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https://www.readbyqxmd.com/read/29452150/cerebral-blood-flow-velocity-and-autoregulation-in-paediatric-patients-following-a-global-hypoxic-ischaemic-insult
#1
Marlina E Lovett, Tensing Maa, Melissa G Chung, Nicole F O'Brien
AIM: To describe the cerebral blood flow velocity pattern and investigate cerebral autoregulation using transcranial Doppler ultrasonography (TCD) following a global hypoxic-ischaemic (HI) event in children. METHODS: This was a prospective, observational study in a quaternary-level paediatric intensive care unit. Intubated children, newborn to 17 years admitted to the PICU following HI injury (asphyxia, drowning, cardiac arrest) were eligible for inclusion. TCD was performed daily until post-injury day 8, discharge, or death, whichever occurred earliest...
February 13, 2018: Resuscitation
https://www.readbyqxmd.com/read/29438721/changes-in-left-ventricular-systolic-and-diastolic-function-on-serial-echocardiography-after-out-of-hospital-cardiac-arrest
#2
Jacob C Jentzer, Nandan S Anavekar, Sunil V Mankad, Roger D White, Kianoush B Kashani, Gregory W Barsness, Alejandro A Rabinstein, Sorin V Pislaru
AIM: Reversible myocardial dysfunction is common after out-of-hospital cardiac arrest (OHCA). The aim of this study was to determine if changes on serial transthoracic echocardiography (TTE) can predict long-term mortality in OHCA subjects. METHODS: This is a single-center historical cohort study of OHCA subjects undergoing targeted temperature management who received >1 TTE during hospitalization. Two-dimensional and Doppler parameters of systolic and diastolic function were compared between paired TTE...
February 10, 2018: Resuscitation
https://www.readbyqxmd.com/read/29432783/effect-of-target-temperature-management-at-32-34%C3%A2-%C3%A2-c-in-cardiac-arrest-patients-considering-assessment-by-regional-cerebral-oxygen-saturation-a-multicenter-retrospective-cohort-study
#3
Yuka Nakatani, Takeo Nakayama, Kei Nishiyama, Yoshimitsu Takahashi
AIM: Target temperature management (TTM) is used in comatose post-cardiac arrest patients, but the recommended temperature range is wide. This study aimed to assess the effectiveness of TTM at 32 to 34 °C while considering the degree of cerebral injury and cerebral circulation, as assessed by regional cerebral oxygen saturation (rSO2). METHODS: This is a secondary analysis of prospectively collected registry data from comatose patients who were transferred to 15 hospitals in Japan after out-of-hospital cardiac arrest (OHCA) from 2011 to 2013...
February 9, 2018: Resuscitation
https://www.readbyqxmd.com/read/29431591/the-role-of-cranial-temperature-in-neuroprotection-by-sodium-hydrogen-sulfide-after-cardiac-arrest-in-mice
#4
Shin Nakayama, Noriko Taguchi, Makoto Tanaka
The hydrogen sulfide donor sodium hydrogen sulfide (NaHS) is recognized as a neuroprotective agent, which induces a hibernation-like metabolic state and hypothermia. However, it remains unclear whether it is the sulfide itself or the hypothermia induced by the sulfide that mediates treatment outcomes following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). We therefore tested whether NaHS improved outcomes following CA/CPR in mice maintained at 35.0°C by active warming during recovery. Adult male mice were subjected to 8 minutes CA/CPR and randomly treated intraperitoneally with either implantation of miniosmotic pump with NaHS (50 μmol/kg/day) for 3 days or vehicle 30 minutes after CPR...
February 12, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29430575/knowledge-and-attitude-of-singapore-schoolchildren-learning-cardiopulmonary-resuscitation-and-automated-external-defibrillator-skills
#5
Phek Hui Jade Kua, Alexander E White, Wai Yee Ng, Stephanie Fook-Chong, Eileen Kai Xin Ng, Yih Yng Ng, Marcus Eng Hock Ong
INTRODUCTION: Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Persons making the call to emergency medical services will be asked to provide dispatcher-guided response until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion. METHODS: We conducted this study among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys...
