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https://www.readbyqxmd.com/read/29689354/timing-of-advanced-airway-management-by-emergency-medical-services-personnel-following-out-of-hospital-cardiac-arrest-a-population-based-cohort-study
#1
Junichi Izawa, Taku Iwami, Koichiro Gibo, Masashi Okubo, Kentaro Kajino, Kousuke Kiyohara, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takeyuki Kiguchi, Daisuke Kobayashi, Sho Komukai, Takashi Kawamura, Clifton W Callaway, Tetsuhisa Kitamura
BACKGROUND: Early prehospital advanced airway management (AAM) by emergency medical services (EMS) personnel has been intended to improve patient outcomes from out-of-hospital cardiac arrest (OHCA). However, few studies examine the effectiveness of early prehospital AAM. We investigated whether early prehospital AAM was associated with functionally favourable survival after adult OHCA. METHODS: We conducted a population-based cohort study of OHCA in Osaka, Japan, between 2005 and 2012...
April 21, 2018: Resuscitation
https://www.readbyqxmd.com/read/29688939/in-hospital-cardiac-arrest-are-we-overlooking-a-key-distinction
#2
Ari Moskowitz, Mathias J Holmberg, Michael W Donnino, Katherine M Berg
PURPOSE OF REVIEW: To review the epidemiology, peri-arrest management, and research priorities related to in-hospital cardiac arrest (IHCA) and explore key distinctions between IHCA and out-of-hospital cardiac arrest (OHCA) as they pertain to the clinician and resuscitation scientist. RECENT FINDINGS: IHCA is a common and highly morbid event amongst hospitalized patients in the United States. As compared with patients who experience an OHCA, patients who experience an IHCA tend to have more medical comorbidities, have a witnessed arrest, and be attended to by professional first responders...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29688297/ten-year-association-of-coronary-artery-calcium-with-atherosclerotic-cardiovascular-disease-ascvd-events-the-multi-ethnic-study-of-atherosclerosis-mesa
#3
Matthew J Budoff, Rebekah Young, Gregory Burke, J Jeffrey Carr, Robert C Detrano, Aaron R Folsom, Richard Kronmal, Joao A C Lima, Kiang J Liu, Robyn L McClelland, Erin Michos, Wendy S Post, Steven Shea, Karol E Watson, Nathan D Wong
Aims: While coronary artery calcium (CAC) has been extensively validated for predicting clinical events, most outcome studies of CAC have evaluated coronary heart disease (CHD) rather than atherosclerotic cardiovascular disease (ASCVD) events (including stroke). Also, virtually all CAC studies are of short- or intermediate-term follow-up, so studies across multi-ethnic cohorts with long-term follow-up are warranted prior to widespread clinical use. We sought to evaluate the contribution of CAC using the population-based MESA cohort with over 10 years of follow-up for ASCVD events, and whether the association of CAC with events varied by sex, race/ethnicity, or age category...
April 23, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29687669/ambulance-cardiopulmonary-resuscitation-outcomes-and-associated-factors-in-out-of-hospital-cardiac-arrest
#4
Fernando Rosell Ortiz, Javier García Del Águila, Patricia Fernández Del Valle, Francisco J Mellado-Vergel, Santiago Vergara-Pérez, María R Ruiz-Montero, Manuela Martínez-Lara, Francisco J Gómez-Jiménez, Ismael Gonzáez-Lobato, Guillermo García-Escudero, Manuel Ruiz-Bailén, Auxiliadora Caballero-García, Itziar Vivar-Díaz, Luis Olavarría-Govantes
OBJECTIVES: To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport. MATERIAL AND METHODS: Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome...
June 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#5
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#6
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29685373/resuscitative-endovascular-balloon-occlusion-of-the-aorta-improves-cardiac-compression-fraction-versus-resuscitative-thoracotomy-in-patients-in-traumatic-arrest
#7
William Teeter, Anna Romagnoli, Philip Wasicek, Peter Hu, Shiming Yang, Deborah Stein, Thomas Scalea, Megan Brenner
STUDY OBJECTIVE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is emerging as an alternative to resuscitative thoracotomy for proximal aortic control in select patients with exsanguinating hemorrhage below the diaphragm. The purpose of this study is to compare interruptions in closed chest compression or open chest cardiac massage during REBOA versus resuscitative thoracotomy. METHODS: From May 2014 to December 2016, patients in arrest who received aortic occlusion with REBOA or resuscitative thoracotomy were included...
