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Return of spontaneous circulation

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https://www.readbyqxmd.com/read/28927190/outcomes-differ-by-first-documented-rhythm-after-witnessed-out-of-hospital-cardiac-arrest-in-children-an-observational-study-with-prospective-nationwide-population-based-cohort-database-in-japan
#1
Masahiko Hara, Kenichi Hayashi, Tetsuhisa Kitamura
Aims: To evaluate and compare outcomes and impacts of delay of time to cardiopulmonary resuscitation (CPR) by type of first documented rhythm in paediatric patients with out-of-hospital cardiac arrest (OHCA). Methods and results: We enrolled 3968 paediatric (aged <18 years) OHCA patients whose events were witnessed between 2005 and 2012 from a prospective nationwide population-based cohort database in Japan. We assessed and compared their neurologically favourable 1-month survival according to first documented rhythm: pulseless ventricular tachycardia/ventricular fibrillation (pVT/VF), pulseless electrical activity (PEA), or asystole...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28924110/bloody-bronchial-cast-formation-due-to-alveolar-hemorrhage-associated-with-h1n1-influenza-infection
#2
Yohei Okada, Asami Okada, Hiromichi Narumiya, Ryoji Iiduka, Kanade Katsura
A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus. A pathological examination revealed that it was composed of intrabronchial and intra-alveolar hemorrhagic tissue. Unfortunately, the patient died due to severe brain ischemia; a subsequent autopsy revealed marked alveolar hemorrhage...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28916478/a-retrospective-study-of-pulseless-electrical-activity-bedside-ultrasound-identifies-interventions-during-resuscitation-associated-with-improved-survival-to-hospital-admission-a-reason-study
#3
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel 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
OBJECTIVE: Our objective was to determine whether organized or disorganized cardiac activity is associated with increased survival in patients who present in pulseless electrical activity (PEA) treated with either 1) standard advanced cardiac life support (ACLS) medications or 2) other interventions. METHODS: This was a secondary analysis of a prospective, multi-center observational study utilizing ultrasound in out-of-hospital or inemergency department PEA arrest...
September 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28915792/levosimendan-combined-with-epinephrine-improves-rescue-outcomes-in-a-rat-model-of-lipid-based-resuscitation-from-bupivacaine-induced-cardiac-arrest
#4
Fubei Nan, Xixi Cai, Yingchao Ye, Xuzhong Xu, Zhengqian Li, Min Li, Limei Chen
BACKGROUND: The effectiveness of a combination of a lipid emulsion with epinephrine in reversing local anesthetic-induced cardiac arrest has been confirmed. The combination of a lipid emulsion with levosimendan, was shown to be superior to administration of a lipid emulsion alone with regard to successful resuscitation. In this study, we compared the reversal effects of levosimendan, epinephrine, and a combination of the two agents in lipid-based resuscitation in a rat model of bupivacaine-induced cardiac arrest...
September 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28912021/association-between-spinal-immobilization-and-survival-at-discharge-for-on-scene-blunt-traumatic-cardiac-arrest-a-nationwide-retrospective-cohort-study
#5
Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi, Shunichi Fukuhara
INTRODUCTION: Spinal immobilization has been indicated for all blunt trauma patients suspected of having cervical spine injury. However, for traumatic cardiac arrest (TCA) patients, rapid transportation without compromising potentially reversible causes is necessary. Our objective was to investigate the temporal trend of spinal immobilization for TCA patients and to examine the association between spinal immobilization and survival. METHODS: We conducted a retrospective cohort study using the Japan Trauma Data Bank 2004-2015 registry data...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28901546/return-of-spontaneous-circulation-and-long-term-survival-according-to-feedback-provided-by-automated-external-defibrillators
#6
M Agerskov, M B Hansen, A M Nielsen, T P Møller, M Wissenberg, L S Rasmussen
BACKGROUND: We aimed to investigate the effect of automated external defibrillator (AED) feedback mechanisms on survival in out-of-hospital cardiac arrest (OHCA) victims. In addition, we investigated converting rates in patients with shockable rhythms according to AED shock waveforms and energy levels. METHODS: We collected data on OHCA occurring between 2011 and 2014 in the Capital Region of Denmark where an AED was applied prior to ambulance arrival. Patient data were obtained from the Danish Cardiac Arrest Registry and medical records...
