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https://www.readbyqxmd.com/read/28818523/cognitive-impairments-and-subjective-cognitive-complaints-after-survival-of-cardiac-arrest-a-prospective-longitudinal-cohort-study
#1
Catherine V M Steinbusch, Caroline M van Heugten, Sascha M C Rasquin, Jeanine A Verbunt, Véronique R M Moulaert
BACKGROUND: Cardiac arrest can lead to hypoxic brain injury, which can affect cognitive functioning. OBJECTIVE: To investigate the course of objective and subjective cognitive functioning and their association during the first year after cardiac arrest. METHODS: A multi-centre prospective longitudinal cohort study with one year follow-up (measurements at two weeks, three months and one year). Cognitive functioning was measured with a neuropsychological test battery and subjective cognitive functioning with the Cognitive Failures Questionnaire...
August 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28814447/acute-myocarditis-secondary-to-cardiac-tuberculosis
#2
Alice Cowley, Laura Dobson, John Kurian, Christopher Saunderson
Isolated myocardial involvement in tuberculosis is exceedingly rare but there are reports it can present with sudden cardiac death, atrioventricular block, ventricular arrhythmias or congestive cardiac failure. We report the case of a 33 year-old male, of South Asian descent, who presented with chest pain, shortness of breath and an abnormal ECG. The patient had no significant past medical history and coronary angiogram showed no evidence of coronary artery disease. Of note the patient had recently been discharged from a local district hospital with an episode of myocarditis...
August 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28812428/microvascular-perfusion-in-cardiac-arrest-a-review-of-microcirculatory-imaging-studies
#3
Petra Krupičková, Zuzana Mormanová, Tomáš Bouček, Tomáš Belza, Jana Šmalcová, Jan Bělohlávek
Cardiac arrest represents a leading cause of mortality and morbidity in developed countries. Extracorporeal cardiopulmonary resuscitation (ECPR) increases the chances for a beneficial outcome in victims of refractory cardiac arrest. However, ECPR and post-cardiac arrest care are affected by high mortality rates due to multi-organ failure syndrome, which is closely related to microcirculatory disorders. Therefore, microcirculation represents a key target for therapeutic interventions in post-cardiac arrest patients...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28812241/plasma-glycoproteomic-study-of-therapeutic-hypothermia-reveals-novel-markers-predicting-neurologic-outcome-post-cardiac-arrest
#4
Wenjun Deng, Jing Cao, Lei Chen, David McMullin, James L Januzzi, Ferdinando S Buonanno, Eng H Lo, MingMing Ning
Therapeutic hypothermia (TH) is a neuroprotective treatment post-cardiac arrest but is grossly underutilized. After TH induction, traditional biomarkers and parameters can no long predict clinical outcome due to a lack of understanding of hypothermic response. Innovative approaches to better understand the clinical effect of TH will help to prognosticate outcome and expand beneficial population. Protein glycosylation is an important extracellular post-translational modification, regulating various extracellular signaling pathways...
August 15, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28807442/age-is-related-to-neurological-outcome-in-patients-with-out-of-hospital-cardiac-arrest-ohca-receiving-therapeutic-hypothermia-th
#5
Se Jong Oh, Jin Joo Kim, Jae Ho Jang, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang
INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28805266/hypothermic-pulsatile-preservation-of-kidneys-from-uncontrolled-deceased-donors-after-cardiac-arrest
#6
Xavier Matillon, Fabrice Danjou, Palmina Petruzzo, Olivier Thaunat, Thomas Rimmele, Claire Delsuc, Alexandre Faure, Maud Rabeyrin, Vannary Meas Yedid, William Hanf, Emmanuel Morelon, Lionel Badet, Ricardo Codas
Kidneys from uncontrolled donors after cardiac arrest (uDCD) suffer from a period of warm ischemia between cardiac arrest and cold flushing. Aim of the study was to evaluate renal outcomes of uDCD kidneys selected on the basis of renal Resistance Index (RI) and its influence on graft function and survival. The study included 44 kidneys procured from 26 uDCD starting 1.1.2006 until 31.12.2013. The donors (Maastricht category II) underwent cardiopulmonary resuscitation by assisted ventilation and chest compression; the organs were preserved with "in situ" cold perfusion or a normothermic regional perfusion...
