outcomes. NGAL levels were measured after return of spontaneous circulation (ROSC)...
November 13, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29129249/association-between-hospital-rates-of-early-do-not-resuscitate-orders-and-favorable-neurological-survival-among-survivors-of-inhospital-cardiac-arrest
#5
Timothy J Fendler, John A Spertus, Kevin F Kennedy, Paul S Chan
BACKGROUND: Current guidelines recommend deferring prognostication for 48 to 72 hours after resuscitation from inhospital cardiac arrest. It is unknown whether hospitals vary in making patients who survive an arrest Do-Not-Resuscitate (DNR) early after resuscitation and whether a hospital's rate of early DNR is associated with its rate of favorable neurological survival. METHODS: Within Get With the Guidelines-Resuscitation, we identified 24,899 patients from 236 hospitals who achieved return of spontaneous circulation (ROSC) after inhospital cardiac arrest between 2006 and 2012...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29128033/association-of-the-emergency-medical-services-related-time-interval-with-survival-outcomes-of-out-of-hospital-cardiac-arrest-cases-in-four-asian-metropolitan-cities-using-the-scoop-and-run-emergency-medical-services-model
#6
Tae Han Kim, Kyungwon Lee, Sang Do Shin, Young Sun Ro, Hideharu Tanaka, Susan Yap, Kwanhathai Darin Wong, Yih Yng Ng, Thammapad Piyasuwankul, Benjamin Leong
BACKGROUND: Response time interval (RTI) and scene time interval (STI) are key time variables in the out-of-hospital cardiac arrest (OHCA) cases treated and transported via emergency medical services (EMS). OBJECTIVE: We evaluated distribution and interactive association of RTI and STI with survival outcomes of OHCA in four Asian metropolitan cities. METHODS: An OHCA cohort from Pan-Asian Resuscitation Outcome Study (PAROS) conducted between January 2009 and December 2011 was analyzed...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29126457/chest-compression-related-fatal-internal-mammary-artery-injuries-manifesting-after-venoarterial-extracorporeal-membrane-oxygenation-a-case-series
#7
Toshinobu Yamagishi, Masahiro Kashiura, Kazuhiro Sugiyama, Kazuha Nakamura, Takuto Ishida, Takahiro Yukawa, Kazuki Miyazaki, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: Cardiopulmonary resuscitation-related bleeding, especially internal mammary artery injuries, can become life-threatening complications after initiating venoarterial extracorporeal membrane oxygenation owing to the frequent involvement of concomitant anticoagulant treatment, antiplatelet treatment, targeted temperature management, and bleeding coagulopathy. We report the cases of five patients who experienced this complication and discuss their management. CASE PRESENTATION: We retrospectively evaluated five patients with cardiopulmonary resuscitation-related internal mammary artery injuries who were treated between February 2011 and February 2016 at our institution...
November 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29124382/use-of-whole-body-ct-to-detect-patterns-of-cpr-related-injuries-after-sudden-cardiac-arrest
#8
Gregor M Dunham, Alexandre Perez-Girbes, Ferdia Bolster, Kellie Sheehan, Ken F Linnau
AIMS AND OBJECTIVES: We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT. METHODS AND MATERIALS: Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51...
November 9, 2017: European Radiology
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#9
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118952/24-hour-survival-after-cardiopulmonary-resuscitation-is-reduced-in-patients-with-diabetes-mellitus
#10
Ali Movahedi, Seyed Reza Mirhafez, Hamidreza Behnam-Voshani, Hamidreza Reihani, Gordon A Ferns, Javad Malekzadeh
Introduction: Diabetes mellitus is a risk factor for cardiovascular disease. Some recent studies have shown an association between diabetes and out-of-hospital cardiac arrest incidence and survival. We aimed to investigate whether there is an association between the presence of diabetes mellitus and survival after cardiopulmonary resuscitation (CPR) in patients with an in-hospital cardiac arrest. Methods: A cross-sectional study was conducted during the period of January to February 2014, among 80 cases of cardiopulmonary arrest in patients at Qaem hospital of Mashhad, Iran...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29116359/use-of-automated-external-defibrillators-for-in-hospital-cardiac-arrest-any-time-any-place
#11
A Wutzler, C Kloppe, A K Bilgard, A Mügge, C Hanefeld
BACKGROUND: Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital. METHODS: IHCA events outside the intensive care unit were analysed over a period of 21 months...
November 7, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29102980/real-time-ventricular-fibrillation-amplitude-spectral-area-analysis-to-guide-timing-of-shock-delivery-improves-defibrillation-efficacy-during-cardiopulmonary-resuscitation-in-swine
#12
Salvatore Aiello, Michelle Perez, Chad Cogan, Alvin Baetiong, Steven A Miller, Jeejabai Radhakrishnan, Christopher L Kaufman, Raúl J Gazmuri
BACKGROUND: The ventricular fibrillation amplitude spectral area (AMSA) predicts whether an electrical shock could terminate ventricular fibrillation and prompt return of spontaneous circulation. We hypothesized that AMSA can guide more precise timing for effective shock delivery during cardiopulmonary resuscitation. METHODS AND RESULTS: Three shock delivery protocols were compared in 12 pigs each after electrically induced ventricular fibrillation, with the duration of untreated ventricular fibrillation evenly stratified into 6, 9, and 12 minutes: AMSA-Driven (AD), guided by an AMSA algorithm; Guidelines-Driven (GD), according to cardiopulmonary resuscitation guidelines; and Guidelines-Driven/AMSA-Enabled (GDAE), as per GD but allowing earlier shocks upon exceeding an AMSA threshold...
