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Return of spontaneous circulation

Yoshikazu Goto, Akira Funada, Yumiko Goto
BACKGROUND: -The appropriate duration of cardiopulmonary resuscitation (CPR) for pediatric out-of-hospital cardiac arrests (OHCAs) remains unclear and may differ based on initial rhythm. We aimed to determine the relationship between the duration of prehospital CPR by emergency medical services (EMS) personnel and post-OHCA outcomes. METHODS: -We analyzed the records of 12,877 pediatric patients who experienced OHCAs (aged <18 years). Data were recorded in a nationwide Japanese database between 2005 and 2012...
October 24, 2016: Circulation
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-hour) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model...
October 19, 2016: Resuscitation
Yuan-Jhen Syue, Jyun-Bin Huang, Fu-Jen Cheng, Chia-Te Kung, Chao-Jui Li
Background. The survival rates of in-hospital cardiac arrests (IHCAs) are reportedly low at night, but the difference between the survival rates of cardiac origin and noncardiac origin IHCAs occurring at night remains unclear. Methods. Outcomes of IHCAs during different shifts (night, day, and evening) were compared and stratified according to the etiology (cardiac and noncardiac origin). Result. The rate of return of spontaneous circulation (ROSC) was 24.7% lower for cardiac origin IHCA and 19.4% lower for noncardiac origin IHCA in the night shift than in the other shifts...
2016: BioMed Research International
Alan M Batt, Ahmed S Al-Hajeri, Fergal H Cummins
To report the characteristics of out-of-hospital cardiac arrest patients and their outcomes in the emirates of Sharjah, Ras-al-Khaimah, Umm Al-Quwain, Fujairah, and Ajman in the United Arab Emirates (collectively known as the Northern Emirates). Methods: This is a prospective descriptive cohort study of out-of-hospital cardiac arrest incidents transported by the national ambulance crews between February 2014 and March 2015 in the Northern Emirates. Results: A total of 384 patients were enrolled in this study...
November 2016: Saudi Medical Journal
Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: -Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest (OHCA), and case features justifying longer or shorter durations are ill-defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in OHCA using a large, multi-center cohort. METHODS: -Secondary analysis of a North American, single blind, multi-center, cluster-randomized clinical trial (ROC-PRIMED) of consecutive adults with non-traumatic, EMS-treated, OHCA...
October 19, 2016: Circulation
Shashank S Sinha, Devraj Sukul, John J Lazarus, Vivek Polavarapu, Paul S Chan, Robert W Neumar, Brahmajee K Nallamothu
BACKGROUND: Cardiac arrest is a major public health concern worldwide. The extent and types of randomized controlled trials (RCT)-our most reliable source of clinical evidence-conducted in these high-risk patients over recent years are largely unknown. METHODS AND RESULTS: We performed a systematic review, identifying all RCTs published in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library from 1995 to 2014 that focused on the acute treatment of nontraumatic cardiac arrest in adults...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Gyuho Song, Yeonho You, Wonjoon Jeong, Junwan Lee, Yongchul Cho, Seungwhan Lee, Seung Ryu, Jinwoong Lee, Seungwhan Kim, Insool Yoo
OBJECTIVE: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) due to an acute myocardial infarction without cardiogenic shock required higher doses of vasopressors with low targeted temperature management (TTM) after return of spontaneous circulation. METHODS: We included consecutive comatose patients resuscitated from OHCA between January 2011 and December 2013. Patients with return of spontaneous circulation, regional wall motion abnormality on echocardiography, and coronary artery stenosis of ≥70% on percutaneous coronary artery angiography were enrolled...
March 2016: Clin Exp Emerg Med
Injune Park, Youn Jung Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim
Electrocardiogram changes in subarachnoid hemorrhage (SAH) have been described as ST-T changes that mimic acute coronary syndrome and even acute ST-segment elevation myocardial infarction. Elevation of cardiac enzymes and abnormality of regional myocardial wall motion have been reported frequently for SAH. We report a case of an out-of-hospital cardiac arrest survivor with high suspicion of ST-segment elevation myocardial infarction based on the electrocardiogram and bedside echocardiography, who had normal coronary arteries on emergent coronary angiography...
