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Return of spontaneous circulation

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https://www.readbyqxmd.com/read/28723789/measuring-the-impact-of-emergency-medical-services-ems-on-out-of-hospital-cardiac-arrest-survival-in-a-developing-country-a-key-metric-for-ems-systems-performance
#1
Mazen El Sayed, Reem Al Assad, Yasmin Abi Aad, Nour Gharios, Marwan M Refaat, Hani Tamim
Out-of-hospital cardiac arrest (OHCA) can be used to evaluate the overall performance of the emergency medical services' (EMS) system. This study assessed the impact of EMS on OHCA survival rates in a setting where the prehospital system is underdeveloped.A retrospective chart review was carried out over a 5-year period of all adult OHCA patients admitted to the emergency department (ED) of a tertiary care center in Lebanon.A total of 271 patients with OHCA (179 [66.1%] men, mean age of 69.9 [standard deviation = 15...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28706745/acute-esophageal-necrosis-in-an-alcoholic-after-successful-resuscitation-from-cardiac-arrest
#2
Amish Shah, Viveksandeep Thoguluva Chandreskar, Ravi Doobay, Arundeep Kahlon, Ioana Amzuta
INTRODUCTION: We present a patient who presented to the ICU after successful resuscitation from cardiac arrest who was subsequently diagnosed with AEN. CASE PRESENTATION: A 66-year-old female presented after cardiac arrest in which return of spontaneous circulation was achieved within 7 minutes after the initiation of CPR. She was intubated on the scene and found to have coffee ground emesis in her bathroom when found unresponsive. Due to the hemodynamically significant GI bleed, patient was started on IV proton pump inhibitor, octreotide, and levophed...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#3
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28701838/a-retrospective-study-of-physiological-observation-reporting-practices-and-the-recognition-response-and-outcomes-following-cardiopulmonary-arrest-in-a-low-to-middle-income-country
#4
Ambepitiyawaduge Pubudu De Silva, Jayasingha Arachchilage Sujeewa, Nirodha De Silva, Rathnayake Mudiyanselage Danapala Rathnayake, Lakmal Vithanage, Ponsuge Chathurani Sigera, Sithum Munasinghe, Abi Beane, Tim Stephens, Priyantha Lakmini Athapattu, Kosala Saroj Amarasiri Jayasinghe, Arjen M Dondorp, Rashan Haniffa
BACKGROUND AND AIMS: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC. PATIENTS AND METHODS: This retrospective study was carried out at District General Hospital Monaragala, Sri Lanka...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28698333/research-protocol-for-platelets-in-out-of-hospital-cardiac-arrest-an-observational-case-controlled-feasibility-study-to-assess-coagulation-and-platelet-function-abnormalities-with-rotem-following-out-of-hospital-cardiac-arrest-pohcar
#5
Agnieszka Skorko, Matthew Thomas, Andrew Mumford, Thomas Johnson, Elinor Griffiths, Rosemary Greenwood, Jonathan Benger
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) has an annual incidence of approximately 60 000 in the UK. Less than 10% of those who receive resuscitation survive to hospital discharge. For OHCA of a presumed cardiac cause, the optimal antiplatelet therapy is currently unknown. Previous studies indicate that a procoagulopathic state exists postcardiac arrest which may contribute to the formation of thrombi and contribute to poor outcomes. However, the administration of antiplatelet therapies needs to be balanced against the increased risk of bleeding that these individuals face...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28698191/manual-versus-semiautomatic-rhythm-analysis-and-defibrillation-for-out-of-hospital-cardiac-arrest
#6
Ziad Nehme, Emily Andrew, Resmi Nair, Stephen Bernard, Karen Smith
BACKGROUND: Although manual and semiautomatic external defibrillation (SAED) are commonly used in the management of out-of-hospital cardiac arrest, the optimal strategy is not known. We hypothesized that SAED would reduce the time to first shock and lead to higher rates of cardioversion and survival compared with a manual strategy. METHODS AND RESULTS: Between July 2005 and June 2015, we included adult out-of-hospital cardiac arrest of presumed cardiac pathogenesis...