August 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28800888/clinical-classification-of-post-anoxic-myoclonic-status
#7
Yara Mikhaeil-Demo, Jay R Gavvala, Irena I Bellinski, Micheal P Macken, Aditi Narechania, Jessica W Templer, Stephen VanHaerents, Stephan U Schuele, Elizabeth E Gerard
INTRODUCTION: Despite decades of research into the prognostic significance of post anoxic myoclonic status (MS), no consistent definition has been used to describe its clinical appearance. We set out to characterize the clinical features of MS and hypothesized that there are distinct clinical subtypes that may have prognostic implications. METHODS: Video EEG reports from 2008 to 2016 were searched to identify adult patients with post anoxic MS defined as persistent myoclonus for >30minutes beginning within 3days of cardiac arrest in a comatose patient...
August 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28799206/the-incidence-and-characteristics-of-3-month-mortality-after-intraoperative-cardiac-arrest-in-adults
#8
M Hur, H-C Lee, K H Lee, J-T Kim, C-W Jung, H-P Park
BACKGROUND: There is little information about clinical outcomes after intraoperative cardiac arrest (IOCA). We determined the incidence and characteristics of 3-month mortality after IOCA. METHODS: The electronic medical records of 238,648 adult surgical patients from January 2005 to December 2014 were reviewed retrospectively. Characteristics of IOCA were documented using the Utstein reporting template. RESULTS: IOCA occurred in 50 patients (21/100,000 surgeries)...
August 11, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28789766/-post-resuscitation-care-after-out-of-hospital-cardiac-arrest
#9
Johannes Grand, Christian Hassager, Jesper Kjærgaard
Survival from out-of-hospital cardiac arrest in Denmark has increased significantly since 2001, and important improvements have been made in the post-resuscitation care. The aim of this article is to summarize the most recent international guidelines for post-resuscitation care in a Danish perspective. The main aspects concern securing haemodynamic and respiratory functions and performing urgent coronary catheterization and targeted temperature management in selected patients. In prognostication a multi-modal approach should be applied...
July 24, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28766924/factors-associated-with-performing-urgent-coronary-angiography-in-out-of-hospital-cardiac-arrest-patients
#10
David H Lam, Lauren M Glassmoyer, Jordan B Strom, Roger B Davis, James M McCabe, Donald E Cutlip, Michael W Donnino, Michael N Cocchi, Duane S Pinto
OBJECTIVES: Factors associated with performing urgent coronary angiography (UCA) in patients with out-of-hospital cardiac arrest (OHCA) were identified. BACKGROUND: Current guidelines for resuscitated OHCA patients recommend UCA if there is ST-elevation on post-arrest electrocardiogram or high suspicion of acute myocardial infarction. Some have advocated for UCA in all OHCA regardless of suspected etiology. The reasons for variations in performing UCA are not well understood...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28765736/factors-influencing-the-quality-of-standardized-treatment-for-patients-with-post-cardiac-arrest-syndrome
#11
Jing Lu, Lijun Liu, Jianliang Zhu, Xinying Guo
BACKGROUND AND OBJECTIVES: For the present study, we investigated the factors that influence the quality of standardized treatment for patients with post-cardiac arrest syndrome (PCAS) to improve the quality of PCAS treatment. SUBJECTS AND METHODS: We collected data on patients with cardiac arrest (CA) who were admitted to the intensive care units (ICUs) of 11 hospitals-Class II Grade A or above-in Suzhou from January to October 2013. Indexes of standardized treatment were observed within 72 hrs of CA...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#12
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28758873/platelet-aggregation-during-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-a-randomised-clinical-trial
#13
Anni Nørgaard Jeppesen, Anne-Mette Hvas, Anders Morten Grejs, Christophe Duez, Susanne Ilkjær, Hans Kirkegaard
Some studies conclude that mild hypothermia causes platelet dysfunction leading to an increased bleeding risk, whereas others state that platelet aggregation is enhanced during mild hypothermia. Therefore, the aim of this study was to clarify whether standard or prolonged duration of targeted temperature management affected platelet aggregation. We randomised 82 comatose patients resuscitated after out-of-hospital cardiac arrest to either 24 hours (standard group) or 48 hours (prolonged group) of targeted temperature management at 33±1°C...