April 20, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29685180/traumatic-cardiac-arrest-in-sweden-1990-2016-a-population-based-national-cohort-study
#8
T Djarv, C Axelsson, J Herlitz, A Stromsoe, J Israelsson, A Claesson
BACKGROUND: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA). METHODS: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016...
April 23, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29685008/medicamentous-thrombolysis-disguises-pulmonary-thromboembolism-as-a-cause-of-death
#9
I O A, A Ferencic, V Stemberga, G Zamolo, S Arbanas, I Dasek, M Perkovic, D Cuculic
We report the case of a 31-year-old female who was admitted to the emergency department with symptoms of cardiac arrest and ultimately died in spite of enormous resuscitation efforts. During resuscitation, pulmonary embolism was considered as a possible non-cardiac cause of cardiac arrest, and following its extremely unfavorable prognosis, the fatal outcome was not so surprising. However, since acute pulmonary emboli obstructing blood flow to a lobe or multiple lung segments was suspected, alteplase was indicated and administered...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29685007/neuroprotection-of-ulinastatin-on-transient-cerebral-ischemia-via-antioxidative-mechanisms
#10
H X Hu, D H Xu, W N Ju, C Ma, X Wang, X L Liu
Ulinastatin [also called urinary trypsin inhibitor (UTI)] has beneficial effects on cerebral ischemic injury evoked by cardiac arrest (CA). However, the underlying mechanisms are unknown. The purpose of this report was to determine the involvement of antioxidative signal pathway of the hippocampus in effects of UTI in the process of neurological functions after transient cerebral ischemia. CA was induced by asphyxia followed by cardiopulmonary resuscitation in rats. Western blot analysis and ELISA were used to examine expression of Nrf2-antioxidant response element (ARE) and superoxide dismutases (SOD), and the levels of products of oxidative stress...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29684654/epidemiology-of-out-of-hospital-cardiac-arrest-a-french-national-incidence-and-mid-term-survival-rate-study
#11
Gérald Luc, Valentine Baert, Joséphine Escutnaire, Michael Genin, Christian Vilhelm, Christophe Di Pompéo, Carlos El Khoury, Nicolas Segal, Eric Wiel, Frédéric Adnet, Karim Tazarourte, Pierre-Yves Gueugniaud, Hervé Hubert
Out-of-hospital cardiac arrest (OHCA) is considered an important public health issue but its incidence has not been examined in France. The aim of this study is to define the incidence of OHCA in France and to compare this to other neighbouring countries. Data were extracted from the French OHCA registry. Only exhaustive centres during the period from January 1, 2013, to September 30, 2014 were included. All patients were included, regardless of their age and cause of OHCA. The participating centres covered about 10% of the French population...
April 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29684433/oxygen-titration-after-resuscitation-from-out-of-hospital-cardiac-arrest-a-multi-centre-randomised-controlled-pilot-study-the-exact-pilot-trial
#12
Janet E Bray, Cindy Hein, Karen Smith, Michael Stephenson, Hugh Grantham, Judith Finn, Dion Stub, Peter Cameron
INTRODUCTION: Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. METHODS: We enrolled unconscious adults with: sustained ROSC; initial shockable rhythm; an advanced airway; and an SpO2 ≥ 95%...
April 20, 2018: Resuscitation
https://www.readbyqxmd.com/read/29681417/fulminant-primary-cardiac-lymphoma-with-sudden-cardiac-death-a-case-report-and-brief-review
#13
Jen-Fang Cheng, Sze-Hwei Lee, Ron-Bin Hsu, Shan-Chi Yu, Chia-Tung Shun, Pang-Shuo Huang, Ying-Hsien Chen, Chii-Ming Lee
Primary cardiac lymphoma (PCL) is very rare, with the variable clinical manifestations potentially leading to a delayed diagnosis. PCL is usually detected incidentally through image studies, whereas the diagnosis can be confirmed via analysis of pericardial effusion, endomyocardial biopsy tissue, or surgical specimens. Although no standard therapy has been established for PCL, without treatment, the prognosis is grave, with the estimated overall survival being approximately 1 year. We report a difficult diagnosis and complicated case of fulminant PCL, which is the first comprehensively reported case of PCL with secondary hemophagocytosis...