February 12, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29425976/non-invasive-characterization-of-hemodynamics-in-adult-out-of-hospital-cardiac-arrest-patients-soon-after-return-of-spontaneous-circulation
#6
Joseph P Ornato, Tammy Nguyen, Peter Moffett, Stephen Miller, Michael J Vitto, David Evans, Alan Payne, Kathy Baker, Mary Schaeffer
BACKGROUND: Little is known about hemodynamics in adult, out-of-hospital (OHCA) patients following return of spontaneous circulation (ROSC). A 1994 study when "high-dose epinephrine" use was common showed consistently elevated systemic vascular resistance (SVR) lasting ≥6 hours in 49 adult patients after return of spontaneous circulation (ROSC). STUDY AIM: To characterize hemodynamic abnormalities in adult OHCA patients soon after ROSC. Our hypothesis was that, unlike the consistently high SVR values reported when "high-dose" epinephrine was in common use, there would be a more heterogenous distribution of SVR values using current adrenergic therapy...
February 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29425975/-resuscitation-time-bias-a-unique-challenge-for-observational-cardiac-arrest-research
#7
Lars W Andersen, Anne V Grossestreuer, Michael W Donnino
Observational studies are prone to a number of biases. One of these is immortal time bias. In this manuscript, we discuss immortal time bias as it pertains to post-cardiac arrest research and describe a related bias which we term "resuscitation time bias". This bias can occur when studying exposures during cardiac arrest. In this unique situation, an exposure is more likely to occur the longer the cardiac arrest continues. Since length of resuscitation is strongly associated with worse outcome, this will bias the results toward a harmful effect of the exposure...
February 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29420551/survival-factors-of-hospitalized-out-of-hospital-cardiac-arrest-patients-in-taiwan-a-retrospective-study
#8
Chung-Yu Lai, Fu-Huang Lin, Hsin Chu, Chih-Hung Ku, Shih-Hung Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chun-Hsien Wu, Chi-Ming Chu, Chi-Wen Chang
The chain of survival has been shown to improve the chances of survival for victims of cardiac arrest. Post-cardiac arrest care has been demonstrated to significantly impact the survival of out-of-hospital cardiac arrest (OHCA). How post-cardiac arrest care influences the survival of OHCA patients has been a main concern in recent years. The objective of this study was to assess the survival outcome of hospitalized OHCA patients and determine the factors associated with improved survival in terms of survival to discharge...
2018: PloS One
https://www.readbyqxmd.com/read/29414264/risk-stratification-for-sudden-cardiac-death-after-myocardial-infarction
#9
Jonathan W Waks, Alfred E Buxton
Sudden cardiac death (SCD) accounts for ∼50% of mortality after myocardial infarction (MI). Most SCDs result from ventricular tachyarrhythmias, and the tachycardias that precipitate cardiac arrest result from multiple mechanisms. As a result, it is highly unlikely that any single test will identify all patients at risk for SCD. Current guidelines for use of implantable cardioverter-defibrillators (ICDs) to prevent SCD are based primarily on measurement of left ventricular ejection fraction (LVEF). Although reduced LVEF is associated with increased total cardiac mortality after MI, the focus of current guidelines on LVEF omits ∼50% of patients who die suddenly...
January 29, 2018: Annual Review of Medicine
https://www.readbyqxmd.com/read/29413844/ripk3-regulates-cardiac-microvascular-reperfusion-injury-the-role-of-ip3r-dependent-calcium-overload-xo-mediated-oxidative-stress-and-f-action-filopodia-based-cellular-migration
#10
Hao Zhou, Jin Wang, Pingjun Zhu, Shunying Hu, Jun Ren
Ripk3-mediated cellular apoptosis is a major contributor to the pathogenesis of myocardial ischemia reperfusion (IR) injury. However, the mechanisms by which Ripk3 influences microvascular homeostasis and endothelial apoptosis are not completely understood. In this study, loss of Ripk3 inhibited endothelial apoptosis, alleviated luminal swelling, maintained microvasculature patency, reduced the expression of adhesion molecules and limited the myocardial inflammatory response. In vitro, Ripk3 deficiency protected endothelial cells from apoptosis and migratory arrest induced by HR injury...