July 31, 2017: Platelets
https://www.readbyqxmd.com/read/28757259/endotoxemia-induces-lung-brain-coupling-and-multi-organ-injury-following-cerebral-ischemia-reperfusion
#14
Nguyen Mai, Landa Prifti, Aric Rininger, Hannah Bazarian, Marc W Halterman
Post-ischemic neurodegeneration remains the principal cause of mortality following cardiac resuscitation. Recent studies have implicated gastrointestinal ischemia in the sepsis-like response associated with the post-cardiac arrest syndrome (PCAS). However, the extent to which the resulting low-grade endotoxemia present in up to 86% of resuscitated patients affects cerebral ischemia-reperfusion injury has not been investigated. Here we report that a single injection of low-dose lipopolysaccharide (50μg/kg, IP) delivered after global cerebral ischemia (GCI) induces blood-brain barrier permeability, microglial activation, cortical injury, and functional decline in vivo, compared to ischemia alone...
July 28, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28754760/accidental-hypothermic-cardiac-arrest-and-rapid-mediastinal-warming-with-pleural-lavage-a-survivor-after-3-5-hours-of-manual-cpr
#15
George Little
A 30-year-old man suffered post-traumatic hypothermic cardiac arrest. On arrival in the emergency department, rectal core temperature was 23°C. Manual cardiopulmonary resuscitation (CPR) was continued as no mechanical chest compression device was available, and active and passive rewarming was undertaken. Bilateral thoracostomies confirmed good lung inflation. Defibrillation and intravenous epinephrine were discontinued until core temperature was elevated above 30°C. Extracorporeal rewarming was unavailable...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28753141/atrial-esophageal-fistula-secondary-to-ablation-for-atrial-fibrillation-a-case-series-and-review-of-the-literature
#16
Lily K Fatula, William D Bolton, Allyson L Hale, Barry R Davis, James E Stephenson, Sharon Ben-Or
This article describes 2 patients who presented to our institution with left atrial esophageal fistula after atrial fibrillation ablation; it also compares our experience with other atrial esophageal fistula cases reported in the literature. We performed a retrospective review of 2 patients who presented to our hospital between July 2015 and September 2015 with atrial esophageal fistula. Patient A, a 57-year-old man, presented 31 days postablation with a fever and right-sided weakness. A chest computed tomography showed gas in the left atrium and esophagus; an echocardiogram confirmed the diagnosis of atrial esophageal fistula...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28752472/technical-challenges-related-to-implementation-of-a-formula-one-real-time-data-acquisition-and-analysis-system-in-a-paediatric-intensive-care-unit
#17
B Rajeswari Matam, Heather Duncan
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded...
July 27, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28750886/intubation-is-not-a-marker-for-coma-after-in-hospital-cardiac-arrest-a-retrospective-study
#18
Katherine M Berg, Anne V Grossestreuer, Amy Uber, Parth V Patel, Michael W Donnino
INTRODUCTION: In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. METHODS: Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28743338/-clinical-characteristics-and-prognosis-in-patients-with-high-plasma-level-of-procalcitonin-an-analysis-in-188-patients
#19
Chuli Pan, Wei Cui, Feifei Zhou, Junwei Tu, Xiuhui Lin, Libin Li, Gensheng Zhang
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. METHODS: A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#20
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
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