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Return of spontaneous circulation

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https://www.readbyqxmd.com/read/29777285/insufficient-left-ventricular-unloading-after-extracorporeal-membrane-oxygenation-a-case-series-observational-study
#1
W Hu, J Zhou, L Chen, J Huang, W Hu, Y Zhu, T Yuan
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a method widely used to support circulation in patients with fulminant myocarditis (FM). However, a common complication associated with ECMO is left ventricular (LV) overload. METHODS: This case series observed the effects of intra-aortic balloon pump (IABP) and beta-blockers for the treatment of LV overload after ECMO. The cases of eight patients with FM who underwent ECMO from September 2009 to July 2016 were reviewed...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29763714/optic-nerve-sheath-diameter-measured-using-early-unenhanced-brain-computed-tomography-shows-no-correlation-with-neurological-outcomes-in-patients-undergoing-targeted-temperature-management-after-cardiac-arrest
#2
Dong Hoon Lee, Sun Hwa Lee, Je Hyeok Oh, In Soo Cho, Young Hwan Lee, Chul Han, Wook Jin Choi, You Dong Sohn
AIM: Previous studies indicated that the optic nerve sheath diameter (ONSD) measured using brain computed tomography (CT) is a prognostic factor for poor neurological outcome after cardiac arrest. However, these studies were retrospective or included a small sample size. We performed a prospective multi-centre observational study to investigate the correlation between the ONSD on early brain CT and neurological outcomes in patients undergoing targeted temperature management (TTM). METHODS: This study used data from the Korean Hypothermia Network prospective registry between November 2015 and October 2016...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#3
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29752776/influence-of-prehospital-airway-management-on-neurological-outcome-in-patients-transferred-to-a-heart-attack-centre-following-out-of-hospital-cardiac-arrest
#4
Timothy Edwards, Julia Williams, Michaela Cottee
OBJECTIVE: To describe the association between prehospital airway management and neurological outcomes in patients transferred by the ambulance service directly to a heart attack centre (HAC) post-return of spontaneous circulation (ROSC). METHODS: A retrospective observational cohort study in which ambulance records were reviewed to determine prehospital airway management strategy and collect physiological and demographic data. HAC notes were obtained to determine in-hospital management and quantify neurological outcome via the cerebral performance category (CPC) scale...
May 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29746986/efficacy-and-safety-of-mechanical-versus-manual-compression-in-cardiac-arrest-a-bayesian-network-meta-analysis
#5
REVIEW
Safi U Khan, Ahmad N Lone, Swapna Talluri, Muhammad Z Khan, Muhammad U Khan, Edo Kaluski
AIM: To compare relative efficacy and safety of mechanical compression devices (AutoPulse and LUCAS) with manual compression in patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR). METHODS: For this Bayesian network meta-analysis, seven randomized controlled trials (RCTs) were selected using PubMed/Medline, EMBASE, and CENTRAL (Inception- 31 October 2017). For all the outcomes, median estimate of odds ratio (OR) from the posterior distribution with corresponding 95% credible interval (Cr I) was calculated...
May 7, 2018: Resuscitation
https://www.readbyqxmd.com/read/29739265/therapeutic-hypothermia-promotes-cerebral-blood-flow-recovery-and-brain-homeostasis-after-resuscitation-from-cardiac-arrest-in-a-rat-model
#6
Qihong Wang, Peng Miao, Hiren R Modi, Sahithi Garikapati, Raymond C Koehler, Nitish V Thakor
Laboratory and clinical studies have demonstrated that therapeutic hypothermia (TH), when applied as soon as possible after resuscitation from cardiac arrest (CA), results in better neurological outcome. This study tested the hypothesis that TH would promote cerebral blood flow (CBF) restoration and its maintenance after return of spontaneous circulation (ROSC) from CA. Twelve Wistar rats resuscitated from 7-min asphyxial CA were randomized into two groups: hypothermia group (7 H, n = 6), treated with mild TH (33-34℃) immediately after ROSC and normothermia group (7 N, n = 6,37...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29733921/circulation-assessment-by-automated-external-defibrillators-during-cardiopulmonary-resuscitation
#7
Jesus M Ruiz, Sofía Ruiz de Gauna, Digna M González-Otero, Purificación Saiz, J Julio Gutiérrez, Jose F Veintemillas, Jose M Bastida, Daniel Alonso
AIM: To design and evaluate a simple algorithm able to discriminate pulsatile rhythms from pulseless electrical activity during automated external defibrillator (AED) analysis intervals, using the ECG and the transthoracic impedance (TI) acquired from defibrillation pads. METHODS: ECG and TI signals from out-of-hospital AED recordings were retrospectively analysed. Experts annotated the cardiac rhythm during AED analysis intervals and at the end of each episode...
