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https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#1
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#2
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#3
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#4
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28648808/are-characteristics-of-hospitals-associated-with-outcome-after-cardiac-arrest-insights-from-the-great-paris-registry
#5
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/28639949/comet-assay-in-evaluating-deoxyribonucleic-acid-damage-after-out-of-hospital-cardiac-arrest
#6
Radka Hazuková, Martina Rezácová, Renata Köhlerová, Tomáš Tomek, Eva Cermáková, Jaromír Kocí, Miloslav Pleskot
OBJECTIVE: This study aimed to investigate whether out-of-hospital cardiac arrest (OHCA) may induce severe DNA damage measured using comet assay in successfully resuscitated humans and to evaluate a short-term prognostic role. METHODS: In this prospective, controlled, blinded study (1/2013-1/2014), 41 patients (age, 63±14 years) successfully resuscitated from non traumatic OHCA and 10 healthy controls (age, 53±17 years) were enrolled. DNA damage [double-strand breaks (DSBs) and single-strand breaks (SSBs)] was measured using comet assay in peripheral lymphocytes sampled at admission...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#7
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28624594/variability-in-the-initiation-of-resuscitation-attempts-by-emergency-medical-services-personnel-during-out-of-hospital-cardiac-arrest
#8
Steven C Brooks, Robert H Schmicker, Sheldon Cheskes, Jim Christenson, Alan Craig, Mohamud Daya, Peter J Kudenchuk, Graham Nichol, Dana Zive, Laurie J Morrison
BACKGROUND: Some patients with out-of-hospital cardiac arrest (OHCA) assessed by emergency medical services (EMS) do not receive attempts at resuscitation on the basis of perceived futility. AIMS: 1) To measure variability in the initiation of resuscitation attempts in EMS-assessed OHCA patients across EMS agencies, 2) to evaluate the association between selected EMS agency characteristics and the proportion of patients receiving resuscitation attempts, and 3) to evaluate the association between proportion receiving resuscitation attempts and survival...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28621620/deep-brain-stimulation-for-the-early-treatment-of-the-minimally-conscious-state-and-vegetative-state-experience-in-14-patients
#9
Darko Chudy, Vedran Deletis, Fadi Almahariq, Petar Marčinković, Jasenka Škrlin, Veronika Paradžik
OBJECTIVE An effective treatment of patients in a minimally conscious state (MCS) or vegetative state (VS) caused by hypoxic encephalopathy or traumatic brain injury (TBI) is not yet available. Deep brain stimulation (DBS) of the thalamic reticular nuclei has been attempted as a therapeutic procedure mainly in patients with TBI. The purpose of this study was to investigate the therapeutic use of DBS for patients in VS or MCS. METHODS Fourteen of 49 patients in VS or MCS qualified for inclusion in this study and underwent DBS...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28601315/age-related-mortality-in-blunt-traumatic-hemorrhagic-shock-the-killers-and-the-life-savers
#10
John O Hwabejire, Christine E Nembhard, Tolulope A Oyetunji, Theodros Seyoum, Mayowa P Abiodun, Suryanarayana M Siram, Edward E Cornwell, Wendy R Greene
BACKGROUND: There are sparse data on the association between age and mortality in hemorrhagic shock (HS). We examined this association in this study. MATERIALS AND METHODS: The Glue Grant database was analyzed. Patients aged ≥16 y with blunt traumatic HS were stratified into eight age groups (16-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 y) to identify the mortality inflection point. Subsequently, patients were restratified into young age (16-44 y), middle age (45-64 y), and elderly (≥65 y)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#11
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28575815/cardiac-disease-induced-ptsd-cdi-ptsd-a-systematic-review
#12
REVIEW
Noa Vilchinsky, Karni Ginzburg, Keren Fait, Edna B Foa
The goal of the current systematic review was to provide an overview of the findings in the field of Cardiac-Disease-Induced Posttraumatic Stress Disorder (CDI-PTSD) in order to establish CDI-PTSD as a valid diagnostic entity for a wide spectrum of cardiac diseases and related medical procedures. In accordance with PRISMA guidelines, we conducted a systematic electronic literature search. Of the 3202 citations identified, 150 studies meeting the selection criteria were reviewed. Our main findings were that the prevalence of CDI-PTSD ranged between 0% and 38% (averaging at 12%) and was highly dependent on the assessment tool used...