December 2015: Clin Exp Emerg Med
Tiffany Healey, Clifford Buckley, Matthew Mollman
BACKGROUND: Brugada syndrome is a genetic disorder that increases an individual's risk for sudden cardiac death and ventricular dysrhythmias that was first described by the Brugada brothers in 1992. Brugada syndrome is characterized by an atypical electrocardiogram pattern that includes a bundle branch block and ST-segment elevation in the precordial leads. CASE REPORT: A 74-year-old man had a cardiac arrest at the time of a low-speed motor vehicle collision. When emergency medical services arrived, the patient was in torsades de pointes...
October 14, 2016: Journal of Emergency Medicine
Sing C Tan, Benjamin Sieu-Hon Leong
BACKGROUND: Emergency Department Cardiac Arrests are typically classified with in-hospital cardiac arrests, but are yet to be well described as a distinct clinical entity. This study provides an Utstein style report on Emergency Department Cardiac Arrests, and identifies factors associated with survival. PATIENTS AND METHODS: Patients who experienced a cardiac arrest in the Emergency Department of the National University Hospital, Singapore, between January 2010 and August 2012 were studied...
October 4, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Jonathan H Rapp, Meggie Yuen, Teena Abraham
PURPOSE: There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist ondansetron. We report a fifth case in which the patient developed asystole after rechallenge with ondansetron. SUMMARY: A 36-year-old pregnant patient with no cardiac history, status post cerclage for cervical insufficiency, experienced nausea in the post ambulatory care unit after administration of morphine and indomethacin for pain...
November 2015: Hospital Pharmacy
Akira Funada, Yoshikazu Goto, Tetsuo Maeda, Hayato Tada, Ryota Teramoto, Yoshihiro Tanaka, Kenshi Hayashi, Masakazu Yamagishi
BACKGROUND: Population aging has rapidly progressed in Japan. However, few data exist regarding the characteristics of extremely elderly patients with out-of-hospital cardiac arrest (OHCA). We aimed to determine the prehospital predictors of one-month survival with favorable neurological outcomes (Cerebral Performance Category scale, category 1 or 2; CPC 1-2) in this population. METHODS: We investigated 23,520 OHCA patients aged ≥95 years from a prospectively recorded, nationwide, Utstein-style Japanese database between 2008 and 2012...
October 7, 2016: Journal of Cardiology
Jonghwan Shin, Kyuseok Kim, Yong Su Lim, Hui Jai Lee, Se Jong Lee, Euigi Jung, Joonghee Kim, Hyuk Jun Yang, Jin Joo Kim, Seong Youn Hwang
OBJECTIVE: The general incidence of intracranial hemorrhage (ICH) as a cause of out-of-hospital cardiac arrest (OHCA) remains unclear, although the incidence of subarachnoid hemorrhage has been determined to be 4% to 18%. The main objectives of our study were to describe the incidence of ICH in OHCA and the different laboratory findings between ICH and non-ICH groups. METHODS: A retrospective cohort study using the prospective OHCA registry was conducted at three university hospitals in Korea...
August 23, 2016: American Journal of Emergency Medicine
David Snipelisky, Jordan Ray, Gautam Matcha, Archana Roy, Brooke Clark, Adrian Dumitrascu, Veronica Bosworth, Anastasia Whitman, Patricia Lewis, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton
INTRODUCTION: Little data exists evaluating how different risk factors influence outcomes following in-hospital arrests. METHODS: A retrospective review of patients that suffered a cardiopulmonary arrest between 1 May 2008 and 30 June 2014 was performed. Patients were stratified into subsets based on cardiac versus non-cardiac reasons for admission. RESULTS: 199 patients met inclusion criteria, of which 138 (69.3%) had a non-cardiac reason for admission and 61 (30...