November 4, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29097198/liver-lacerations-as-a-complication-of-cpr-during-pregnancy
#13
Timothy R Cox, Sarah D Crimmins, Allison M Shannon, Kristin L Atkins, Ronald Tesoriero, Andrew M Malinow
AIM: Cardiac arrest in peripartum patients is a rare but devastating event; reported rates in the literature range from 0.019% to 0.0085%. In the general population, a well-described complication of cardiopulmonary resuscitation (CPR), liver laceration and injury, is reported at a rate of between 0.5-2.9% after CPR. Liver laceration rate among peripartum patients receiving CPR has not been well-studied. We sought to find the rate of liver lacerations in the peripartum population associated with CPR, with the hypothesis that the rate would be higher than in the general population...
October 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/29089341/mechanical-cardiopulmonary-resuscitation-and-hospital-survival-among-adult-patients-with-nontraumatic-out-of-hospital-cardiac-arrest-attending-the-emergency-department-a-prospective-multicenter-observational-study-in-japan-sos-kanto-survey-of-survivors-after
#14
Kei Hayashida, Takashi Tagami, Tatsuma Fukuda, Masaru Suzuki, Naohiro Yonemoto, Yutaka Kondo, Tomoko Ogasawara, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. METHODS AND RESULTS: In a prospective, multicenter, observational study, adult patients with out-of-hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29077660/successful-resuscitation-of-maternal-cardiac-arrest-with-disseminated-intravascular-coagulation-guided-by-rotational-thromboelastometry-and-transesophageal-echocardiography-a-case-report
#15
Hannah Brown, Helen L Barrett, Julie Lee, Jason M Pincus, Rebecca M Kimble, Victoria A Eley
We present a case of maternal cardiac arrest during an elective cesarean delivery. Transesophageal echocardiography identified a large pulmonary artery mass, and guided resuscitation efforts. After return of spontaneous circulation, the patient developed disseminated intravascular coagulation with massive hemorrhage. Blood product selection and volume replacement were guided by rotational thromboelastometry and transesophageal echocardiography, respectively. Correction of coagulopathy was observed clinically and confirmed by rotational thromboelastometry...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29076947/left-versus-biventricular-assist-devices-in-cardiac-arrest
#16
Erik J S Packer, Grete Slettom, Atle Solholm, Arve Mongstad, Rune Haaverstad, Vegard Tuseth, Ketil Grong, Jan Erik Nordrehaug
Maintaining adequate organ perfusion during cardiac arrest remains a challenge, and various assist techniques have been evaluated. We assessed whether a right ventricular impeller assist device (RVAD) in adjunct to a left ventricular impeller assist device (LVAD) is beneficial. Twenty anesthetized pigs were randomized to maximized circulatory support by percutaneously implanted left- or biventricular assist device(s) during 30 minutes of electrically induced ventricular fibrillation followed by three attempts of cardioversion...
October 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29072869/research-protocol-intravenous-access-during-resuscitation-the-ivar-trial
#17
Pwb Nanayakkara, Y M Smulder
OBJECTIVE: To compare the effects of central versus peripheral drug administration on the rate of return of organised electrical activity and/or spontaneous circulation during CPR. STUDY DESIGN: Randomized clinical trial. STUDY POPULATION: Hospitalized patients and patients presenting at the emergency department, older than 18 years, requiring CPR. INTERVENTION: Central venous access Main study parameters/endpoints: Combined primary endpoint: rate of appearance of organised electrical activity or return of spontaneous circulation...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29067112/bone-marrow-mesenchymal-stem-cells-repair-the-hippocampal-neurons-and-increase-the-expression-of-igf-1-after-cardiac-arrest-in-rats
#18
Xiahong Tang, Feng Chen, Qinming Lin, Yan You, Jun Ke, Shen Zhao
The present study aimed to investigate the beneficial effects and underlying mechanisms of bone marrow mesenchymal stem cells (BMSCs) on global ischemic hypoxic brain injury. Cells collected from the femurs and tibias of male Sprague Dawley rats were used to generate BMSCs following three culture passages. A rate model of cardiac arrest (CA) was induced by asphyxia. One hour following return of spontaneous circulation (ROSC), BMSCs were transplanted through injection into the tail vein. Neurological status was assessed using modified neurological severity score (mNSS) tests 1, 3 and 7 days following ROSC...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29064271/effects-of-extracorporeal-cardiopulmonary-resuscitation-on-neurological-and-cardiac-outcome-after-ischaemic-refractory-cardiac-arrest
#19
Francesca Cesana, Leonello Avalli, Laura Garatti, Anna Coppo, Stefano Righetti, Ivan Calchera, Elisabetta Scanziani, Paolo Cozzolino, Cristina Malafronte, Andrea Mauro, Federica Soffici, Endrit Sulmina, Veronica Bozzon, Elena Maggioni, Giuseppe Foti, Felice Achilli
BACKGROUND: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation...
October 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29064266/outcome-after-cardiopulmonary-resuscitation-in-patients-with-congenital-heart-disease
#20
Tim Van Puyvelde, Koen Ameloot, Mieke Roggen, Els Troost, Marc Gewillig, Werner Budts, Alexander Van De Bruaene
BACKGROUND: Outcome after cardiopulmonary resuscitation (CPR) in patients with underlying congenital heart disease is uncertain. This study aimed at evaluating outcome after CPR in patients with underlying congenital heart disease, factors related to worse outcome after CPR and whether survivors of sudden cardiac death (SCD) have a worse outcome when compared to an age, gender and disease-matched control population. METHODS: Between 1984 and 2015, all patients with congenital heart disease who received in or out-of-hospital CPR were identified from the database of congenital heart disease from the University Hospitals Leuven...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
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