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Traumatic cardiac arrest

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https://www.readbyqxmd.com/read/28434268/ubiquitin-c-terminal-hydrolase-l1-uch-l1-as-a-therapeutic-and-diagnostic-target-in-neurodegeneration-neurotrauma-and-neuro-injuries
#1
Kevin K Wang, Zhihui Yang, George Sarkis, Isabel Torres, Vijaya Raghavan
Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease...
April 24, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28395982/cardiopulmonary-resuscitation-of-out-of-hospital-traumatic-cardiac-arrest-in-qatar-a-nationwide-population-based-study
#2
Furqan B Irfan, Rafael Consunji, Ayman El-Menyar, Pooja George, Ruben Peralta, Hassan Al-Thani, Stephen Hodges Thomas, Guillaume Alinier, Ashfaq Shuaib, Jassim Al-Suwaidi, Rajvir Singh, Maaret Castren, Peter A Cameron, Therese Djarv
BACKGROUND: Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar. METHODS: An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA)...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#3
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28389857/predictors-of-good-neurologic-outcome-after-resuscitation-beyond-30%C3%A2-min-in-out-of-hospital-cardiac-arrest-patients-undergoing-therapeutic-hypothermia
#4
Shin Ahn, Byung Kook Lee, Chun Song Youn, Youn-Jung Kim, Chang Hwan Sohn, Dong-Woo Seo, Won Young Kim
Neurologically intact survival after cardiac arrest is possible even after prolonged resuscitation efforts. However, the factors associated with good neurologic outcome in these patients remain unknown. This study identifies predictors associated with good neurologic outcome after resuscitation beyond 30 min in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM). This multicenter, registry-based, retrospective cohort study conducted in 24 hospitals across South Korea between 2007 and 2012 includes adult (≥18 years) non-traumatic OHCA patients with prolonged (>30 min) downtime who underwent TTM treatment...
April 7, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28373095/out-of-hospital-cardiac-arrest-survivors-with-inconclusive-coronary-angiogram-impact-of-cardiovascular-magnetic-resonance-on-clinical-management-and-decision-making
#5
A Baritussio, A Zorzi, A Ghosh Dastidar, A Susana, G Mattesi, J C L Rodrigues, G Biglino, A Scatteia, E De Garate, J Strange, L Cacciavillani, S Iliceto, A Nisbet, G D Angelini, D Corrado, M Perazzolo Marra, C Bucciarelli-Ducci
BACKGROUND: Non-traumatic out of hospital cardiac arrest (OHCA) is the leading cause of death worldwide, mainly due to acute coronary syndromes. Urgent coronary angiography with view to revascularisation is recommended in patients with suspected acute coronary syndrome. Diagnosis and management of patients with inconclusive coronary angiogram (unobstructed coronaries or unidentified culprit lesion) is challenging. We sought to assess the role of Cardiovascular Magnetic Resonance (CMR) in the diagnosis and management of OHCA survivors with an inconclusive coronary angiogram...
March 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28343957/adult-out-of-hospital-cardiac-arrest-in-philadelphia-from-2008-2012-an-epidemiological-study
#6
David F Gaieski, Anish K Agarwal, Benjamin S Abella, Robert W Neumar, Crawford Mechem, Sarah Wallace Cater, Frances S Shofer, Marion Leary, William P Pajerowski, Lance B Becker, Brendan Carr, Raina Merchant, Roger A Band
BACKGROUND: Wide variation in out-of-hospital cardiac arrest (OHCA) survival has been reported, with low survival in urban settings. We sought to describe the epidemiology of OHCA in Philadelphia, Pennsylvania, the fifth largest U.S. city, and identify potential areas for targeted interventions to improve survival. METHODS AND RESULTS: Retrospective chart review of adult, non-traumatic, OHCA occurring in Philadelphia between 2008 and 2012. We determined incidence and epidemiological factors including: demographics, initial cardiac rhythm, bystander cardiopulmonary resuscitation, automated external defibrillator use, return of spontaneous circulation and 30-day survival...
