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https://www.readbyqxmd.com/read/27908910/hospital-variation-in-time-to-epinephrine-for-non-shockable-in-hospital-cardiac-arrest
#1
Rohan Khera, Paul S Chan, Michael W Donnino, Saket Girotra
BACKGROUND: -For patients with in-hospital cardiac arrests due to non-shockable rhythms, delays in epinephrine administration beyond 5 minutes is associated with worse survival. However, the extent of hospital variation in delayed epinephrine administration and its impact on hospital-level outcomes is unknown. METHODS: -Within Get with the Guidelines-Resuscitation, we identified 103,932 adult patients (≥18 years) at 548 hospitals with an in-hospital cardiac arrest due to a non-shockable rhythm who received at least 1 dose of epinephrine between 2000 to 2014...
December 1, 2016: Circulation
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#2
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#3
Raúl J Gazmuri, Kasen Whitehouse, Kruti Shah, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32 to 40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#4
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27904259/profile-and-outcome-of-sudden-cardiac-arrests-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#5
Gautham Raja Pandian, Suma Mary Thampi, Nilanchal Chakraborty, Deepthi Kattula, Paul Prabhakar Abhilash Kundavaram
BACKGROUND: Sudden cardiac arrest (SCA) requiring cardiopulmonary resuscitation (CPR) is one of the common emergencies encountered in the emergency department (ED) of any hospital. Although several studies have reported the predictors of CPR outcome in general, there are limited data from the EDs in India. MATERIALS AND METHODS: This retrospective study included all patients above 18 years with SCA who were resuscitated in the ED of a tertiary care hospital with an annual census of 60,000 patients between August 2014 and July 2015...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27903540/greater-volume-but-not-higher-density-of-abdominal-aortic-calcium-is-associated-with-increased-cardiovascular-disease-risk-mesa-multi-ethnic-study-of-atherosclerosis
#6
Nketi I Forbang, Erin D Michos, Robyn L McClelland, Rosemay A Remigio-Baker, Matthew A Allison, Veit Sandfort, Joachim H Ix, Isac Thomas, Dena E Rifkin, Michael H Criqui
BACKGROUND: Abdominal aortic calcium (AAC) and coronary artery calcium (CAC) independently and similarly predict cardiovascular disease (CVD) events. The standard AAC and CAC score, the Agatston method, upweights for greater calcium density, thereby modeling higher calcium density as a CVD hazard. METHODS AND RESULTS: Computed tomography scans were used to measure AAC and CAC volume and density in a multiethnic cohort of community-dwelling individuals, and Cox proportional hazard was used to determine their independent association with incident coronary heart disease (CHD, defined as myocardial infarction, resuscitated cardiac arrest, or CHD death), cardiovascular disease (CVD, defined as CHD plus stroke and stroke death), and all-cause mortality...
November 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#7
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27903392/-resuscitation-efficacy-of-extracorporeal-membrane-oxygenation-in-non-postcardiotomy-adult-patients-with-cardiac-arrest
#8
L Huang, Y W Liu, T Li, X M Hu, D W Duan, P Wu
Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27902664/team-based-learning-improves-staff-nurses-knowledge-of-open-and-closed-chest-cardiac-surgical-resuscitation
#9
Marion E McRae, Alice Chan, Ai Jin Lee, Renee Hulett, Bernice Coleman
BACKGROUND: There are few reports of the use of 1-session team-based learning (TBL) in hospital settings and none to teach cardiac surgical resuscitation (CSR). OBJECTIVE: The aim of this study was to investigate whether 1-session TBL is an effective method to increase nursing knowledge of CSR. METHODS: The participating subjects viewed a PowerPoint presentation about CSR prior to the learning session. Participants completed a 16-item individual readiness assessment test...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27899017/public-access-defibrillation-and-outcomes-after-pediatric-out-of-hospital-cardiac-arrest
#10
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Hiroaki Kobayashi, Masataka Gunshin, Toshiki Sera, Yutaka Kondo, Naoki Yahagi
BACKGROUND: Use of automated external defibrillators (AEDs) has been recommended for pediatric out-of-hospital cardiac arrest (OHCA). However, there are no conclusive studies that elucidated the effectiveness of public-access defibrillation (PAD) in children. METHODS: This was a nationwide, population-based, propensity score-matched study of pediatric OHCA in Japan from 2011 to 2012, based on data from the All-Japan Utstein Registry. We included pediatric OHCA patients (aged 1-17 years) who received bystander cardiopulmonary resuscitation...
