keyword
https://read.qxmd.com/read/38535090/machine-learning-identifies-higher-survival-profile-in-extracorporeal-cardiopulmonary-resuscitation
#1
JOURNAL ARTICLE
Ruben Crespo-Diaz, Julian Wolfson, Demetris Yannopoulos, Jason A Bartos
OBJECTIVES: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to improve neurologically favorable survival in patients with refractory out-of-hospital cardiac arrest (OHCA) caused by shockable rhythms. Further refinement of patient selection is needed to focus this resource-intensive therapy on those patients likely to benefit. This study sought to create a selection model using machine learning (ML) tools for refractory cardiac arrest patients undergoing ECPR. DESIGN: Retrospective cohort study...
March 27, 2024: Critical Care Medicine
https://read.qxmd.com/read/38535014/ultrasound-during-advanced-life-support-help-or-harm
#2
JOURNAL ARTICLE
Adrian Goudie, Michael Blaivas, Rudolf Horn, Wan-Ching Lien, Guido Michels, Daniel Wastl, Christoph Frank Dietrich
Ultrasound is used in cardiopulmonary resuscitation (CPR) and advanced life support (ALS). However, there is divergence between the recommendations of many emergency and critical care societies who support its use and the recommendations of many international resuscitation organizations who either recommend against its use or recommend it only in limited circumstances. Ultrasound offers potential benefits of detecting reversable causes of cardiac arrest, allowing specific interventions. However, it also risks interfering with ALS protocols and increasing unhelpful interventions...
March 11, 2024: Diagnostics
https://read.qxmd.com/read/38533974/return-to-work-after-refractory-out-of-hospital-cardiac-arrest-in-patients-managed-with-or-without-extracorporeal-cardiopulmonary-resuscitation-a-nationwide-register-based-study
#3
JOURNAL ARTICLE
Emilie Gregers, Kristian Kragholm, Louise Linde, Sivagowry Rasalingam Mørk, Jo Bønding Andreasen, Christian Juhl Terkelsen, Jens Flensted Lassen, Jacob Eifer Møller, Helle Laugesen, Morten Smerup, Jesper Kjærgaard, Peter Hasse Møller-Sørensen, Lene Holmvang, Christian Torp-Pedersen, Christian Hassager, Helle Søholm
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory out-of-hospital cardiac arrest (OHCA). However, survivors managed with ECPR are at risk of poor functional status. The purpose of this study was to investigate return to work (RTW) after refractory OHCA. METHODS AND RESULTS: Of 44 360 patients with OHCA in the period of 2011 to 2020, this nationwide registry-based study included 805 patients with refractory OHCA in the working age (18-65 years) who were employed before OHCA (2% of the total OHCA cohort)...
March 27, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38533945/association-between-defibrillation-using-lifepak-15-or-zoll-x-series-and-survival-outcomes-in-out-of-hospital-cardiac-arrest-a-nationwide-cohort-study
#4
JOURNAL ARTICLE
Carsten Meilandt, Mette Qvortrup, Morten Thingemann Bøtker, Fredrik Folke, Lars Borup, Helle Collatz Christensen, Louise Milling, Kasper G Lauridsen, Bo Løfgren
BACKGROUND: Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA. METHODS AND RESULTS: This study included adult patients with OHCA from the Danish Cardiac Arrest Registry from 2016 to 2021 with at least 1 defibrillation by the emergency medical services. We used multivariable logistic regression and a difference-in-difference analysis, including all patients with or without emergency medical services shock to assess the causal inference of using the different defibrillator models (LIFEPAK or ZOLL) for OHCA defibrillation...