July 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28691985/hemodynamically-directed-two-person-chest-compressions-a-case-report
#7
Michael Dorbad, Ashley Kass, Michael Marvin
Cardiopulmonary resuscitation has a low success rate both in and out of the hospital setting. Return of spontaneous circulation, however, is considerably higher for intraoperative cardiac arrests. Chest compressions remain of utmost importance. Optimal chest compression depth is believed to be greater than 5 cm. However, this depth is often not achieved. We describe a case in which the adequacy of chest compressions, based on hemodynamic monitoring, was achieved with 2 persons simultaneously providing a compressive force...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28680517/out-of-hospital-cardiac-arrest-resuscitation-outcome-in-north-india-caro-study
#8
Chennappa Kalvatala Krishna, Hakim Irfan Showkat, Meenakshi Taktani, Vikram Khatri
BACKGROUND: To evaluate the outcome of cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrests (OHCA) in India and factors influencing the outcome. METHODS: The outcome and related factors like demographics, aspects of the OHCA event, return of spontaneous circulation (ROSC) and survival to discharge, among the 80 adult patients presenting to emergency department experiencing OHCA considered for resuscitation between January 2014 to April 2015, were analyzed, according to the guidelines of the Utstein consensus conference...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28672894/emulsified-isoflurane-postconditioning-improves-survival-and-neurological-outcomes-in-a-rat-model-of-cardiac-arrest
#9
Ya-Jie Zhang, Meng-Jun Wu, Hai Yu, Jin Liu
Emulsified isoflurane (EIso) has a protective effect against ischemia/reperfusion (I/R) injury in animal models. However, the protective effects of EIso on global cerebral I/R injury remain unclear. The present study aimed to investigate whether EIso postconditioning was able to improve survival and neurological outcomes in a rat model of cardiac arrest (CA). Rats were randomly divided into five groups, namely the control, EIso-2ml, EIso-4ml, isoflurane (Iso) and emulsion (E) groups. All rats were resuscitated by a standardized method following 6 min of asphyxia...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28669033/monitoring-the-brain-after-cardiac-arrest-a-new-era
#10
REVIEW
Niraj Sinha, Sam Parnia
PURPOSE OF REVIEW: Of the approximately 350,000 out-of-hospital, and 750,000 after in-hospital cardiac arrest (CA) events in the US annually approximately 5-9% and 20% respectively may achieve return of spontaneous circulation (ROSC) after attempted cardiopulmonary resuscitation (CPR). Up to 2/3 of these initial survivors may go on die in the subsequent 24-72 hours after ROSC due to a combination of (1) on-going cerebral injury, (2) myocardial dysfunction and (3) massive systemic inflammatory response...
August 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28668700/comparison-of-brain-computed-tomography-and-diffusion-weighted-magnetic-resonance-imaging-to-predict-early-neurologic-outcome-before-target-temperature-management-comatose-cardiac-arrest-survivors
#11
Chi Heon Jeon, Jung Soo Park, Ji Han Lee, Hoon Kim, Sang Chul Kim, Kyung Hye Park, Kyung Sik Yi, Sun Moon Kim, Chun Song Youn, Young-Min Kim, Byung Kook Lee
AIM: We previously reported that diffusion-weighted magnetic resonance imaging (DW-MRI) could be used to predict neurologic outcomes before targeted temperature management (TTM) after return of spontaneous circulation (ROSC) from cardiac arrest (CA). We compared the efficacy of brain computed tomography (CT) and DW-MRI to predict neurologic outcome before TTM in comatose cardiac arrest survivors. METHODS: We performed a retrospective study of CA patients treated with TTM...
