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"Out of Hospital"

Matteo Danielis, Martina Chittaro, Amato De Monte, Giulio Trillò, Davide Durì
BACKGROUND: The reporting and analysing of data of out-of-hospital cardiac arrests encourages the quality improvement of the emergency medical services. For this reason, the establishment of a sufficiently large patient database is intended to allow analysis of resuscitation treatments for out-of-hospital cardiac arrests and performances of different emergency medical services. AIMS: The aim of this study was to describe the demographics, characteristics, outcomes and determinant factors of survival for patients who suffered an out-of-hospital cardiac arrest...
June 1, 2018: European Journal of Cardiovascular Nursing
Demilade Adedinsewo, Oluwatosin Omole, Oludamilola Oluleye, Itse Ajuyah, Fred Kusumoto
Data on cardiovascular disease, including arrhythmias, in Africa is limited. However, the burden of cardiovascular disease appears to be on the rise. Recent global data suggests an increase in atrial fibrillation rates despite declining rates of rheumatic heart disease. Atrial fibrillation is also associated with increased mortality in Africa. Current management with medical therapy is sub-optimal and ablation procedures, inaccessible. Atrial fibrillation is also an independent risk factor for death in patients with rheumatic heart disease...
June 22, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Reidun Aarsetøy, Hildegunn Aarsetøy, Tor-Arne Hagve, Heidi Strand, Harry Staines, Dennis W T Nilsen
Aim: Sudden cardiac arrest (SCA) secondary to ventricular fibrillation (VF) may be due to different cardiac conditions. We investigated whether copeptin, hs-cTnT and NT-proBNP in addition to clinical assessment may help to identify the etiology of SCA and yield prognostic information. Methods and Results: EDTA-blood was collected prior to or at hospital admission from patients with SCA of assumed cardiac origin. Clinical data were obtained from hospital records...
2018: Frontiers in Cardiovascular Medicine
Svetlana Lions, Robert Dragu, Yoav Carsenty, Robert Zukermann, Doron Aronson
PURPOSE: We aimed to investigate the factors that modulate the extent of QTc prolongation and potential arrhythmogenic consequences during mild therapeutic hypothermia (MTH). METHODS: We studied 205 patients after out-of-hospital cardiac arrest (131 underwent MTH). QTc was measured at baseline, 3h, 6h, 12h, 24h (end of hypothermia), 48h and 72h, and ventricular arrhythmias quantified. RESULTS: During MTH, the QTc interval increased progressively peaking at 12h (mean increase 42ms, 95% CI 30-55)...
August 2018: Journal of Critical Care
J Düring, J Dankiewicz, T Cronberg, C Hassager, J Hovdenes, J Kjaergaard, M Kuiper, N Nielsen, T Pellis, P Stammet, J Vulto, M Wanscher, M Wise, A Åneman, H Friberg
BACKGROUND: Admission lactate and lactate clearance are implemented for risk stratification in sepsis and trauma. In out-of-hospital cardiac arrest, results regarding outcome and lactate are conflicting. METHODS: This is a post-hoc analysis of the Target Temperature Management trial in which 950 unconscious patents after out-of-hospital cardiac arrest were randomized to a temperature intervention of 33°C or 36°C. Serial lactate samples during the first 36 hours were collected...
June 21, 2018: Acta Anaesthesiologica Scandinavica
Zian H Tseng, Jeffrey E Olgin, Eric Vittinghoff, Philip C Ursell, Anthony S Kim, Karl Sporer, Clement Yeh, Benjamin Colburn, Nina M Clark, Rana Khan, Amy P Hart, Ellen Moffatt
BACKGROUND: Studies of out-of-hospital cardiac arrest and sudden cardiac death (SCD) use emergency medical services records, death certificates, or definitions that infer cause of death; thus, the true incidence of SCD is unknown. Over 90% of SCDs occur out-of-hospital; nonforensic autopsies are rarely performed, and therefore causes of death are presumed. We conducted a medical examiner-based investigation to determine the precise incidence and autopsy-defined causes of all SCDs in an entire metropolitan area...
June 19, 2018: Circulation
Jessica R Balderston, Zachary M Gertz, Kenneth A Ellenbogen, Kelly P Schaaf, Joseph P Ornato
BACKGROUND: Several characteristics of the ventricular fibrillation (VF) waveform during cardiac arrest are associated with defibrillation success, including peak amplitude in the seconds prior to defibrillation. It is not known if immediate pre-defibrillation amplitude is associated with successful defibrillation, return of spontaneous circulation (ROSC) or survival to hospital discharge (SHD). METHODS: We analyzed automated external defibrillation recordings of 80 patients with out-of-hospital VF cardiac arrest who received 284 defibrillations...