November 26, 2016: Resuscitation
https://www.readbyqxmd.com/read/27898548/two-cardiac-arrests-because-of-venous-air-embolism-during-endoscopic-retrograde-cholangiopancreatography
#11
Joseph M Sisk, Monica D Choi, Andrew B Casabianca, Ali M Hassan
Venous air embolism is a rare but potentially catastrophic complication of endoscopic retrograde cholangiopancreatography. We report 2 cases of venous air embolism and subsequent cardiac arrests. During resuscitation efforts, a transesophageal echocardiogram was placed, which demonstrated significant air in the right heart. Although gastroenterologists seem to be more aware of this complication, it is underreported in the anesthesiology literature. As anesthesiologists continue to expand coverage to endoscopy suites, anesthesia providers must be aware of predisposing factors and maintain a high index of suspicion to recognize and treat in a timely manner to prevent serious adverse outcomes...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27896328/liver-laceration-related-to-cardiopulmonary-resuscitation
#12
Halil Beydilli, Yasemin Balci, Melike Erbas, Ethem Acar, Sahin Isik, Bulent Savran
Cardiopulmonary resuscitation (CPR) is recognized as a medical procedure performed to maintain vital functions of a person whose cardiac and respiratory functions have stopped. Chest compression is the most essential component of CPR and it is performed on the lower half of the sternum. During CPR, many complications may occur because of chest compressions, especially chest injuries including sternum and rib fractures. Rarely tracheal injury, rupture of the stomach, or liver or spleen injury may also occur as complications...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27896320/influences-of-do-not-resuscitate-order-prohibition-on-cpr-outcomes
#13
Umut Gulacti, Ugur Lok
OBJECTIVES: The aim of the study is to determine factors affecting the return of spontaneous circulation (ROSC) ratios, neurological outcomes at discharge, the ratio of living patients discharged from the hospital and due to Do not attempt resuscitation (DNAR) prohibition. MATERIAL AND METHODS: This is a retrospective observational study conducted on patients of cardiopulmonary resuscitation (CPR) performed in emergency department (ED) and intensive care units between February 2010 and February 2012...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27896005/cerebral-blood-flow-is-decoupled-from-blood-pressure-and-linked-to-eeg-bursting-after-resuscitation-from-cardiac-arrest
#14
Christian Crouzet, Robert H Wilson, Afsheen Bazrafkan, Maryam H Farahabadi, Donald Lee, Juan Alcocer, Bruce J Tromberg, Bernard Choi, Yama Akbari
In the present study, we have developed a multi-modal instrument that combines laser speckle imaging, arterial blood pressure, and electroencephalography (EEG) to quantitatively assess cerebral blood flow (CBF), mean arterial pressure (MAP), and brain electrophysiology before, during, and after asphyxial cardiac arrest (CA) and resuscitation. Using the acquired data, we quantified the time and magnitude of the CBF hyperemic peak and stabilized hypoperfusion after resuscitation. Furthermore, we assessed the correlation between CBF and MAP before and after stabilized hypoperfusion...
November 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27895877/unexplained-cardiac-arrest-after-near-drowning-in-a-young-experienced-swimmer-insight-from-cardiovascular-magnetic-resonance-imaging
#15
Cesare Mantini, Giancarlo Messalli, Leonardo Paloscia, Domenico Mastrodicasa, Marco Francone, Marco Mascellanti, Alberto D'Alleva, Antonio Raffaele Cotroneo
Cardiac magnetic resonance imaging (cMRI) is a well-established noninvasive imaging modality in clinical cardiology. Its ability to provide tissue characterization make it well suited for the study of patients with cardiac diseases. We describe a multi-modality imaging evaluation of a 45-year-old man who experienced a near drowning event during swimming. We underline the unique capability of tissue characterization provided by cMRI, which allowed detection of subtle, clinically unrecognizable myocardial damage for understanding the causes of sudden cardiac arrest and also showed the small damages caused by cardiopulmonary resuscitation...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27894909/characteristics-of-bystander-cardiopulmonary-resuscitation-for-paediatric-out-of-hospital-cardiac-arrests-a-national-observational-study-from-2012-to-2014
#16
Ikwan Chang, Young Ho Kwak, Sang Do Shin, Young Sun Ro, Do Kyun Kim
OBJECTIVES: This study evaluated the associations between the provision of bystander cardiopulmonary resuscitation (BCPR) and both the relationship of bystanders with paediatric out-of-hospital cardiac arrest (OHCA) victims and the community educational level. METHODS: This observational study was conducted using the Korean national OHCA registry of paediatric OHCAs (<19years old) between 2012 and 2014. The main factor was the relationship between the bystander and the OHCA victim...