March 27, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38533649/examining-the-impact-of-layperson-rescuer-gender-on-the-receipt-of-bystander-cpr-for-women-in-cardiac-arrest
#5
JOURNAL ARTICLE
Shelby K Shelton, John D Rice, Christopher E Knoepke, Daniel D Matlock, Edward P Havranek, Stacie L Daugherty, Sarah M Perman
BACKGROUND: Women who suffer a witnessed out-of-hospital cardiac arrest receive bystander cardiopulmonary resuscitation (CPR) less often than men. To understand this phenomenon, we queried whether there are differences in deterrents to providing CPR based on the rescuer's gender. METHODS: Participants were surveyed using a national crowdsourcing platform. Participants ranked the following 5 previously identified themes as reasons: rescuers are afraid to injure or hurt women; rescuers might have a misconception that women do not suffer cardiac arrest; rescuers are afraid to be accused of sexual assault or sexual harassment; rescuers have a fear of touching women or that their touch might be inappropriate; and rescuers think that women are faking it or being overdramatic...
March 27, 2024: Circulation. Cardiovascular Quality and Outcomes
https://read.qxmd.com/read/38533482/machine-learning-prediction-of-refractory-ventricular-fibrillation-in-out-of-hospital-cardiac-arrest-using-features-available-to-ems
#6
JOURNAL ARTICLE
Rayhan Erlangga Rahadian, Yohei Okada, Nur Shahidah, Dehan Hong, Yih Yng Ng, Michael Y C Chia, Han Nee Gan, Benjamin S H Leong, Desmond R Mao, Wei Ming Ng, Nausheen Edwin Doctor, Marcus Eng Hock Ong
BACKGROUND: Shock-refractory ventricular fibrillation (VF) or ventricular tachycardia (VT) is a treatment challenge in out-of-hospital cardiac arrest (OHCA). This study aimed to develop and validate machine learning models that could be implemented by emergency medical services (EMS) to predict refractory VF/VT in OHCA patients. METHODS: This was a retrospective study examining adult non-traumatic OHCA patients brought into the emergency department by Singapore EMS from the Pan-Asian Resuscitation Outcomes Study (PAROS) registry...
June 2024: Resuscitation plus
https://read.qxmd.com/read/38531575/survival-and-neurological-function-in-patients-treated-with-extracorporeal-membrane-oxygenation-and-therapeutic-hypothermia-a-protocol-for-updating-a-systematic-review
#7
JOURNAL ARTICLE
Pengfei Cheng, Haizhen Wang, Luyao Guo, Meiling Wang, He Xu, Peipei Gu, Jinjing Wu, Minfei Yang
INTRODUCTION: The widespread application of extracorporeal membrane oxygenation (ECMO) has enhanced clinical outcomes for patients experiencing cardiac arrest. However, its effectiveness is still limited and falls short of the desired level. Therapeutic hypothermia, which maintains body temperatures between 32°C and 36°C in cardiac arrest patients treated with ECMO, has been proposed as a potential means of neuroprotection and increased survival rates. Nevertheless, it remains controversial, and its impact on patient complications has yet to be fully understood...
March 25, 2024: BMJ Open
https://read.qxmd.com/read/38531394/integration-of-extracorporeal-membrane-oxygenation-into-the-management-of-high-risk-pulmonary-embolism-an-overview-of-current-evidence
#8
JOURNAL ARTICLE
Romain Chopard, Raquel Morillo, Nicolas Meneveau, David Jiménez
High-risk pulmonary embolism (PE) refers to a large embolic burden causing right ventricular failure and hemodynamic instability. It accounts for approximately 5% of all cases of PE but contributes significantly to overall PE mortality. Systemic thrombolysis is the first-line revascularization therapy in high-risk PE. Surgical embolectomy or catheter-directed therapy is recommended in patients with an absolute contraindication to systemic thrombolysis. Extracorporeal membrane oxygenation (ECMO) provides respiratory and hemodynamic support for the most critically ill PE patients with refractory cardiogenic shock or cardiac arrest...