January 27, 2018: Cellular Signalling
https://www.readbyqxmd.com/read/29410284/coronary-angiographic-findings-and-outcomes-in-patients-with-sudden-cardiac-arrest-without-st-elevation-myocardial-infarction-a-swedeheart-study
#11
Axel Wester, Moman A Mohammad, Pontus Andell, Rebecca Rylance, Josef Dankiewicz, Hans Friberg, Stefan James, Elmir Omerovic, David Erlinge, Sasha Koul
BACKGROUND/AIM: Sudden cardiac arrest (SCA) has a substantial mortality rate and the acute coronary syndrome constitutes the major cause. Post-resuscitation electrocardiogram ST-elevation SCA (STE-SCA) is a strong indication for emergency coronary angiography, but the role of early angiography and PCI in patients without ST-elevation (NSTE-SCA) remains to be established. This paper aimed to describe this patient group and evaluate the prognostic effect of early PCI in a large nationwide cohort of NSTE-SCA patients undergoing coronary angiography...
February 1, 2018: Resuscitation
https://www.readbyqxmd.com/read/29409776/the-validation-of-simplified-eeg-derived-from-the-bispectral-index-monitor-in-post-cardiac-arrest-patients
#12
Jolien Haesen, Ward Eertmans, Cornelia Genbrugge, Ingrid Meex, Jelle Demeestere, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans, Ludovic Ernon, Cathy De Deyne
AIMS: We aimed to validate retrospectively the accuracy of simplified electroencephalography (EEG) monitoring derived from the bispectral index (BIS) monitor in post-cardiac arrest (CA) patients. METHODS: Successfully resuscitated CA patients were transferred to the Catherization Lab followed by percutaneous coronary intervention when indicated. On arrival at the coronary care unit, bilateral BIS monitoring was started and continued up to 72 h. Raw simplified EEG tracings were extracted from the BIS monitor at a time point coinciding with the registration of standard EEG monitoring...
February 1, 2018: Resuscitation
https://www.readbyqxmd.com/read/29408229/trends-in-care-processes-and-survival-following-prehospital-resuscitation-improvement-initiatives-for-out-of-hospital-cardiac-arrest-in-british-columbia-2006-2016
#13
Brian Grunau, Takahisa Kawano, William Dick, Ronald Straight, Helen Connolley, Robert Schlamp, Frank Scheuermeyer, Christopher B Fordyce, David Barbic, John Tallon, Jim Christenson
BACKGROUND: British Columbia (BC) Emergency Health Services implemented a strategy to improve outcomes for out-of-hospital cardiac arrest (OHCA), focusing on paramedic-led high-quality on-scene resuscitation. We measured changes in care metrics and survival trends. METHODS: This was a post-hoc study of prospectively identified consecutive non-traumatic ambulance-treated adult OHCAs from 2006 to 2016 within BC's four metropolitan areas. The primary outcome was survival to hospital discharge; we described available favourable neurological outcomes (mRS ≤3)...
February 2, 2018: Resuscitation
https://www.readbyqxmd.com/read/29407205/women-have-worse-cognitive-functional-and-psychiatric-outcomes-at-hospital-discharge-after-cardiac-arrest
#14
Sachin Agarwal, Alex Presciutti, Jayati Verma, Marykay A Pavol, Deepti Anbarasan, Daniel Brodie, Leroy E Rabbani, David J Roh, Soojin Park, Jan Claassen, Yaakov Stern
AIM: To examine gender differences among cardiac arrest (CA) survivors' cognitive, functional, and psychiatric outcomes at discharge. METHODS: This is a prospective, observational cohort of 187 CA patients admitted to Columbia University Medical Center, considered for Targeted Temperature Management (TTM), and survived to hospital discharge between September 2015 and July 2017. Patients with sufficient mental status at hospital discharge to engage in the Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (M-PSMS), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies Depression Scale (CES-D), and Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) were included...
