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https://www.readbyqxmd.com/read/28226873/using-hilbert-huang-transform-to-assess-eeg-slow-wave-activity-during-anesthesia-in-post-cardiac-arrest-patients
#1
Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko, Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko, Eero Vayrynen, Janne T Backman, Jukka Kortelainen, Tapio Seppanen, Jouko Laurila, Usko Huuskonen, Seppo Alahuhta, Tero Ala-Kokko, Juha Koskenkari
Hypoxic ischemic encephalopathy (HIE) is a severe consequence of cardiac arrest (CA) representing a substantial diagnostic challenge. We have recently designed a novel method for the assessment of HIE after CA. The method is based on estimating the severity of the brain injury by analyzing changes in the electroencephalogram (EEG) slow wave activity while the patient is exposed to an anesthetic drug propofol in a controlled manner. In this paper, Hilbert-Huang Transform (HHT) was used to analyze EEG slow wave activity during anesthesia in ten post-CA patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223053/diabetes-upregulation-of-cyclooxygenase-2%C3%A2-contributes-to-altered-coronary-reactivity-after-cardiac-surgery
#2
Jun Feng, Kelsey Anderson, Arun K Singh, Afshin Ehsan, Hunter Mitchell, Yuhong Liu, Frank W Sellke
BACKGROUND: We hypothesized that upregulation of inducible cyclooxygenase 2 (COX-2) contributes to altered coronary arteriolar reactivity early after cardioplegic arrest and cardiopulmonary bypass (CP/CPB) in patients with diabetes mellitus who are undergoing cardiac surgery. METHODS: The right atrial tissue samples of nondiabetes (ND), controlled diabetes (CDM), and uncontrolled diabetes (UDM) patients undergoing cardiac surgery were harvested before and after CP/CPB...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216089/health-status-and-psychological-distress-among-in-hospital-cardiac-arrest-survivors-in-relation-to-gender
#3
Johan Israelsson, Anders Bremer, Johan Herlitz, Åsa B Axelsson, Tobias Cronberg, Therese Djärv, Marja-Leena Kristofferzon, Ing-Marie Larsson, Gisela Lilja, Katharina S Sunnerhagen, Ewa Wallin, Susanna Ågren, Eva Åkerman, Kristofer Årestedt
AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender. METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS). RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28215591/the-effect-of-resuscitation-position-on-cerebral-and-coronary-perfusion-pressure-during-mechanical-cardiopulmonary-resuscitation-in-porcine-cardiac-arrest-model
#4
Taeyun Kim, Sang Do Shin, Kyoung Jun Song, Yong Joo Park, Hyun Ho Ryu, Guillaume Debaty, Keith Lurie, Ki Jeong Hong
OBJECTIVE: Automated cardiopulmonary resuscitation (CPR) devices can be used during transport in a small spaces (e.g. an elevator) to reduce the length of stretcher and via body position change. It is unknown whether patient position is associated with the optimal cerebral (CePP) and coronary (CoPP) perfusion pressure. METHODS: This study utilized a randomized experimental design and anesthetized, intubated and paralyzed female pigs (n=12) (mean 42, SD 3kg) on a customized tilt table...
February 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#5
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28214538/contemporary-animal-models-of-cardiac-arrest-a-systematic-review
#6
REVIEW
Mikael Vognsen, Bjørn K Fabian-Jessing, Niels Secher, Bo Løfgren, Cameron Dezfulian, Lars W Andersen, Asger Granfeldt
AIM OF THE STUDY: Animal models are widely used in cardiac arrest research. This systematic review aimed to provide an overview of contemporary animal models of cardiac arrest. METHODS: Using a comprehensive research strategy, we searched PubMed and EMBASE from March 8, 2011 to March 8, 2016 for cardiac arrest animal models. Two investigators reviewed titles and abstracts for full text inclusions from which data were extracted according to pre-defined definitions...
February 15, 2017: Resuscitation
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
#7
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/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
#8
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...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#9
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#10
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28192003/web-based-distress-management-for-implantable-cardioverter-defibrillator-patients-a-randomized-controlled-trial
#11
Mirela Habibović, Johan Denollet, Pim Cuijpers, Pepijn H van der Voort, Jean-Paul Herrman, Leon Bouwels, Suzanne D A Valk, Marco Alings, Dominic A M J Theuns, Susanne S Pedersen
OBJECTIVE: Sudden cardiac arrest caused by cardiac arrhythmias is 1 of the leading causes of death worldwide. Implantable cardioverter defibrillators (ICDs) are considered as standard care for patients with increased risk of arrhythmias. However, 1 in 4 ICD patients experiences psychological distress post-ICD implantation. The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate anxiety and depression and enhance health-related quality of life in ICD patients...