September 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28898484/pre-hospital-supraglottic-airway-was-associated-with-good-neurological-outcome-in-cardiac-arrest-victims-especially-who-received-prolonged-cardiopulmonary-resuscitation
#7
Min Ji Park, Woon Yong Kwon, Kyuseok Kim, Gil Joon Suh, Jonghwan Shin, You Hwan Jo, Kyung Su Kim, Hui Jai Lee, Joonghee Kim, Se Jong Lee, Jeong Yeon Kim, Jun Hwi Cho
INTRODUCTION: We performed this study to investigate the association of pre-hospital supraglottic airway (SGA) on neurological outcome in cardiac arrest victims with adjustment of post-resuscitation variables as well as pre-hospital and resuscitation variables. METHODS: This study was a retrospective study based on a multicenter prospective cohort registry from December 2013 to April 2016. According to the 28-day cerebral performance categories (CPC) scale, patients were divided into good outcome group (CPC 1-2) and poor outcome group (CPC 3-5)...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#8
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887695/a-nirs-death-experience-a-reduction-in-cortical-oxygenation-by-time-resolved-near-infrared-spectroscopy-preceding-cardiac-arrest
#9
C Lanks, C B Kim, H B Rossiter
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS...
September 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28885969/the-use-of-the-abdominal-aortic-and-junctional-tourniquet-during-cardiopulmonary-resuscitation-following-traumatic-cardiac-arrest-in-swine
#10
Jason Rall, Jennifer M Cox, Joseph Maddry
BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is ineffective in treating traumatic cardiac arrest (TCA) following hemorrhagic shock despite fluid resuscitation. CPR adjuncts, including abdominal compressions and external counter pressure, have shown some success in laboratory settings. The Abdominal Aortic and Junctional Tourniquet (AAJT) is a device that occludes both venous and arterial blood at the level of the aortic bifurcation and likely increases thoracic pressure when applied to the abdomen...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#11
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in pre-hospital and battlefield settings and 14g angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive pressure ventilation swine model...
September 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28884858/unassisted-return-of-spontaneous-circulation-after-ventricular-fibrillation
#12
Wern Yew Ding, Mohammed Meah, Paul Mann
No abstract text is available yet for this article.
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28884833/circulatory-flow-restoration-versus-cardiopulmonary-resuscitation-new-therapeutic-approach-in-sudden-cardiac-arrest
#13
Sayed Nour, Daniel Carbognani, Juan Carlos Chachques
Sudden cardiac arrest (SCA) remains a major problem for health authorities worldwide. Insufficiencies of current cardiopulmonary resuscitation (CPR) are most probably related to an inappropriate concept and applied methods that still concentrate on heartbeat as priority, instead of blood circulation to maintain organs' perfusions. The aim of this works is to propose a new therapeutic approach for SCA in a more effective and secure manner compared with current CPR methods. It correlates to a non-invasive circulatory flow restoration (CFR) device composed of a multilayered thoracic and infradiaphragmatic compartments that will be pulsated alternatively and in fixed frequencies using a low-pressure pneumatic generator...
September 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28877036/recovery-from-ropivacaine-induced-or-levobupivacaine-induced-cardiac-arrest-in-rats-comparison-of-lipid-emulsion-effects
#14
Masashi Yoshimoto, Takashi Horiguchi, Tetsu Kimura, Toshiaki Nishikawa
BACKGROUND: Lipid emulsion treatment appears to have application in the treatment of local anesthetic-induced cardiac arrest. To examine whether the efficacy of lipid resuscitation in the treatment of local anesthetic-induced cardiac arrest is affected by lipophilicity, the effects of lipid infusions were compared between levobupivacaine-induced (high lipophilicity) and ropivacaine-induced (lower lipophilicity) rat cardiac arrest model. METHODS: A total of 28 female Sprague-Dawley rats were anesthetized using sevoflurane, which subsequently underwent tracheostomy, followed by femoral artery and vein cannulation...
September 2, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28870720/post-resuscitation-arterial-oxygen-and-carbon-dioxide-and-outcomes-after-out-of-hospital-cardiac-arrest
#15
Henry E Wang, David K Prince, Ian R Drennan, Brian Grunau, David Carlbom, Nicholas Johnson, Matthew Hansen, Jonathan Elmer, Jim Christenson, Peter Kudenchuk, Tom Aufderheide, Myron Weisfeldt, Ahamed Idris, Stephen Trzeciak, Michael Kurz, Jon C Rittenberger, Denise Griffiths, Jamie Jasti, Susanne May
OBJECTIVE: To determine if arterial oxygen and carbon dioxide abnormalities in the first 24hours after return of spontaneous circulation (ROSC) are associated with increased mortality in adult out-of-hospital cardiac arrest (OHCA). METHODS: We used data from the Resuscitation Outcomes Consortium (ROC), including adult OHCA with sustained ROSC ≥1hour after Emergency Department arrival and at least one arterial blood gas (ABG) measurement. Among ABGs measured during the first 24hours of hospitalization, we identified the presence of hyperoxemia (PaO2 ≥300mmHg), hypoxemia (PaO2 <60mmHg), hypercarbia (PaCO2>50mmHg) and hypocarbia (PaCO2<30mmHg)...