March 26, 2024: Hämostaseologie
https://read.qxmd.com/read/38530625/acute-high-output-heart-failure-with-pulmonary-hypertension-and-severe-liver-injury-caused-by-amlodipine-poisoning-a-case-report
#9
JOURNAL ARTICLE
Chenlong Wang, Qingcheng Zhu, Dingyu Tan, Joseph Walline, Yachao Wang
Acute high-output heart failure (HOHF) with pulmonary hypertension and liver injury caused by amlodipine poisoning is very rare. We report a 52-year-old woman who suffered from severe shock after an overdose of amlodipine. Hemodynamic monitoring showed that while her left ventricular systolic function and cardiac output were elevated, her systemic vascular resistance decreased significantly. At the same time, the size of her right heart, her central venous pressure, and the oxygen saturation of her central venous circulation all increased abnormally...
March 26, 2024: Cardiovascular Toxicology
https://read.qxmd.com/read/38530387/-extracorporeal-cardiopulmonary-resuscitation-an-orientation
#10
JOURNAL ARTICLE
Axel Rand, Peter M Spieth
Both in-hospital and out-of-hospital cardiac arrests are associated with a high mortality. In the past survival advantages for patients could be achieved by optimizing the chain of rescue and postresuscitation treatment; however, for patients with refractory cardiac arrest, there have so far been few promising treatment options. For selected patients with refractory cardiac arrest who do not achieve return of spontaneous circulation with conventional cardiopulmonary resuscitation (CPR), extracorporeal (e)CPR using venoarterial extracorporeal membrane oxygenation is an option to improve the probability of survival...
March 26, 2024: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://read.qxmd.com/read/38529632/incorporation-of-drone-technology-into-the-chain-of-survival-for-ohca-estimation-of-time-needed-for-bystander-treatment-of-ohca-and-cpr-performance
#11
JOURNAL ARTICLE
Monique A Starks, Audrey L Blewer, Christine Chow, Edward Sharpe, Lee Van Vleet, Evan Arnold, Daniel M Buckland, Anjni Joiner, Denise Simmons, Cynthia L Green, Daniel B Mark
BACKGROUND: Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopulmonary resuscitation (CPR) quality. METHODS: Mock out-of-hospital cardiac arrest simulations that included a 9-1-1 call, CPR, and drone-delivered AED were conducted. Each simulation was timed and video-recorded...
March 26, 2024: Circulation. Cardiovascular Quality and Outcomes
https://read.qxmd.com/read/38529434/recovery-and-survival-of-patients-after-out-of-hospital-cardiac-arrest-a-literature-review-showcasing-the-big-picture-of-intensive-care-unit-related-factors
#12
REVIEW
Srdjan S Nikolovski, Aleksandra D Lazic, Zoran Z Fiser, Ivana A Obradovic, Jelena Z Tijanic, Violetta Raffay
As an important public health issue, out-of-hospital cardiac arrest (OHCA) requires several stages of high quality medical care, both on-field and after hospital admission. Post-cardiac arrest shock can lead to severe neurological injury, resulting in poor recovery outcome and increased risk of death. These characteristics make this condition one of the most important issues to deal with in post-OHCA patients hospitalized in intensive care units (ICUs). Also, the majority of initial post-resuscitation survivors have underlying coronary diseases making revascularization procedure another crucial step in early management of these patients...
February 2024: Curēus
https://read.qxmd.com/read/38528572/characteristics-of-traumatic-major-haemorrhage-in-a-tertiary-trauma-center
#13
JOURNAL ARTICLE
Pieter van Wyk, Marcus Wannberg, Anna Gustafsson, Jane Yan, Agneta Wikman, Louis Riddez, Carl-Magnus Wahlgren
BACKGROUND: Major traumatic haemorrhage is potentially preventable with rapid haemorrhage control and improved resuscitation techniques. Although advances in prehospital trauma management, haemorrhage is still associated with high mortality. The aim of this study was to use a recent pragmatic transfusion-based definition of major bleeding to characterize patients at risk of major bleeding and associated outcomes in this cohort after trauma. METHODS: This was a retrospective cohort study including all trauma patients (n = 7020) admitted to a tertiary trauma center from January 2015 to June 2020...
