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https://www.readbyqxmd.com/read/28073687/adverse-event-detection-using-the-fda-post-marketing-drug-safety-surveillance-system-cardiotoxicity-associated-with-loperamide-abuse-and-misuse
#1
Kimberley A Swank, Eileen Wu, Cindy Kortepeter, Jana McAninch, Robert L Levin
OBJECTIVE: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use. METHODS: We searched the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database for post-marketing reports of serious cardiac adverse events associated with loperamide use from December 28, 1976 (U.S. drug approval date), through December 14, 2015. We also conducted a Pubmed and Google Scholar search to identify additional published reports of cardiotoxicity associated with loperamide in the medical literature through February 11, 2016...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28072500/ultrasound-guided-intracardiac-xenotransfusion-of-canine-packed-red-blood-cells-and-epinephrine-to-the-left-ventricle-of-a-severely-anemic-cat-during-cardiopulmonary-resuscitation
#2
Liron Oron, Yaron Bruchim, Sigal Klainbart, Efrat Kelmer
OBJECTIVE: To describe the use of an ultrasound-guided intracardiac xenotransfusion of canine packed red blood cells (pRBC) to the left ventricle of a severely anemic cat during cardiopulmonary resuscitation (CPR). CASE SUMMARY: An 8-year-old previously healthy neutered female cat was presented with severe weakness after she had disappeared for 1 month. On presentation, the cat was in hypovolemic shock, laterally recumbent, and severely anemic with massive flea infestation...
January 10, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28069838/incidence-of-atrial-fibrillation-detected-by-continuous-rhythm-monitoring-after-acute-myocardial-infarction-in-patients-with-preserved-left-ventricular-ejection-fraction-results-of-the-arrest-study
#3
Alexander Romanov, Martin Martinek, Helmut Pürerfellner, Shaojie Chen, Mirko De Melis, Igor Grazhdankin, Dmitry Ponomarev, Denis Losik, Artem Strelnikov, Vitaliy Shabanov, Alexander Karaskov, Evgeny Pokushalov
AIMS: Cardiac arrhythmias following acute myocardial infarction (AMI) can be associated with major adverse cardiovascular events. Data on the "real incidence" of post-MI arrhythmias are limited. We aimed to determine the rate and burden of cardiac arrhythmias by the use of insertable cardiac monitors (ICM) in patients with preserved left ventricular ejection fraction (LVEF) after AMI. METHODS AND RESULTS: In this prospective observational study, patients with LVEF ≥40% who underwent PCI within 7 days following AMI were enrolled to receive an ICM...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28069098/bolus-dose-of-epinephrine-for-refractory-post-arrest-hypotension
#4
Michael Gottlieb
Post-cardiac arrest hypotension is associated with worse outcomes. However, a significant proportion of patients may not be responsive to intravenous (IV) fluids, and vasopressor infusions require significant time to initiate. This case series describes the successful use of a bolus dose of epinephrine to rapidly treat IV fluid refractory hypotension among three patients in the post-arrest period. A bolus dose of epinephrine may be considered as a treatment for post-arrest hypotension that does not respond to IV fluids, but further studies should be performed prior to routine use...
January 10, 2017: CJEM
https://www.readbyqxmd.com/read/28062881/characteristics-and-risk-factors-for-mortality-in-paediatric-in-hospital-cardiac-events-in-singapore-retrospective-single-centre-experience
#5
Yee Hui Mok, Amanda Pt Loke, Tsee Foong Loh, Jan Hau Lee
Introduction: There is limited data on paediatric resuscitation outcomes in Asia. We aimed to describe outcomes of paediatric in-hospital cardiac arrests (IHCA) and peri-resuscitation factors associated with mortality in our institution. Materials and Methods: Using data from our hospital's code registry from 2009 to 2014, we analysed all patients younger than 18 years of age with IHCA who required cardiopulmonary resuscitation (CPR). Exposure variables were obtained from clinical demographics, CPR and post-resuscitation data...