May 4, 2018: Resuscitation
https://www.readbyqxmd.com/read/29723609/advanced-vs-basic-life-support-in-the-treatment-of-out-of-hospital-cardiopulmonary-arrest-in-the-resuscitation-outcomes-consortium
#8
Michael Christopher Kurz, Robert H Schmicker, Brian Leroux, Graham Nichol, Tom P Aufderheide, Sheldon Cheskes, Brian Grunau, Jamie Jasti, Peter Kudenchuk, Gary M Vilke, Jason Buick, Lynn Wittwer, Ritu Sahni, Ronald Straight, Henry E Wang
BACKGROUND: Prior observational studies suggest no additional benefit from advanced life support (ALS) when compared with providing basic life support (BLS) for patients with out-of-hospital cardiac arrest (OHCA). We compared the association of ALS care with OHCA outcomes using prospective clinical data from the Resuscitation Outcomes Consortium (ROC). METHODS: Included were consecutive adults OHCA treated by participating emergency medical services (EMS) agencies between June 1, 2011, and June 30, 2015...
April 30, 2018: Resuscitation
https://www.readbyqxmd.com/read/29714510/does-non-targeted-community-cpr-training-increase-bystander-cpr-frequency
#9
Amy Uber, Richard C Sadler, Todd Chassee, Joshua C Reynolds
OBJECTIVE: Only 37% of out-of-hospital cardiac arrests (OHCA) receive bystander Cardiopulmonary resuscitation (CPR) in Kent County, MI. In May 2014, prehospital providers offered one-time, point-of-contact compression-only CPR training to 2,253 passersby at 7 public locations in Grand Rapids, Michigan. To assess the impact of this intervention, we compared bystander CPR frequency and clinical outcomes in regions surrounding training sites before and after the intervention, adjusting for prehospital covariates...
May 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29710068/association-of-prehospital-advanced-life-support-by-physician-with-survival-after-out-of-hospital-cardiac-arrest-with-blunt-trauma-following-traffic-collisions-japanese-registry-based-study
#10
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Kei Hayashida, Ichiro Kukita
Importance: Controversy remains as to whether advanced life support (ALS) or basic life support (BLS) is superior for critically ill and injured patients, including out-of-hospital cardiac arrest (OHCA) and major trauma, in the prehospital setting. Objective: To assess whether prehospital ALS should be provided for traumatic OHCA and who should perform it. Design, Setting, and Participants: Japanese government-managed nationwide population-based registry data of patients with OHCA transported to an emergency hospital were analyzed...
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29706055/hemoglobin-concentration-is-associated-with-neurologic-outcome-after-cardiac-arrest-in-patients-treated-with-targeted-temperature-management
#11
Daesung Kim, Soo Hyun Kim, Kyu Nam Park, Sang Hoon Oh, Young Min Kim, Chun Song Youn
Objective: The objective of this study was to test the hypothesis that hemoglobin concentration after return of spontaneous circulation (ROSC) is associated with neurologic outcome after cardiac arrest in patients treated with targeted temperature management. Methods: We studied consecutive adult patients with out-of-hospital cardiac arrest treated with targeted temperature management between January 2009 and December 2015. We quantified the association between post ROSC hemoglobin concentrations and good neurologic outcome (defined as Cerebral Performance Category of 1 and 2) at hospital discharge using multivariate logistic regression analysis...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29704693/cardiac-arrest-during-spine-surgery-in-the-prone-position-case-report-and-review-of-the-literature
#12
REVIEW
Victor E Staartjes, Shiva A Schillevoort, Patricia G Blum, J Peter van Tintelen, Wouter E Kok, Marc L Schröder
OBJECTIVE: Intraoperative cardiac arrest (CA) is usually attributable to pre-existing disease, or to intraoperative complications. In rare cases, intraoperative stress can demask certain genetic diseases, such as Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). It is essential that neurosurgeons are aware of the etiologies, risk factors, and initial management of CA during surgery in the prone position. METHODS: We present a case of CA directly after spinal fusion for lumbar spondylolisthesis, and review the literature on cardiac arrests during spinal neurosurgery in the prone position...
April 26, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29703565/dispatcher-assisted-bystander-cardiopulmonary-resuscitation-and-survival-in-out-of-hospital-cardiac-arrest
#13
Akihito Hagihara, Daisuke Onozuka, Hidetoshi Shibuta, Manabu Hasegawa, Takashi Nagata
INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA. METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs...
April 19, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29698335/pediatric-veno-veno-extracorporeal-membrane-oxygenation-rescue-from-carbon-monoxide-poisoning
#14
David A Baran, Kelly Stelling, Derrick McQueen, Mark Pearson, Vaishali Shah
BACKGROUND: Carbon monoxide poisoning affects approximately 5000 children per year and can be challenging to diagnose and treat (Pediatr Emerg Med Pract. 2016;13:1-24). It is in the differential diagnosis of a patient presented with altered consciousness. Patients may look quite "pink" and well perfused, but are often in serious distress. We present the first case in the literature of carbon monoxide poisoning treated with the use of veno-veno extracorporeal membrane oxygenation (ECMO)...