March 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28330804/cardiac-arrest-attributable-to-dysfunction-of-the-autonomic-nervous-system-after-traumatic-cervical-spinal-cord-injury
#7
Sei Won Kim, Chan Joo Park, Kyungil Kim, Yoon-Chung Kim
Bradycardia is the most common form of dysrhythmia developing after disruption of the sympathetic pathway by a spinal cord injury (SCI), and it can have fatal consequences, including cardiac arrest. Here, we report a case of cardiac arrest developing after cervical SCI attributable to sympathetic hypoactivity. A 26-year-old male pedestrian was admitted after a traffic accident. Radiologically, fractures were apparent at the C6-7 bilateral articular facets, and cord contusion with hemorrhage was evident at C4-7...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28319562/translating-biomarkers-from-research-to-clinical-use-in-pediatric-neurocritical-care-focus-on-traumatic-brain-injury-and-cardiac-arrest
#8
Andrew J Prout, Michael S Wolf, Ericka L Fink
PURPOSE OF REVIEW: Traumatic brain injury (TBI) and cardiac arrest are important causes of morbidity and mortality in children. Improved diagnosis and outcome prognostication using validated biomarkers could allow clinicians to better tailor therapies for optimal efficacy. RECENT FINDINGS: Contemporary investigation has yielded plentiful biomarker candidates of central nervous system (CNS) injury, including macromolecules, genetic, inflammatory, oxidative, and metabolic biomarkers...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#9
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28238004/effects-of-therapeutic-hypothermia-for-neuroprotection-from-the-viewpoint-of-redox-regulation
#10
REVIEW
Nobuyuki Nosaka, Ayumi Okada, Hirokazu Tsukahara
Redox regulation has recently been recognized as an important factor in acute illnesses as well as in chronic diseases. It has also become a target for neuroprotection in acute intensive care. Despite its well-known therapeutic effects, therapeutic hypothermia has recently been re-evaluated for its potential use in emergency and critical care medicine. Hypothermia is an undesirable physiological condition that can increase oxidative stress and decrease anti-oxidative potency. However, many studies have shown that under ischemia/reperfusion conditions, therapeutic hypothermia actually suppresses enhanced oxidative stress and maintains or increases anti-oxidative potency...
February 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#11
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#12
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28212177/neurocognitive-outcomes-for-acute-global-acquired-brain-injury-in-children
#13
Fenella J Kirkham
PURPOSE OF REVIEW: In children, acute global brain injury from traumatic brain injury (TBI) and nontraumatic coma has a substantial cost to the child, the family, and the society. There have historically been relatively few studies looking at long-term cognition and behavioural outcomes. RECENT FINDINGS: Long-term follow-up studies, population-based studies, and meta-analyses are now available for TBI in children as well as adults and suggest that there is a significant cognitive cost, particularly for processing speed, working memory, and intelligence quotient (IQ) in severe TBI...