June 28, 2017: Resuscitation
https://www.readbyqxmd.com/read/28666490/an-unusual-cause-of-asystole-insertion-of-a-central-venous-catheter
#12
Harun Gunes, Elif Nisa Unlu, Ozlem Suzer, Abdullah Ibrahim, Ahmet Afacan, Ayhan Saritas, Hayati Kandis
Central venous catheters are a commonly used medical device which may sometimes cause complications. We present first case who had an asystolic cardiac arrest during insertion of a central venous catheter, needed cardiopulmonary resuscitation (CPR), and was resuscitated successfully. A46-year lady presented to the emergency department due to mushroom poisoning. Acentral venous catheter was inserted through the internal jugular vein. However, the patient suddenly lost consciousness and asystole was seen on the monitor immediately after the insertion of the catheter...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28661972/continuous-chest-compressions-during-sustained-inflations-in-a-perinatal-asphyxial-cardiac-arrest-lamb-model
#13
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Satyan Lakshminrusimha
OBJECTIVE: Continuous chest compressions are more effective during resuscitation in adults. Sustained inflation rapidly establishes functional residual capacity in fluid-filled lungs at birth. We sought to compare the hemodynamics and success in achieving return of spontaneous circulation in an asphyxial cardiac arrest lamb model with transitioning fetal circulation and fluid-filled lungs between subjects receiving continuous chest compressions during sustained inflation and those receiving conventional 3:1 compression-to-ventilation resuscitation...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28661970/efficacy-and-safety-of-combination-therapy-of-shenfu-injection-and-postresuscitation-bundle-in-patients-with-return-of-spontaneous-circulation-after-in-hospital-cardiac-arrest-a-randomized-assessor-blinded-controlled-trial
#14
Qian Zhang, Chunsheng Li, Fei Shao, Lianxing Zhao, Miaomiao Wang, Yingying Fang
OBJECTIVES: Postresuscitation care bundle treatment after return of spontaneous circulation in patients experiencing in-hospital cardiac arrest can improve patients' survival and quality of life. The aim of the study was to evaluate the efficacy and safety of combined therapy of Shenfu injection and postresuscitation care bundle in these patients. DESIGN: Prospective, randomized, controlled clinical study. SETTING: Fifty hospitals in China...
June 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28655625/impact-of-city-police-layperson-education-and-equipment-with-automatic-external-defibrillators-on-patient-outcome-after-out-of-hospital-cardiac-arrest
#15
Philipp Stein, Gabriela H Spahn, Stefan Müller, Andreas Zollinger, Werner Baulig, Martin Brüesch, Burkhardt Seifert, Donat R Spahn
INTRODUCTION: Out of hospital cardiac arrest (OHCA) occurs frequently and the outcome is often dismal. Early defibrillation saves lives and brain function in OHCA. The Zurich city police (STAPO) forces were instructed and equipped to provide basic life support (BLS) and to use an AED in 2009. METHODS: Retrospective observational study comparing period 1 (P1) 2004-2009 before equipping and training of the STAPO and period 2 (P2) 2010-2015 after the implementation...
June 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28648809/improving-quality-in-measuring-time-to-initiation-of-cpr-during-in-hospital-resuscitation
#16
Ashley Siems, Elyse Tomaino, Anne Watson, Michael C Spaeder, Lillian Su
OBJECTIVE: Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. METHODS: Retrospective review on prospectively identified resuscitation records and monitor data were compared...
June 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28648808/are-characteristics-of-hospitals-associated-with-outcome-after-cardiac-arrest-insights-from-the-great-paris-registry
#17
Richard Chocron, Wulfran Bougouin, Frankie Beganton, Philippe Juvin, Thomas Loeb, Frédéric Adnet, Eric Lecarpentier, Lionel Lamhaut, Daniel Jost, Eloi Marijon, Alain Cariou, Xavier Jouven, Florence Dumas
PURPOSE: As post-cardiac arrest care may influence patients' outcome, characteristics of receiving hospitals should be integrated in the evaluation of survival. We aimed at assessing the influence of care level center on patients' survival at hospital discharge using a regional registry of out-of-hospital cardiac arrest patients (OHCA). METHODS: We retrospectively analysed a Utstein and in-hospital data prospectively collected for all non-traumatic OHCA patients, in whom a successful return of spontaneous circulation (ROSC) had been obtained, from a large metropolitan area (Great Paris)...
June 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28646584/prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest-a-cohort-study
#18
Alexis Cournoyer, Eric Notebaert, Massimiliano Iseppon, Sylvie Cossette, Luc Londei-Leduc, Yoan Lamarche, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Catalina Sokoloff, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
OBJECTIVES: Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC) and delay from call to hospital arrival...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#19
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#20
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
August 2017: Resuscitation
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