February 13, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28188385/pure-autonomic-failure-without-synucleinopathy
#12
Risa Isonaka, Courtney Holmes, Glen A Cook, Patti Sullivan, Yehonatan Sharabi, David S Goldstein
Pure autonomic failure is a rare form of chronic autonomic failure manifesting with neurogenic orthostatic hypotension and evidence of sympathetic noradrenergic denervation unaccompanied by signs of central neurodegeneration. It has been proposed that pure autonomic failure is a Lewy body disease characterized by intra-neuronal deposition of the protein alpha-synuclein in Lewy bodies and neurites. A middle-aged man with previously diagnosed pure autonomic failure experienced a sudden, fatal cardiac arrest. He was autopsied, and tissues were harvested for neurochemical and immunofluorescence studies...
February 10, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28179016/shock-induced-endotheliopathy-shine-in-acute-critical-illness-a-unifying-pathophysiologic-mechanism
#13
REVIEW
PärIngemar Johansson, Jakob Stensballe, SisseRye Ostrowski
One quarter of patients suffering from acute critical illness such as severe trauma, sepsis, myocardial infarction (MI) or post cardiac arrest syndrome (PCAS) develop severe hemostatic aberrations and coagulopathy, which are associated with excess mortality. Despite the different types of injurious "hit", acutely critically ill patients share several phenotypic features that may be driven by the shock. This response, mounted by the body to various life-threatening conditions, is relatively homogenous and most likely evolutionarily adapted...
February 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#14
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28174052/a-randomised-trial-of-expedited-transfer-to-a-cardiac-arrest-centre-for-non-st-elevation-ventricular-fibrillation-out-of-hospital-cardiac-arrest-the-arrest-pilot-randomised-trial
#15
Tiffany Patterson, Gavin D Perkins, Jubin Joseph, Karen Wilson, Laura Van Dyck, Steven Robertson, Hanna Nguyen, Hannah McConkey, Mark Whitbread, Rachael Fothergill, Joanne Nevett, Miles Dalby, Roby Rakhit, Philip MacCarthy, Divaka Perera, Jerry P Nolan, Simon R Redwood
BACKGROUND: Wide variation exists in inter-hospital survival from out-of-hospital cardiac arrest (OHCA). Regionalisation of care into cardiac arrest centres (CAC) may improve this. We report a pilot randomised trial of expedited transfer to a CAC following OHCA without ST-elevation. The objective was to assess the feasibility of performing a large-scale randomised controlled trial. METHODS: Adult witnessed ventricular fibrillation OHCA of presumed cardiac cause were randomised 1:1 to either: (1) treatment: comprising expedited transfer to a CAC for goal-directed therapy including access to immediate reperfusion, or (2) control: comprising current standard of care involving delivery to the geographically closest hospital...
February 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#16
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#17
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28163232/prognostic-significance-of-clinical-seizures-after-cardiac-arrest-and-target-temperature-management
#18
Anna Lybeck, Hans Friberg, Anders Aneman, Christian Hassager, Janneke Horn, Jesper Kjærgaard, Michael Kuiper, Niklas Nielsen, Susann Ullén, Matthew P Wise, Erik Westhall, Tobias Cronberg
AIM: Clinical seizures are common after cardiac arrest and predictive of a poor neurological outcome. Seizures may be myoclonic, tonic-clonic or a combination of seizure types. This study reports the incidence and prognostic significance of clinical seizures in the target temperature management (TTM) after cardiac arrest trial. Our hypotheses were that seizures are associated with a poor prognosis and that the incidence of seizures is not affected by the target temperature. METHODS: Post-hoc analysis of reported clinical seizures during day 1-7 in the TTM-trial including their treatment, EEG-findings, and long-term neurological outcome...
February 3, 2017: Resuscitation
https://www.readbyqxmd.com/read/28147420/neuroimaging-in-cardiac-arrest-prognostication
#19
David M Greer, Ona Wu
Neuroimaging is commonly utilized in the evaluation of post-cardiac arrest patients, providing a unique ability to visualize and quantify structural brain injury that can complement clinical and electrophysiologic data. Despite its lack of validation, we would advocate that neuroimaging is a valuable prognostication tool, worthy of further study, and an essential part of the armamentarium when used in combination with other modalities in the assessment of the post-cardiac arrest patient. Herein, we discuss the data and its limitations for neuroimaging to date and how it is being studied prospectively...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28131602/correlation-of-impedance-threshold-device-use-during-cardiopulmonary-resuscitation-with-post-cardiac-arrest-acute-kidney-injury
#20
Panagiota Niforopoulou, Nicoletta Iacovidou, Pavlos Lelovas, George Karlis, Αpostolos Papalois, Spyros Siakavellas, Vasileios Spapis, George Kaparos, Ioanna Siafaka, Theodoros Xanthos
PURPOSE: To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. METHODS: After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n=8) or with ACD-CPR plus an active ITD (ITD group, n=8)...
January 23, 2017: American Journal of Emergency Medicine
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