July 2018: American Heart Journal
Roberto Bolli, Joshua M Hare, Timothy D Henry, Carrie G Lenneman, Keith L March, Kathy Miller, Carl J Pepine, Emerson C Perin, Jay H Traverse, James T Willerson, Phillip C Yang, Adrian P Gee, João A Lima, Lem Moyé, Rachel W Vojvodic, Shelly L Sayre, Judy Bettencourt, Michelle Cohen, Ray F Ebert, Robert D Simari
OBJECTIVES: SENECA (StEm cell iNjECtion in cAncer survivors) is a phase I, randomized, double-blind, placebo-controlled study to evaluate the safety and feasibility of delivering allogeneic mesenchymal stromal cells (allo-MSCs) transendocardially in subjects with anthracycline-induced cardiomyopathy (AIC). BACKGROUND: AIC is an incurable and often fatal syndrome, with a prognosis worse than that of ischemic or nonischemic cardiomyopathy. Recently, cell therapy with MSCs has emerged as a promising new approach to repair damaged myocardium...
July 2018: American Heart Journal
Ryan J Anderson, Sayuri P Jinadasa, Leeyen Hsu, Tiffany Bita Ghafouri, Sanjeev Tyagi, Jisha Joshua, Ariel Mueller, Daniel Talmor, Rebecca E Sell, Jeremy R Beitler
BACKGROUND: Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognostic and therapeutic value. METHODS: A two-hospital cohort was assembled of patients in shock following OHCA. Left ventricular ejection fraction (LVEF) was assessed via echocardiography or cardiac ventriculography within 1 day post arrest and used to delineate shock physiology...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
Jolande A Zijlstra, Rudolph W Koster, Marieke T Blom, Freddy K Lippert, Leif Svensson, Johan Herlitz, Jo Kramer-Johansen, Mattias Ringh, Mårten Rosenqvist, Thea Palsgaard Møller, Hanno L Tan, Stefanie G Beesems, Michiel Hulleman, Andreas Claesson, Fredrik Folke, Theresa Mariero Olasveengen, Mads Wissenberg, Carolina Malta Hansen, Soren Viereck, Jacob Hollenberg
BACKGROUND: In the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (AEDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. The aim of this study was to study the association between different defibrillation strategies on survival rates over time in Copenhagen, Stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-EMS defibrillation increased over time and was associated with increased survival...
June 14, 2018: Heart: Official Journal of the British Cardiac Society
Esther Salgueiro, Bryana Candelaria Elizarde, Ana Isabel Elola, Beatriz García-Pulido, María Luisa Nicieza-García, Gloria Manso
OBJECTIVE: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. METHODS: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion...
June 11, 2018: Revista Española de Geriatría y Gerontología
Lotte Verweij, Eva van de Korput, Joost G Daams, Gerben Ter Riet, Ron J G Peters, Raoul H H Engelbert, Wilma J M Scholte Op Reimer, Bianca M Buurman
OBJECTIVE: Many older individuals receive rehabilitation in an out-of-hospital setting (OOHS) after acute hospitalization; however, its effect on mobility and unplanned hospital readmission is unclear. Therefore a systematic review and meta-analysis were conducted on this topic. DATA SOURCES: Medline OVID, Embase OVID, and Cinahl were searched from their inception until February 22, 2018. STUDY SELECTION: OOHS (i.e., skilled nursing facilities, outpatient clinics, or community-based at home) randomized trials studying the effect of multidisciplinary rehabilitation were selected, including those assessing exercise in older patients (mean age ≥ 65 years) after discharge from hospital following an acute illness...
June 11, 2018: Archives of Physical Medicine and Rehabilitation
Ludvig Elfwén, Rickard Lagedal, Stefan James, Martin Jonsson, Ulf Jensen, Mattias Ringh, Andreas Claesson, Jonas Oldgren, Johan Herlitz, Sten Rubertsson, Per Nordberg
BACKGROUND: The potential benefit of early coronary angiography in out-of-hospital cardiac arrest (OHCA) patients without ST elevation on ECG is unclear. The aim of this study was to evaluate the association between early coronary angiography and survival in these patients. METHODS: Nationwide observational study between 2008 and 2013. Included were patients admitted to hospital after witnessed OHCA, with shockable rhythm, age 18 to 80 years and unconscious. Patients with ST-elevation on ECG were excluded...