November 25, 2016: Resuscitation
https://www.readbyqxmd.com/read/27894023/persistent-generalized-periodic-discharges-a-specific-marker-of-fatal-outcome-in-cerebral-hypoxia
#17
Roland Renzel, Christian R Baumann, Ian Mothersill, Rositsa Poryazova
OBJECTIVES: Electroencephalography (EEG) is one of the methods used in predicting the outcome after cerebral hypoxia. In this study we aim to evaluate the significance of generalized periodic discharges (GPD) as a prognostic marker. METHODS: We retrospectively analyzed the medical histories of patients, who underwent an EEG after cardiac arrest during the time period from 2005 to 2013 at the University Hospital Zurich. All EEGs were re-interpreted using the 2012 American Clinical Neurophysiology Society (ACNS) classification for intensive care unit (ICU) EEGs...
November 5, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27890777/psychological-wellbeing-in-survivors-of-cardiac-arrest-and-its-relationship-to-neurocognitive-function
#18
Siân E Davies, Megan Rhys, Sarah E Voss, Rosemary Greenwood, Matthew Thomas, Jonathan R Benger
OBJECTIVE: To characterise psychological wellbeing in survivors of out-of-hospital cardiac arrest (OHCA), and examine its relationship to cognitive function. PATIENTS: Forty-one highly functioning cardiac arrest survivors were drawn from the follow-up cohort of a randomised controlled trial of initial airway management in OHCA (ISRCTN:18528625). DESIGN: Psychological wellbeing was assessed with a self-report questionnaire (the Depression Anxiety and Stress Scale; DASS) and cognitive function was examined using the Delayed Matching to Samples (DMS) test from the Cambridge Neuropsychological Test Automated Battery (CANTAB)...
November 24, 2016: Resuscitation
https://www.readbyqxmd.com/read/27890105/use-of-postmortem-computed-tomography-angiography-to-detect-vascular-injuries-accompanying-skull-base-fracture
#19
Hikaru Kuninaka, Yoichiro Takahashi, Rie Sano, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Hiroyuki Tokue, Sachiko Awata, Satoshi Hirasawa
A 58-year-old woman who had presented for upper gastrointestinal barium examination accidently slipped from the movable bed, and her head became compressed between the end of the bed and the side wall. She suffered massive bleeding from her nose and ear followed by cardiac arrest, and subsequent attempts at cardiopulmonary resuscitation failed. A medicolegal autopsy was performed to reveal the cause of death, as part of the investigation of the accident. During the autopsy, postmortem cerebral CT angiography was carried out by injection of 5% gelatin-barium emulsion as a radiopaque contrast medium into the bilateral common carotid arteries, demonstrating transudation of the contrast medium into the right acoustic meatus and the sphenoidal sinus cavity...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27888429/inappropriateness-of-diagnostic-imaging-examinations-in-the-inpatient-setting-a-case-study-research
#20
Ettore Squillaci, Francesca Bolacchi, Jacopo Scaggiante, Francesca Ricci, Luca Pugliese, Alberto Bergamini, Francesco Garaci, Roberto Floris
OBJECTIVE: The purpose of our study was to audit the clinical appropriateness of the prescriptions of whole body CT (WB-CT), PET-CT and chest X-rays (CXRs) performed at Tor Vergata University Hospital in the inpatient setting. MATERIALS AND METHODS: WB-CT, PET-CT and CXRs examinations were retrospectively analysed in the period between January and December 2014. CXR examinations were divided into bedside CXRs and traditional CXRs. The appropriateness of the examinations was defined according the American College of Radiology Appropriateness Criteria...
November 25, 2016: La Radiologia Medica
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