April 25, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29685358/the-gradient-between-arterial-and-end-tidal-carbon-dioxide-predicts-in-hospital-mortality-in-post-cardiac-arrest-patient
#15
Yong Won Kim, Sung Oh Hwang, Hee Seung Kang, Kyoung-Chul Cha
PURPOSE: We investigated the predictive value of the gradient between arterial carbon dioxide (PaCO2 ) and end-tidal carbon dioxide (ETCO2 ) (Pa-ETCO2 ) in post-cardiac arrest patients for in-hospital mortality. METHODS: This retrospective observational study evaluated cardiac arrest patients admitted to the emergency department of a tertiary university hospital. The PaCO2 and ETCO2 values at 6, 12, and 24 h after return of spontaneous circulation (ROSC) were obtained from medical records and Pa-ETCO2 gap was calculated as the difference between PaCO2 and ETCO2 at each time point...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29684433/oxygen-titration-after-resuscitation-from-out-of-hospital-cardiac-arrest-a-multi-centre-randomised-controlled-pilot-study-the-exact-pilot-trial
#16
Janet E Bray, Cindy Hein, Karen Smith, Michael Stephenson, Hugh Grantham, Judith Finn, Dion Stub, Peter Cameron
INTRODUCTION: Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. METHODS: We enrolled unconscious adults with: sustained ROSC; initial shockable rhythm; an advanced airway; and an SpO2 ≥ 95%...
April 20, 2018: Resuscitation
https://www.readbyqxmd.com/read/29666716/survival-after-cardiac-arrest-secondary-to-massive-pulmonary-embolism
#17
Abdullah E Laher, Muhammed Moolla, Feroza Motara, Fathima Paruk, Guy Richards
Introduction: It is estimated that the diagnosis of pulmonary embolism (PE) is missed in as many as 84% of all cases of PE. Cardiac arrest following PE is generally associated with poor outcomes. Case Report: A 43-year-old man presented to the Emergency Department (ED) in cardiac arrest. Swelling of his right lower limb was noted on arrival. Point of care ultrasound was performed during ongoing cardiopulmonary resuscitation (CPR) and showed a thrombus in the right iliofemoral vein as well as dilatation of the right ventricle...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29665427/end-tidal-co-2-guided-automated-robot-cpr-system-in-the-pig-preliminary-communication
#18
Gil Joon Suh, Jaeheung Park, Jung Chan Lee, Sang Hoon Na, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, Yoon Sun Jung, Jung-In Ko, So Mi Shin, Kyoung Min You
BACKGROUND: Our aim was to compare the efficacy of the end-tidal CO2 -guided automated robot CPR (robot CPR) system with manual CPR and mechanical device CPR. METHODS: We developed the algorithm of the robot CPR system which automatically finds the optimal compression position under the guidance of end-tidal CO2 feedback in swine models of cardiac arrest. Then, 18 pigs after 11 minutes of cardiac arrest were randomly assigned to one of three groups, robot CPR, LUCAS CPR, and manual CPR groups (n = 6 each group)...
April 14, 2018: Resuscitation
https://www.readbyqxmd.com/read/29661780/gender-and-survival-from-out-of-hospital-cardiac-arrest-a-new-zealand-registry-study
#19
Bridget Dicker, Kate Conaglen, Graham Howie
OBJECTIVE: To determine the relationships between survival from all-cause out-of-hospital cardiac arrest (OHCA) and gender in New Zealand. METHODS: A retrospective observational study was conducted using data compliant with the Utstein guidelines from the St John New Zealand OHCA Registry for adult patients who were treated for an OHCA between 1 October 2013 and 30 September 2015. Univariate logistic regression was used to investigate factors associated with return of spontaneous circulation sustained to handover at hospital and survival to 30 days...
April 16, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29652719/vasopressors-during-cardiopulmonary-resuscitation-a-network-meta-analysis-of-randomized-trials
#20
Alessandro Belletti, Umberto Benedetto, Alessandro Putzu, Enrico A Martino, Giuseppe Biondi-Zoccai, Gianni D Angelini, Alberto Zangrillo, Giovanni Landoni
OBJECTIVES: Several randomized controlled trials have compared adrenaline (epinephrine) with alternative therapies in patients with cardiac arrest with conflicting results. Recent observational studies suggest that adrenaline might increase return of spontaneous circulation but worsen neurologic outcome. We systematically compared all the vasopressors tested in randomized controlled trials in adult cardiac arrest patients in order to identify the treatment associated with the highest rate of return of spontaneous circulation, survival, and good neurologic outcome...
May 2018: Critical Care Medicine
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