July 2017: Clinical Psychology Review
https://www.readbyqxmd.com/read/28568968/effect-of-known-history-of-heart-disease-on-survival-outcomes-after-out-of-hospital-cardiac-arrests
#13
Magdalene Hm Lee, Stephanie Fook-Chong, Win Wah, Sang Do Shin, Tatsuya Nishiuchi, Patrick Chow-In Ko, Ghulam Yasin Naroo, Kwanhathai Darin Wong, Ling Tiah, Apichaya Monsomboon, Fahad J Siddiqui, Marcus Eh Ong
OBJECTIVE: We aimed to investigate the effect of known heart disease on post-out-of-hospital cardiac arrest (OHCA) survival outcomes, and its association with factors influencing survival. METHODS: This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009-2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non-traumatic arrests for whom resuscitation was attempted and with known medical histories were included...
May 31, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28552656/prevalence-natural-history-and-time-dependent-outcomes-of-a-multi-center-north-american-cohort-of-out-of-hospital-cardiac-arrest-extracorporeal-cpr-candidates
#14
Joshua C Reynolds, Brian E Grunau, Jonathan Elmer, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Ben Singer, Alastair Proudfoot, Clifton W Callaway
AIM: Estimate prevalence of ECPR-eligible subjects in a large, North American, multi-center cohort, describe natural history with conventional resuscitation, and predict optimal timing of transition to ECPR. METHODS: Secondary analysis of clinical trial enrolling adults with non-traumatic OHCA. Primary outcome was survival to discharge with favorable outcome (mRS 0-3). Subjects were additionally classified as survival with unfavorable outcome (mRS 4-5), ROSC without survival (mRS 6), or without ROSC...
May 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28539371/bet1-pre-hospital-finger-thoracostomy-in-patients-with-traumatic-cardiac-arrest
#15
Pritchard Jodie, Hogg Kerstin
A short cut review was carried out to see if 'finger' thoracostomy was a safe and effective procedure to use in the pre-hospital setting in patients with traumatic cardiac arrest. Three relevant papers were found describing the use of this technique in the pre-hospital setting. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. Finger thoracostomy appears to be an acceptable and effective technique for trained physicians in the pre-hospital setting...
June 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#16
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#17
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28476479/the-cost-effectiveness-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest
#18
Joachim Marti, Claire Hulme, Zenia Ferreira, Silviya Nikolova, Ranjit Lall, Charlotte Kaye, Michael Smyth, Charlotte Kelly, Tom Quinn, Simon Gates, Charles D Deakin, Gavin D Perkins
AIM: To assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest. METHODS: We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28466799/-resuscitation-after-trauma-better-survival-chances-thanks-to-goal-oriented-treatment
#19
L Koers, J L van Schuppen, V A Viersen, F O Kooij, J C Goslings, M W Hollmann
- Recent literature shows increased survival for patients with traumatic cardiac arrest.- An early and aggressive approach to underlying causes and good integrated trauma care are probably responsible for this.- The new resuscitation guideline of the European Resuscitation Council emphasises that treatment of the underlying cause deserves more priority than performing chest compressions.- In addition to a structured approach with interventions focused on the causes of the arrest, standard operating procedures and protocols, regular scenario training and clinical governance are vital to improve survival chances for these patients...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28458831/intraoperative-rescue-extracorporeal-membrane-oxygenation-and-damage-control-during-repair-of-a-traumatic-aortic-injury
#20
Seong K Lee, Enrique Gongora, Sean O'Donnell, Eddy H Carrillo, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare, Andrew A Rosenthal
A 21-year-old male involved in a motorcycle crash presented with abdominal hemorrhage and a widened mediastinum on chest radiograph. He required an initial exploratory laparotomy for mesenteric injuries. An aortic injury was confirmed on computed tomography imaging and he subsequently underwent attempted endovascular repair. During that procedure, the patient experienced massive thoracic hemorrhage with cardiac arrest and profound respiratory failure. Damage-control thoracic surgery and rescue extracorporeal membrane oxygenation were successfully utilized with a favorable outcome...
February 2017: Journal of Surgical Case Reports
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