January 29, 2018: Resuscitation
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#15
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29405806/delayed-sequence-intubation-by-intensive-care-flight-paramedics-in-victoria-australia
#16
Jacinta Waack, Matthew Shepherd, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29405103/case-report-a-case-of-severe-cerebral-malaria-managed-with-therapeutic-hypothermia-and-other-modalities-for-brain-edema
#17
AbdAllah Gad, Sajjad Ali, Talal Zahoor, Nick Azarov
Malarial infections are uncommon in the United States and almost all reported cases stem from recent travelers coming from endemic countries. Cerebral malaria (CM) is a severe form of the disease usually affecting children and individuals with limited immunity. Despite proper management, mortality from CM can reach up to 25%, especially when it is associated with brain edema. Inefficient management of the edema may result in brain herniation and death. Uniform guidelines for management of CM-associated brain edema are lacking...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29396094/r-chop-radioimmunotherapy-and-maintenance-rituximab-in-untreated-follicular-lymphoma-swog-s0801-a-single-arm-phase-2-multicentre-study
#18
Paul M Barr, Hongli Li, W Richard Burack, Michael LeBlanc, Sonali M Smith, Ajay K Gopal, Justin D Floyd, Daniel O Persky, Oliver W Press, Richard I Fisher, Jonathan W Friedberg
BACKGROUND: Despite an abundance of therapeutic options, advanced-stage follicular lymphoma remains incurable. Furthermore, the ideal sequence and absolute benefit of post-induction therapy is unclear. We designed SWOG S0801 to assess the efficacy and safety of consolidative radioimmunotherapy and sequential maintenance rituximab following chemoimmunotherapy. METHODS: For this single-arm, phase 2, multicentre study, we enrolled patients aged 18 years and older with a diagnosis of stage III, IV, or bulky stage II follicular lymphoma, grades 1, 2, or 3a, who had not received previous therapy, from from 20 institutions within the United States National Cancer Institute Clinical Trials Network...
January 25, 2018: Lancet Haematology
https://www.readbyqxmd.com/read/29393490/erythropoietin-alleviates-post-resuscitation-myocardial-dysfunction-in-rats-potentially-through-increasing-the-expression-of-angiotensin-ii-receptor-type-2-in-myocardial-tissues
#19
Hourong Zhou, Jia Huang, Li Zhu, Yu Cao
Activation of renin-angiotensin system (RAS) is one of the pathological mechanisms associated with myocardial ischemia-reperfusion injury following resuscitation. The present study aimed to determine whether erythropoietin (EPO) improves post‑resuscitation myocardial dysfunction and how it affects the renin‑angiotensin system. Sprague‑Dawley rats were randomly divided into sham, vehicle, epinephrine (EP), EPO and EP + EPO groups. Excluding the sham group, all groups underwent cardiopulmonary resuscitation (CPR) 4 min after asphyxia‑induced cardiac arrest (CA)...
January 24, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29392429/minimally-invasive-surgery-mis-in-children-and-adolescents-with-pheochromocytomas-and-retroperitoneal-paragangliomas-experiences-in-42-patients
#20
Martin K Walz, Laura D Iova, Judith Deimel, Hartmut P H Neumann, Birke Bausch, Stefan Zschiedrich, Harald Groeben, Pier F Alesina
BACKGROUND: Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access. MATERIALS: In the setting of a prospective study (1/2001-12/2016), 42 consecutive children and adolescents (33 m, 9 f) were operated on...
February 1, 2018: World Journal of Surgery
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