September 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28870394/variability-in-interpretation-of-cardiac-standstill-among-physician-sonographers
#16
Kevin Hu, Nachi Gupta, Felipe Teran, Turandot Saul, Bret P Nelson, Phillip Andrus
STUDY OBJECTIVE: Cardiac standstill on point-of-care ultrasonography has been widely studied as a marker of prognosis in cardiac arrest. Return of spontaneous circulation has been reported in as few as 0% and as many as 45% of patients with cardiac standstill. When explicitly documented, the definition of cardiac activity in these studies varied from any slight change in echogenicity of the myocardium to any kinetic cardiac activity. We hypothesize that the variability in research definitions of cardiac activity may affect interpretation of video clips of patients in cardiac arrest...
September 1, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28866108/characteristics-and-outcome-of-patients-with-hypothermic-out-of-hospital-cardiac-arrest-experience-from-a-european-trauma-center
#17
Elfriede Ruttmann, Marion Dietl, Tobias Kastenberger, Rene El Attal, Mathias Ströhle, Hanno Ulmer, Peter Mair
BACKGROUND: Aim of the study was to investigate patient characteristics, survival rates and neurological outcome among hypothermic patients with out-of-hospital cardiac arrest (OHCA) admitted to a trauma center. METHODS: A review of patients with OHCA and a core temperature ≤32°C admitted to a trauma center between 2004 and 2016. RESULTS: Ninety-six patients (mean temperature 25.8°C±3.9°C) were entered in the study, 37 (39%) of them after avalanche burial...
September 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28859066/the-association-between-the-first-locating-emergency-ambulance-being-single-crewed-and-cardiac-arrest-outcomes-in-new-zealand
#18
Bridget Dicker, Paul Davey, Tony Smith
AIM: This study investigated the association between the first locating emergency ambulance being single crewed on outcomes following out-of-hospital cardiac arrest in New Zealand. METHOD: Using data from the St John cardiac arrest registry for the period of 1 October 2013 to 30 June 2015, cases were included if a resuscitation attempt was made and the patient was an adult. Logistic regression modelling was used to account for confounding factors. The primary outcome was survival to hospital discharge...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28857853/valproic-acid-combined-with-postcardiac-arrest-hypothermic-targeted-temperature-management-prevents-delayed-seizures-and-improves-survival-in-a-rat-cardiac-arrest-model
#19
Joo Suk Oh, Jinka Tulasi, Ren Xiaodan, William C Stacey, Robert W Neumar
OBJECTIVES: High-dose valproic acid in combination with hypothermic-targeted temperature management has been reported to synergistically improve neurologic outcomes after cardiac arrest. This study investigated the potential synergistic mechanisms. DESIGN: Prospective, randomized, experimental study. SETTING: University research institution. SUBJECTS: Male Long Evans rats. INTERVENTION: Rats resuscitated from asphyxial cardiac arrest were randomized to one of the three groups: normothermic-targeted temperature management (37°C ± 1°C), hypothermic-targeted temperature management (33° ± 1° × 24 hr + placebo infusion), hypothermic-targeted temperature management plus high-dose valproic acid (300 mg/kg IV × 1 initiated 5 min post return of spontaneous circulation and infused over 20 min) (hypothermic-targeted temperature management + valproic acid)...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28856660/prognostic-indicators-of-survival-and-survival-prediction-model-following-extracorporeal-cardiopulmonary-resuscitation-in-patients-with-sudden-refractory-cardiac-arrest
#20
Sung Woo Lee, Kap Su Han, Jong Su Park, Ji Sung Lee, Su Jin Kim
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) has been considered in selected candidates with potentially reversible causes during a limited period. Candidate selection and the identification of predictable conditions are important factors in determining outcomes during CPR in the emergency department (ED). The objective of this study was to determine the key indicators and develop a prediction model for survival to hospital discharge in patients with sudden cardiac arrest who received ECPR...
August 30, 2017: Annals of Intensive Care
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