April 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28210211/app-as-a-protective-factor-in-acute-neuronal-insults
#14
REVIEW
Dimitri Hefter, Andreas Draguhn
Despite its key role in the molecular pathology of Alzheimer's disease (AD), the physiological function of amyloid precursor protein (APP) is unknown. Increasing evidence, however, points towards a neuroprotective role of this membrane protein in situations of metabolic stress. A key observation is the up-regulation of APP following acute (stroke, cardiac arrest) or chronic (cerebrovascular disease) hypoxic-ischemic conditions. While this mechanism may increase the risk or severity of AD, APP by itself or its soluble extracellular fragment APPsα can promote neuronal survival...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#15
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28187811/determinants-of-prognosis-in-neurocatastrophes
#16
REVIEW
K Sharma, R D Stevens
A neurocatastrophe or severe brain injury (SBI) is a central nervous system insult associated with a high likelihood of death or severe disability. While many etiologic processes may lead to SBI, the most common and best-studied clinical paradigms are traumatic brain injury and anoxic-ischemic encephalopathy following cardiac arrest. Clinical phenotypes following SBI include acute and chronic disorders of consciousness as well as a range of cognitive and behavioral impairments. A fundamental task for medical teams working in the acute phase is to estimate SBI recovery probabilities with the highest degree of accuracy possible...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28163233/the-impact-of-first-responder-turnout-and-curb-to-care-intervals-on-survival-from-out-of-hospital-cardiac-arrest
#17
Nicolaas P DeRuyter, Sofia Husain, Lihua Yin, Michele Olsufka, Andrew M McCoy, Charles Maynard, Leonard A Cobb, Thomas D Rea, Michael R Sayre
PURPOSE: Patients with out-of-hospital cardiac arrest (OHCA) more likely survive when emergency medical services (EMS) arrive quickly. We studied time response elements in OHCA with attention to EMS intervals before wheels roll and after wheels stop to understand their contribution to total time response and clinical outcome. METHODS: We analyzed EMS responses to OHCA from 2009-2014 in an urban, fire department based system. The Call-to-Care Interval, from call receipt to hands-on EMS care, was comprised of four time intervals: 1) call received to EMS notification (Activation), 2) EMS notification to vehicle wheels rolling (Turnout), 3) wheels rolling to arrival at scene (Travel), and 4) arrival at scene to hands-on EMS care (Curb-to-Care)...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28158980/early-exposure-to-hyperoxia-and-mortality-in-critically-ill-patients-with-severe-traumatic-injuries
#18
Derek W Russell, David R Janz, William L Emerson, Addison K May, Gordon R Bernard, Zhiguo Zhao, Tatsuki Koyama, Lorraine B Ware
BACKGROUND: Hyperoxia is common early in the course of resuscitation of critically ill patients. It has been associated with mortality in some, but not all, studies of cardiac arrest patients and other critically ill cohorts. Reasons for the inconsistency are unclear and may depend on unmeasured patient confounders, the timing and duration of hyperoxia, population characteristics, or the way that hyperoxia is defined and measured. We sought to determine whether, in a prospectively collected cohort of mechanically ventilated patients with traumatic injuries with and without head trauma, higher maximum partial pressure of arterial oxygen (PaO2) within 24 hours of admission would be associated with increased risk of in-hospital mortality...
February 3, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28144602/hyperammonemia-as-a-marker-of-subclinical-seizures-after-traumatic-cardiac-arrest
#19
Patricia Aswani, Michael Kalina
This report details the presence of hyperammonemia in a patient who sustained cardiac arrest after a traumatic amputation. Serum ammonia levels may rise due to numerous etiologies; however, few reports detail its usefulness in diagnosing subclinical seizures. In this case, we successfully utilized persistently elevated serum ammonia levels as a marker of subclinical seizures in a patient who sustained traumatic cardiac arrest.
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28127711/how-to-manage-tension-gastrothorax-a-case-report-of-tension-gastrothorax-with-multiple-trauma-due-to-traumatic-diaphragmatic-rupture
#20
Naofumi Bunya, Keigo Sawamoto, Shuji Uemura, Takashi Toyohara, Yukino Mori, Ryoko Kyan, Kei Miyata, Hideto Irifune, Keisuke Harada, Eichi Narimatsu
BACKGROUND: Tension gastrothorax is a kind of obstructive shock with prolapse and distention of the stomach into the thoracic cavity. Progressive gastric distension leads to mediastinal shift, reduced venous return, decreased cardiac output, and ultimately cardiac arrest. Therefore, it is crucial to decompress the stomach distension for the initial resuscitation of tension gastrothorax. CASE PRESENTATION: A 75-year-old female was transported to our resuscitation bay due to motor vehicle crash...
December 2017: International Journal of Emergency Medicine
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