June 2018: American Heart Journal
Mario Krammel, Sebastian Schnaubelt, David Weidenauer, Markus Winnisch, Matthias Steininger, Jakob Eichelter, Thomas Hamp, Raphael van Tulder, Patrick Sulzgruber
BACKGROUND: The 'chain of survival'-including early call for help, early cardiopulmonary resuscitation (CPR) and early defibrillation-represents the most beneficial approach for favourable patient outcome after out-of-hospital cardiac arrest (OHCA). Despite increasing numbers of publicly accessible automated external defibrillators (AED) and interventions to increase public awareness for basic life support (BLS), the number of their use in real-life emergency situations remains low. METHODS: In this prospective population-based cross-sectional study, a total of 501 registered inhabitants of Vienna (Austria) were randomly approached via telephone calls between 08/2014 and 09/2014 and invited to answer a standardized questionnaire in order to identify public knowledge and awareness of BLS and AED-use...
2018: PloS One
Giacomo Veronese, Manlio Cipriani, Duccio Petrella, Patrizia Pedrotti, Cristina Giannattasio, Andrea Garascia, Fabrizio Oliva, Karin Klingel, Maria Frigerio, Enrico Ammirati
: Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation...
June 7, 2018: Journal of Cardiovascular Medicine
Silvia Castelletti, Federica Dagradi, Karine Goulene, Aurora I Danza, Enrico Baldi, Marco Stramba-Badiale, Peter J Schwartz
BACKGROUND: A correct measurement of the QT interval in the out-of-hospital setting is important whenever the long QT syndrome (LQTS) is suspected or a therapy might lead to drug-induced LQTS (diLQTS) because QT interval monitoring in the initial days of therapy could alert to dangerous QT prolongation. We explored whether automated QTc measurements (BGM) by BodyGuardian™ (BG), a wearable remote monitoring system, are sufficiently reliable compared to our own manual measurements (MM) performed on the same beats during 12‑lead Holter recordings in LQTS patients (pts) and in healthy controls...
September 1, 2018: International Journal of Cardiology
J A Barea-Mendoza, L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, M Valiente-Fernández, A Rodríguez-Biendicho, J C Montejo González, M Chico-Fernández
BACKGROUND: Hypoperfusion plays a central role in shock states, and has been proposed as a coagulopathy trigger. The study of the rotational thromboelastometry (ROTEM) profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states. OUTCOME: To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis. DESIGN: A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest (CA)...
June 7, 2018: Medicina Intensiva
Dong Keon Lee, Yong Sung Cha, Oh Hyun Kim, Kyoung Chul Cha, Kang Hyun Lee, Sung Oh Hwang, Hyun Kim, Young Hwan Lee, Minjung Kathy Chae
BACKGROUND: An automatic simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device is an apparatus that performs CPR by providing simultaneous cyclic compressions of the thorax with a thoracic strap and compression of the sternum with a piston. OBJECTIVE: This study was conducted to compare the hemodynamic effects of CPR with an automatic SST-CPR device to those with standard CPR (STD-CPR) in cardiac arrest patients. METHODS: A randomized trial was performed on victims of out-of-hospital cardiac arrest resistant to initial 20 min of CPR after emergency department (ED) arrival...
June 6, 2018: Journal of Emergency Medicine
Simon Foged Haugaard, Anni Nørgaard Jeppesen, Anne Troldborg, Hans Kirkegaard, Steffen Thiel, Anne-Mette Hvas
The lectin pathway (LP) of the complement system may initiate inflammatory reactions when body tissue is altered. We aimed to investigate levels of the LP proteins in out-of-hospital cardiac arrest patients, and to compare these with healthy individuals. Furthermore, we aimed to clarify whether duration of targeted temperature management influenced LP protein levels, and we further examined whether LP proteins were associated with 30-day mortality. We included 82 patients resuscitated from out-of-hospital cardiac arrest...
June 9, 2018: Scandinavian Journal of Immunology
Rebecca Ichord, Faye S Silverstein, Beth S Slomine, Russell Telford, James Christensen, Richard Holubkov, J Michael Dean, Frank W Moler
OBJECTIVE: To implement a standardized approach to characterize neurologic outcomes among 12-month survivors in the Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) trials. METHODS: Two multicenter trials enrolled children age 48 hours to 18 years who remained comatose after cardiac arrest (CA) occurring out-of-hospital (THAPCA-OH, NCT00878644) or in-hospital (THAPCA-IH, NCT00880087); patients were randomized to therapeutic hypothermia or therapeutic normothermia...
June 8, 2018: Neurology
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