March 25, 2024: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/38527130/scrutinizing-the-role-of-venoarterial-extracorporeal-membrane-oxygenation-has-clinical-practice-outpaced-the-evidence
#14
REVIEW
Enzo Lüsebrink, Leonhard Binzenhöfer, Daniel Hering, Laura Villegas Sierra, Benedikt Schrage, Clemens Scherer, Walter S Speidl, Aitor Uribarri, Manel Sabate, Marko Noc, Elena Sandoval, Andrejs Erglis, Federico Pappalardo, Frederic De Roeck, Guido Tavazzi, Jordi Riera, Roberto Roncon-Albuquerque, Benjamin Meder, Peter Luedike, Tienush Rassaf, Jörg Hausleiter, Christian Hagl, Sebastian Zimmer, Dirk Westermann, Alain Combes, Uwe Zeymer, Steffen Massberg, Andreas Schäfer, Martin Orban, Holger Thiele
The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for temporary mechanical circulatory support in various clinical scenarios has been increasing consistently, despite the lack of sufficient evidence regarding its benefit and safety from adequately powered randomized controlled trials. Although the ARREST trial (Advanced Reperfusion Strategies for Patients with Out-of-Hospital Cardiac Arrest and Refractory Ventricular Fibrillation) and a secondary analysis of the PRAGUE OHCA trial (Prague Out-of-Hospital Cardiac Arrest) provided some evidence in favor of VA-ECMO in the setting of out-of-hospital cardiac arrest, the INCEPTION trial (Early Initiation of Extracorporeal Life Support in Refractory Out-of-Hospital Cardiac Arrest) has not found a relevant improvement of short-term mortality with extracorporeal cardiopulmonary resuscitation...
March 26, 2024: Circulation
https://read.qxmd.com/read/38526578/british-societies-guideline-on-the-management-of-emergencies-in-implantable-left-ventricular-assist-device-recipients-in-transplant-centres
#15
JOURNAL ARTICLE
Waqas Akhtar, Veronica Rial Baston, Marius Berman, Sai Bhagra, Colin Chue, Charles D Deakin, Jonathan R Dalzell, Joel Dunning, John Dunning, Roy S Gardner, Kristine Kiff, Shishir Kore, Sern Lim, Guy MacGowan, Ian Naldrett, Marlies Ostermann, Sofia Pinto, Stephen Pettit, Fernando Riesgo Gil, Alex Rosenberg, Antonio Rubino, Rana Sayeed, Joao Sequeira, Neil Swanson, Steven Tsui, Christopher Walker, Stephen Webb, Andrew Woods, Rajamiyer Ventkateswaran, Christopher T Bowles
An implantable left ventricular assist device (LVAD) is indicated as a bridge to transplantation or recovery in the United Kingdom (UK). The mechanism of action of the LVAD results in a unique state of haemodynamic stability with diminished arterial pulsatility. The clinical assessment of an LVAD recipient can be challenging because non-invasive blood pressure, pulse and oxygen saturation measurements may be hard to obtain. As a result of this unusual situation and complex interplay between the device and the native circulation, resuscitation of LVAD recipients requires bespoke guidelines...
March 25, 2024: Intensive Care Medicine
https://read.qxmd.com/read/38526135/sirt3-mediates-the-cardioprotective-effect-of-therapeutic-hypothermia-after-cardiac-arrest-and-resuscitation-by-restoring-autophagic-flux-via-the-pi3k-akt-mtor-pathway
#16
JOURNAL ARTICLE
Hui Wang, Wenwen Wang, Zhiwei Xue, Huiping Gong
BACKGROUND: Postresuscitation cardiac dysfunction is a significant contributor to early death following cardiopulmonary resuscitation (CPR). Therapeutic hypothermia (TH) mitigates myocardial dysfunction due to cardiac arrest (CA); however, the underlying mechanism remains unclear. Sirtuin 3 (Sirt3) was found to affect autophagic activity in recent research, motivating us to investigate its role in the cardioprotective effects of TH in the treatment of CA. METHODS: Sprague-Dawley rats were used to establish an in vivo CA/CPR model and treated with a selective Sirt3 inhibitor or vehicle...