April 19, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29679698/neurophysiological-and-neuroradiological-multimodal-approach-for-early-poor-outcome-prediction-after-cardiac-arrest
#14
Maenia Scarpino, Giovanni Lanzo, Francesco Lolli, Riccardo Carrai, Marco Moretti, Maddalena Spalletti, Morena Cozzolino, Adriano Peris, Aldo Amantini, Antonello Grippo
INTRODUCTION: Prognosticating outcome after cardiac arrest(CA) requires a multimodal approach. However, evidence regarding combinations of methods is limited. We evaluated whether the combination of electroencephalography(EEG), somatosensory evoked potentials(SEPs) and brain computed tomography(CT) could predict poor outcome. METHODS: We screened our database regarding patients successfully resuscitated after CA, for whom EEG, SEPs and brain CT were available within 24 hours...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679696/effect-of-neuromonitor-guided-titrated-care-on-brain-tissue-hypoxia-after-opioid-overdose-cardiac-arrest
#15
Jonathan Elmer, Katharyn L Flickinger, Maighdlin W Anderson, Allison Koller, Matthew Sundermann, Cameron Dezfulian, David O Okonkwo, Lori A Shutter, David Salcido, Clifton W Callaway, James J Menegazzi
INTRODUCTION: Brain tissue hypoxia may contribute to preventable secondary brain injury after cardiac arrest. We developed a porcine model of opioid overdose cardiac arrest and post-arrest care including invasive, multimodal neurological monitoring of regional brain physiology. We hypothesized brain tissue hypoxia is common with usual post-arrest care and can be prevented by modifying mean arterial pressure (MAP) and arterial oxygen concentration (PaO2 ). METHODS: We induced opioid overdose and cardiac arrest in sixteen swine, attempted resuscitation after 9 minutes of apnea, and randomized resuscitated animals to three alternating 6-hour blocks of standard or titrated care...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679694/the-introduction-of-a-rapid-response-system-in-acute-hospitals-a-pragmatic-stepped-wedge-cluster-randomised-controlled-trial
#16
Filip Haegdorens, Peter Van Bogaert, Ella Roelant, Koen De Meester, Marie Misselyn, Kristien Wouters, Koenraad G Monsieurs
AIM: Deterioration of hospitalised patients is often missed, misinterpreted, and mismanaged. Rapid Response Systems (RRSs) have been proposed to solve this problem. This study aimed to investigate the effect of an RRS on the incidence of unexpected death, cardiac arrest with cardiopulmonary resuscitation (CPR), and unplanned intensive care unit (ICU) admission. METHODS: We conducted a stepped wedge cluster randomised controlled trial including 14 Belgian acute care hospitals with two medical and two surgical wards each...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679693/bystander-witnessed-cardiac-arrest-is-associated-with-reported-agonal-breathing-and-leads-to-less-frequent-bystander-cpr
#17
P Brinkrolf, B Metelmann, C Scharte, A Zarbock, K Hahnenkamp, A Bohn
AIM: Although the importance of bystander cardiopulmonary resuscitation has been shown in multiple studies, the rate of bystander cardiopulmonary resuscitation is still relatively low in many countries. Little is known on bystanders' perceptions influencing the decision to start cardiopulmonary resuscitation. Our study aims to determine such factors. MATERIALS AND METHODS: Semi-structured telephone interviews with bystanders of out-of-hospital cardiac arrests between December 2014 and April 2016 were performed in a prospective manner...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679443/a-20-year-review-the-use-of-exception-from-informed-consent-and-waiver-of-informed-consent-in-emergency-research
#18
Lauren Klein, Johanna Moore, Michelle Biros
BACKGROUND: Due to the acuity and time sensitive needs of their clinical condition, patients presenting with certain emergent pathologies may lack capacity to provide meaningful prospective informed consent to participate in clinical research. For these reasons, these populations have often been excluded from research investigations. To mitigate this, regulations allowing Exception from Informed Consent (EFIC) (21 CFR 50.24) or Waiver of Informed Consent (WIC) (45 CFR 46.101) were developed in 1996...
April 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29678294/association-between-body-mass-index-and-clinical-outcomes-of-patients-after-cardiac-arrest-and-resuscitation-a-meta-analysis
#19
REVIEW
Ye Ma, Lili Huang, Lu Zhang, Hai Yu, Bin Liu
BACKGROUND: Obesity as one of the risk factors for cardiovascular diseases increases mortality in general population. Several clinical studies investigated clinical outcomes in patients with different body mass index (BMI) after cardiac arrest (CA). Controversial data regarding BMI on clinical outcomes in those patients exist in those studies. Therefore, we conducted a meta-analysis to evaluate the effect of BMI on survival condition and neurological prognosis in those patients. METHODS: We searched Pubmed, Embase, Ovid/Medline and EBM reviews databases for relational studies investigating the association between BMI and clinical outcomes of patients after CA...
April 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#20
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
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