December 2015: Acute Cardiac Care
Lars W Andersen, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Anne V Grossestreuer, Tobias Kurth, Michael W Donnino
Importance: Tracheal intubation is common during pediatric in-hospital cardiac arrest, although the relationship between intubation during cardiac arrest and outcomes is unknown. Objective: To determine if intubation during pediatric in-hospital cardiac arrest is associated with improved outcomes. Design, Setting, and Participants: Observational study of data from United States hospitals in the Get With the Guidelines-Resuscitation registry...
October 4, 2016: JAMA: the Journal of the American Medical Association
Gregory J Hollis, Toby M Keene, Rory M Ardlie, David Ge Caldicott, Stuart G Stapleton
OBJECTIVE: The aim of this study was to describe prehospital use of ketamine by ACT Ambulance Service, and frequency of endotracheal intubation. METHODS: This was a retrospective study of patients receiving prehospital ketamine between 1 January and 31 December 2013. Episodes were identified from the prehospital electronic patient care records, then linkage to ED records at two receiving hospitals. Demographics, dose, indication and occasions of intubation were analysed...
October 3, 2016: Emergency Medicine Australasia: EMA
Jiří Bonaventura, David Alan, Jiri Vejvoda, Jakub Honek, Josef Veselka
In spite of many years of development and implementation of pre-hospital advanced life support programmes, the survival rate of out-of-hospital cardiac arrest (OHCA) used to be very poor. Neurologic injury from cerebral hypoxia is the most common cause of death in patients with OHCA. In the past two decades, post-resuscitation care has developed many new concepts aimed at improving the neurological outcome and survival rate of patients after cardiac arrest. Systematic post-cardiac arrest care after the return of spontaneous circulation, including induced mild therapeutic hypothermia (TH) in selected patients, is aimed at significantly improving rates of long-term neurologically intact survival...
October 1, 2016: Archives of Medical Science: AMS
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki E Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel M Brown, Terrell Caffery, Emily Douglass, Jacqueline Fraser, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Fernando Lopez, Elke Platz, Michelle Mendoza, Hal Minnigan, Christopher Moore, Joseph Novik, Louise Rang, Will Scruggs, Christopher Raio
BACKGROUND: Point-of-care ultrasound has been suggested to improve outcomes from advanced cardiac life support (ACLS), but no large studies have explored how it should be incorporated into ACLS. Our aim was to determine whether cardiac activity on ultrasound during ACLS is associated with improved survival. METHODS: We conducted a non-randomized, prospective, protocol-driven observational study at 20 hospitals across United States and Canada. Patients presenting with out-of-hospital arrest or in-ED arrest with pulseless electrical activity or asystole were included...
September 28, 2016: Resuscitation
Bana Agha Nasser, Julinar Idris, Abdu Rahman Mesned, Tageldein Mohamad, Mohamed S Kabbani, Ali Alakfash
BACKGROUND: Outcomes of cardiopulmonary resuscitation (CPR) in children with congenital heart disease have improved and many children have survived after an in-hospital cardiac arrest. AIM: The purpose of this study is to determine predictors of poor outcome after CPR in critical children undergoing cardiac surgery. METHODS: We conducted a retrospective chart review and data analysis of all CPR records and charts of all postoperative cardiac children who had a cardiac arrest and required resuscitation from 2011 until 2015...
October 2016: Journal of the Saudi Heart Association
Patrik Gilje, Sasha Koul, Jakob Hartvig Thomsen, Yvan Devaux, Hans Friberg, Michael Kuiper, Janneke Horn, Niklas Nielsen, Tomasso Pellis, Pascal Stammet, Matthew P Wise, Jesper Kjaergaard, Christian Hassager, David Erlinge
AIM OF THE STUDY: Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA). Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA...
October 2016: Resuscitation
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