March 25, 2024: Shock
https://read.qxmd.com/read/38526060/a-proof-of-concept-study-evaluating-cardiac-compression-techniques-for-cardiopulmonary-resuscitation-in-laying-hens-gallus-gallus
#17
JOURNAL ARTICLE
Jessica Eisenbarth, Charles O Cummings, Elizabeth A Rozanski, Emily Karlin, John Rush
OBJECTIVE: To determine in adult chickens which of 3 CPR techniques, sternal compressions (SC), SC with interposed caudal coelomic compressions (ICCC), or lateral compressions (LC), results in the highest mean systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) as measured directly from the carotid artery. DESIGN: Prospective, nonblinded, experimental crossover study. SETTING: University teaching hospital laboratory. ANIMALS: Ten retired laying hens...
March 25, 2024: Journal of Veterinary Emergency and Critical Care
https://read.qxmd.com/read/38524148/socioeconomic-disadvantage-and-long-term-survival-duration-in-out-of-hospital-cardiac-arrest-patients-a-population-based-cohort-study
#18
JOURNAL ARTICLE
Dawn Yi Xin Lee, Chun En Yau, Maeve Pin Pin Pek, Hanzhang Xu, Daniel Yan Zheng Lim, Arul Earnest, Marcus Eng Hock Ong, Andrew Fu Wah Ho
BACKGROUND: Socioeconomic status (SES) is a well-established determinant of cardiovascular health. However, the relationship between SES and clinical outcomes in long-term out-of-hospital cardiac arrest (OHCA) is less well-understood. The Singapore Housing Index (SHI) is a validated building-level SES indicator. We investigated whether SES as measured by SHI is associated with long-term OHCA survival in Singapore. METHODS: We conducted an open cohort study with linked data from the Singapore Pan-Asian Resuscitation Outcomes Study (PAROS), and the Singapore Registry of Births and Deaths (SRBD) from 2010 to 2020...
June 2024: Resuscitation plus
https://read.qxmd.com/read/38524147/top-5-barriers-in-cardiac-arrest-research-as-perceived-by-international-early-career-researchers-a-consensus-study
#19
JOURNAL ARTICLE
Stephan Katzenschlager, Ahmed Elshaer, Bibiana Metelmann, Camilla Metelmann, Kaushila Thilakasiri, Vlasios Karageorgos, Tomas Barry, Kristin Alm-Kruse, Hritul Karim, Holger Maurer, Jo Kramer-Johansen, Simon Orlob
AIM OF THE STUDY: Cardiac arrest research has not received as much scientific attention as research on other topics. Here, we aimed to identify cardiac arrest research barriers from the perspective of an international group of early career researchers. METHODS: Attendees of the 2022 international masterclass on cardiac arrest registry research accompanied the Global Out-of-Hospital Cardiac Arrest Registry collaborative meeting in Utstein, Norway, and used an adapted hybrid nominal group technique to obtain a diverse and comprehensive perspective...
June 2024: Resuscitation plus
https://read.qxmd.com/read/38524146/extracting-physiologic-and-clinical-data-from-defibrillators-for-research-purposes-to-improve-treatment-for-patients-in-cardiac-arrest
#20
REVIEW
Trond Nordseth, Trygve Eftestøl, Elisabete Aramendi, Jan Terje Kvaløy, Eirik Skogvoll
BACKGROUND: A defibrillator should be connected to all patients receiving cardiopulmonary resuscitation (CPR) to allow early defibrillation. The defibrillator will collect signal data such as the electrocardiogram (ECG), thoracic impedance and end-tidal CO2 , which allows for research on how patients demonstrate different responses to CPR. The aim of this review is to give an overview of methodological challenges and opportunities in using defibrillator data for research. METHODS: The successful collection of defibrillator files has several challenges...
June 2024: Resuscitation plus
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