December 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28058848/implantable-cardioverter-defibrillator-and-survival-after-out-of-hospital-cardiac-arrest-due-to-acute-myocardial-infarction-in-denmark-in-the-years-2001-2012-a-nationwide-study
#6
Matilde Winther-Jensen, Jesper Kjaergaard, Jens F Lassen, Lars Køber, Christian Torp-Pedersen, Steen M Hansen, Freddy Lippert, Kristian Kragholm, Erika F Christensen, Christian Hassager
AIM: The purpose of this study was to describe the implantation of implantable cardioverter defibrillator after out-of-hospital cardiac arrest caused by myocardial infarction in Denmark 2001-2012 and subsequent survival. METHODS: The Danish Cardiac Arrest Registry was used to identify patients ⩾18 years surviving to discharge without prior implantable cardioverter defibrillator. Information on cardioverter defibrillator implantation was obtained from the National Patient Registry...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28057527/use-of-early-head-ct-following-out-of-hospital-cardiopulmonary-arrest
#7
Alexandra S Reynolds, Elizabeth Matthews, Jessica Magid-Bernstein, Ashley Rodriguez, Soojin Park, Jan Claassen, Sachin Agarwal
AIM: Neurological emergencies can lead to cardiac arrest, and post-arrest patients can develop life-threatening neurological abnormalities. This study aims to estimate and characterize the use of early head CT (HCT), and its potential impact on post-resuscitation management. METHODS: This retrospective study analyzed 213 adults who suffered an out-of-hospital cardiac arrest (OHCA) and survived for at least 24h. Demographics were collected and arrest-related variables were documented...
January 3, 2017: Resuscitation
https://www.readbyqxmd.com/read/28045326/non-occlusive-mesenteric-ischaemia-in-out-of-hospital-cardiac-arrest-survivors
#8
Raphael Wurm, Anna Cho, Henrike Arfsten, Raphael van Tulder, Christian Wallmüller, Philipp Steininger, Fritz Sterz, Kristina Tendl, Csilla Balassy, Klaus Distelmaier, Martin Hülsmann, Gottfried Heinz, Christopher Adlbrecht
BACKGROUND AND AIM OF THE STUDY: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#9
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28017511/out-of-hospital-cardiac-arrest-in-pregnancy-with-good-neurological-outcome-for-mother-and-infant
#10
S Pecher, E Williams
Cardiac arrest in pregnancy is rare (about 1:30000 pregnancies) and out-of-hospital cardiac arrests are even less frequent. Resuscitation of the pregnant mother is challenging and requires attention to the altered physiology, specific pathologies and the presence and well-being of the fetus. Once circulation has been restored, the lack of high-grade evidence regarding delivery of the baby and post-resuscitation care makes decision making complex. We present a case of out-of-hospital maternal cardiac arrest with successful resuscitation and good neurological outcome for mother and infant...
November 15, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28011292/utilization-of-palliative-care-services-for-cardiac-arrest-patients-undergoing-therapeutic-hypothermia-a-retrospective-analysis
#11
Emily K Zern, Michael N Young, Taylor Triana, Meng Xu, Benjamin Holmes, Nyal Borges, John A McPherson, Mohana B Karlekar
BACKGROUND: Palliative care (PC) services are integral to the care of patients with advanced medical illnesses. Given the significant morbidity and mortality associated with cardiac arrest, we sought to measure the use and impact of PC in the care of patients treated with therapeutic hypothermia (TH). METHODS: We conducted a retrospective study of 317 consecutive patients undergoing TH after cardiac arrest. We compared intensive care unit (ICU) characteristics and clinical outcomes of subjects who received PC consultation (n=125) to those who did not (n=192)...
December 21, 2016: Resuscitation
https://www.readbyqxmd.com/read/28004331/delayed-deterioration-of-eeg-background-rhythm-post-cardiac-arrest
#12
Tadeu A Fantaneanu, Rani Sarkis, Kathleen Avery, Benjamin M Scirica, Shelley Hurwitz, Galen V Henderson, Jong Woo Lee
BACKGROUND: Electroencephalogram (EEG) background continuity is associated with a favorable prognosis in cardiac arrest patients post-therapeutic hypothermia. However, the continuous EEG in a subset of patients will undergo 'delayed EEG deterioration'; they will invariably have poor outcome. The aim of this study was to characterize this phenomenon. METHODS: We studied a prospectively collected cohort of consecutive cardiac arrest patients who underwent therapeutic hypothermia between July 2012 and May 2015...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27998282/does-therapeutic-hypothermia-during-extracorporeal-cardiopulmonary-resuscitation-preserve-cardiac-function
#13
Harald A Bergan, Per S Halvorsen, Helge Skulstad, Erik Fosse, Jan F Bugge
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (E-CPR) is increasingly used as a rescue method in the management of cardiac arrest and provides the opportunity to rapidly induce therapeutic hypothermia. The survival after a cardiac arrest is related to post-arrest cardiac function, and the application of therapeutic hypothermia post-arrest is hypothesized to improve cardiac outcome. The present animal study compares normothermic and hypothermic E-CPR considering resuscitation success, post-arrest left ventricular function and magnitude of myocardial injury...
