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https://www.readbyqxmd.com/read/29677083/east-multicenter-trial-on-targeted-temperature-management-for-hanging-induced-cardiac-arrest
#1
Cindy H Hsu, Bryce E Haac, Mack Drake, Andrew C Bernard, Alberto Aiolfi, Kenji Inaba, Holly E Hinson, Chinar Agarwal, Joseph Galante, Emily M Tibbits, Nicholas J Johnson, David Carlbom, Mina F Mirhoseini, Mayur B Patel, Karen R OʼBosky, Christian Chan, Pascal O Udekwu, Megan Farrell, Jeffrey L Wild, Katelyn A Young, Daniel C Cullinane, Deborah J Gojmerac, Alexandra Weissman, Clifton Callaway, Sarah M Perman, Mariana Guerrero, Imoigele P Aisiku, Raghu R Seethala, Ivan N Co, Debbie Y Madhok, Bryan Darger, Dennis Y Kim, Lara Spence, Thomas M Scalea, Deborah M Stein
BACKGROUND: We sought to determine the outcome of suicidal hanging and the impact of targeted temperature management (TTM) on hanging-induced cardiac arrest (CA) through an Eastern Association for the Surgery of Trauma (EAST) multicenter retrospective study. METHODS: We analyzed hanging patient data and TTM variables from January 1992 to December 2015. Cerebral performance category (CPC) score of 1 or 2 was considered good neurologic outcome, while CPC of 3 or 4 was considered poor outcome...
April 19, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#2
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29661665/combining-early-post-resuscitation-eeg-and-hrv-features-improves-the-prognostic-performance-in-cardiac-arrest-model-of-rats
#3
Chenxi Dai, Zhi Wang, Liang Wei, Gang Chen, Bihua Chen, Feng Zuo, Yongqin Li
OBJECTIVE: Early and reliable prediction of neurological outcome remains a challenge for comatose survivors of cardiac arrest (CA). The purpose of this study was to evaluate the predictive ability of EEG, heart rate variability (HRV) features and the combination of them for outcome prognostication in CA model of rats. METHODS: Forty-eight male Sprague-Dawley rats were randomized into 6 groups (n=8 each) with different cause and duration of untreated arrest. Cardiopulmonary resuscitation was initiated after 5, 6 and 7min of ventricular fibrillation or 4, 6 and 8min of asphyxia...
April 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29653154/association-between-intra-and-post-arrest-hyperoxia-on-mortality-in-adults-with-cardiac-arrest-a-systematic-review-and-meta-analysis
#4
REVIEW
Jignesh K Patel, Abdo Kataya, Puja B Parikh
OBJECTIVES: The association between intra-arrest and post-arrest hyperoxia and mortality in adults with cardiac arrest (CA) is widely debated. We therefore conducted a systematic review and meta-analysis to investigate the association between intra-arrest and post-arrest hyperoxia and mortality in adults with CA. METHODS: We systematically searched MEDLINE and Cochrane databases to identify observational studies from January 2008 to December 2017 investigating the relationship between hyperoxia (either intra-arrest or post-arrest) and mortality in adults with CA...
April 10, 2018: Resuscitation
https://www.readbyqxmd.com/read/29649316/effect-of-one-lung-ventilation-on-end-tidal-carbon-dioxide-during-cardiopulmonary-resuscitation-in-a-pig-model-of-cardiac-arrest
#5
Dong Hyun Ryu, Yong Hun Jung, Kyung Woon Jeung, Byung Kook Lee, Young Won Jeong, Jong Geun Yun, Dong Hun Lee, Sung Min Lee, Tag Heo, Yong Il Min
Unrecognized endobronchial intubation frequently occurs after emergency intubation. However, no study has evaluated the effect of one-lung ventilation on end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR). We compared the hemodynamic parameters, blood gases, and ETCO2 during one-lung ventilation with those during conventional two-lung ventilation in a pig model of CPR, to determine the effect of the former on ETCO2. A randomized crossover study was conducted in 12 pigs intubated with double-lumen endobronchial tube to achieve lung separation...