December 20, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27993631/infectious-complications-after-out-of-hospital-cardiac-arrest-a-comparison-between-two-target-temperatures
#14
Josef Dankiewicz, Niklas Nielsen, Adam Linder, Michael Kuiper, Matthew P Wise, Tobias Cronberg, David Erlinge, Yvan Gasche, Matthew B Harmon, Christian Hassager, Janneke Horn, Jesper Kjaergaard, Tommaso Pellis, Pascal Stammet, Johan Undén, Michael Wanscher, Jørn Wetterslev, Anders Åneman, Susann Ullén, Nicole P Juffermans, Hans Friberg
BACKGROUND: It has been suggested that target temperature management (TTM) increases the probability of infectious complications after cardiac arrest. We aimed to compare the incidence of pneumonia, severe sepsis and septic shock after out-of-hospital cardiac arrest (OHCA) in patients with two target temperatures and to describe changes in biomarkers and possible mortality associated with these infectious complications. METHODS: Post-Hoc analysis of the TTM-trial which randomized patients resuscitated from OHCA to a target temperature of 33 °C or 36 °C...
December 16, 2016: Resuscitation
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#15
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27992736/factors-associated-with-re-arrest-following-initial-resuscitation-from-cardiac-arrest
#16
Abhishek Bhardwaj, Daniel J Ikeda, Anne V Grossestreuer, Kelsey R Sheak, Gail Delfin, Timothy Layden, Benjamin S Abella, Marion Leary
BACKGROUND: To examine patient- and arrest-level factors associated with the incidence of re-arrest in the hospital setting, and to measure the association between re-arrest and survival to discharge. METHODS: This work represents a retrospective cohort study of adult patients who were successfully resuscitated from an initial out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (ICHA) of non-traumatic origin at two urban academic medical centers...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27990707/acute-kidney-injury-and-mortality-prognosis-in-acute-coronary-syndrome-patients-a-meta-analysis
#17
John W Pickering, Isabella Rh Blunt, Martin P Than
AIM: To provide a robust estimates of mortality risk in acute coronary syndrome (ACS) associated acute kidney injury (AKI) to inform clinical practice and policy. METHODS: A meta-analysis of cohort studies evaluating outcomes of ACS and which reported AKI and AKI associated mortality. Studies were excluded if they incorporated patients not admitted through the emergency department (i.e. for elective procedures), were limited to cardiogenic shock or cardiac arrest, or relied on registry data for outcomes without further adjudication...
December 19, 2016: Nephrology
https://www.readbyqxmd.com/read/27988273/the-association-of-maximum-troponin-values-post-out-of-hospital-cardiac-arrest-with-electrocardiographic-findings-cardiac-reperfusion-procedures-and-survival-to-discharge-a-sub-study-of-roc-primed
#18
Laurie J Morrison, Sean M Devlin, Michael C Kontos, Sheldon Cheskes, Tom P Aufderheide, Jim Christenson, Joseph P Ornato, Ian G Stiell, Valeria E Rac, Andrew J Thomas, Jane G Wigginton, Paul Dorian
BACKGROUND: The role of Troponin (Tn) levels in the management of patients post out-of-hospital cardiac arrest (OHCA) is unclear. METHODS: All OHCA patients enrolled in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis trial and admitted to hospital with a Tn level and a 12-lead electrocardiogram were stratified by ST elevation (STE) or no STE in a regression model for survival to discharge adjusted for Utstein predictors and site...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27983865/suicide-risk-management-protocol-in-post-cardiac-arrest-survivors-development-feasibility-and-outcomes
#19
Rachel A Bucy, Kaitlyn A Hanisko, Lee A Kamphuis, Brahmajee K Nallamothu, Theodore J Iwashyna, Paul N Pfeiffer
RATIONALE: Suicidal ideation is an important part of the spectrum of depression, but studies of outcomes following cardiac events often avoid asking about suicide as part of their assessment due to perceived resource constraints and the complexity of managing this finding. OBJECTIVES: To describe the development, feasibility, and outcomes of a suicide risk management protocol implemented by research assistants (RAs) administering the Patient Health Questionnaire Depression Scale (PHQ-9)...
December 16, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27982758/burst-suppression-in-hypothermia-after-cardiac-arrest-because-of-drowning-treated-with-targeted-temperature-management-a-case-report
#20
Tomoya Okazaki, Toru Hifumi, Satoshi Egawa, Hideyuki Hamaya, Natsuyo Shinohara, Shohei Kawamoto, Takuma Iwaki, Kohei Tsukahara, Kenya Kawakita, Takashi Kusaka, Yasuhiro Kuroda
Outcomes of cardiac arrest (CA) because of drowning in children are generally poor, but some reports show that cases with post-CA hypothermia because of drowning exhibit good recovery when treated with targeted temperature management (TTM). However, because electroencephalogram (EEG) findings are not reported in those cases, a complete examination of brain damage has not been performed during TTM. Here we report a case of a 15-month-old boy with post-CA hypothermia recovery after treating with TTM, along with EEG findings...
December 16, 2016: Therapeutic Hypothermia and Temperature Management
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