2018: PloS One
https://www.readbyqxmd.com/read/29644151/trans-cranial-doppler-as-an-ancillary-study-supporting-irreversible-brain-injury-in-a-post-cardiac-arrest-patient-on-extracorporeal-membrane-oxygenation
#6
Naresh Mullaguri, Aarti Sarwal, Nakul Katyal, Premkumar Nattanamai, Pravin George, Christopher R Newey
Obtaining neuroimaging in patients on cardiopulmonary support devices such as extracorporeal membrane oxygenation (ECMO) can be challenging, given the complexities in monitoring, instrumentation, and associated hemodynamic lability. Transcranial Doppler (TCD) is used as an ancillary test for the assessment of cerebral circulatory arrest, but its use in non-pulsatile blood flow in venoarterial (VA) ECMO is not well described. We report the use of TCD in a patient on VA ECMO post-cardiac arrest for evaluation of death by neurological criteria...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29628595/anesthesia-in-a-child-with-newly-diagnosed-hypertrophic-cardiomyopathy-for-placement-of-implantable-cardioverter-defibrillator
#7
Rajnish Kumar, Bibha Kumari
Hypertrophic cardiomyopathy (HCM) is a genetic myocardial disease usually characterized by asymmetric ventricular septal hypertrophy. HCM is an important cause of sudden cardiac death in adolescents and young adults. We are presenting a case report, ten years boy came in emergency with sudden loss of consciousness (witness cardiac arrest). Child was revived after cardiopulmonary resuscitation and send to coronary care unit. Echocardiography findings were suggestive of HCM. There was history of sudden death of her mother and maternal uncle...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29626611/preliminary-observations-in-systemic-oxygen-consumption-during-targeted-temperature-management-after-cardiac-arrest
#8
Amy Uber, Anne V Grossestreuer, Catherine E Ross, Parth V Patel Rn, Ambica Trehan, Michael W Donnino, Katherine M Berg
AIM: Limited data suggests low oxygen consumption (VO2 ), driven by mitochondrial injury, is associated with mortality after cardiac arrest. Due to the challenges of measurement in the critically ill, post-arrest metabolism remains poorly characterized. We monitored VO2 , carbon dioxide production (VCO2 ) and the respiratory quotient (RQ) in post-arrest patients and explored associations with outcome. METHODS: Using a gas exchange monitor, we measured continuous VO2 and VCO2 in post- arrest patients treated with targeted temperature management...
April 4, 2018: Resuscitation
https://www.readbyqxmd.com/read/29618599/triglyceride-rich-lipoprotein-cholesterol-and-risk-of-cardiovascular-events-among-patients-receiving-statin-therapy-in-the-treating-to-new-targets-tnt-trial
#9
Antonio J Vallejo-Vaz, Rana Fayyad, S Matthijs Boekholdt, G Kees Hovingh, John J Kastelein, Shari Melamed, Philip Barter, David D Waters, Kausik K Ray
Background -Mendelian randomization data suggest genetic determinants of lifetime higher triglyceride-rich lipoprotein-cholesterol (TRL-C) are causally related to cardiovascular disease and therefore a potential therapeutic target. The relevance of TRL-C among patients receiving statins is unknown. We assessed the relationship between TRL-C and cardiovascular risk, and whether this risk was modifiable among patients receiving statins in the TNT trial. Methods -Patients with coronary heart disease [CHD] and LDL-C 130-250mg/dL entered an 8-week run-in phase with atorvastatin 10mg/day (ATV10)...
April 4, 2018: Circulation
https://www.readbyqxmd.com/read/29608502/xenon-an-emerging-neuroprotectant-with-potential-application-for-cardiac-arrest-care
#10
Mohammad Roostan, William H Frishman
Xenon is an inert, highly polarizable noble gas with demonstrated safety and application in general anesthesia for over fifty years. A potent inhibitor of the N-methyl-D-aspartate subtype of glutamate receptors, xenon has a well-documented ameliorating effect on excitotoxic neuronal injury in numerous cellular and animal models of hypoxic-ischemic brain injury. The most important determinant of overall survival and morbidity in out-of-hospital cardiac arrest is the severity of neurological injury. The only approved neuroprotective strategy in this setting is mild therapeutic hypothermia, which has demonstrated significant, albeit modest, improvements in mortality...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29601846/burden-of-caregiving-after-a-child-s-in-hospital-cardiac-arrest
#11
Kathleen Meert, Beth S Slomine, James R Christensen, Russell Telford, Richard Holubkov, J Michael Dean, Frank W Moler
OBJECTIVE: To describe caregiver burden among those whose children survive in-hospital cardiac arrest and have high risk of neurologic disability, and explore factors associated with burden during the first year post-arrest. METHODS: The study is a secondary analysis of the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial. 329 children who had an in-hospital cardiac arrest, chest compressions for >2 minutes, and mechanical ventilation after return of circulation were recruited to THAPCA-IH...
March 27, 2018: Resuscitation
https://www.readbyqxmd.com/read/29596291/interprofessional-simulations-promote-knowledge-retention-and-enhance-perceptions-of-teamwork-skills-in-a-surgical-trauma-burn-intensive-care-unit-setting
#12
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29593417/long-term-outcomes-and-predictors-of-survival-after-cardiopulmonary-resuscitation-for-in-hospital-cardiac-arrest-in-a-tertiary-care-hospital-in-thailand
#13
Panita Limpawattana, Wannaporn Aungsakul, Chomchanok Suraditnan, Anupol Panitchote, Boonsong Patjanasoontorn, Anakapong Phunmanee, Nittaya Pittayawattanachai
Background: There are limited data available regarding long-term survival and its predictors in cases of in-hospital cardiac arrest (IHCA) in which patients receive cardiopulmonary resuscitation. Purpose: The objectives of this study were to determine the 1-year survival rates and predictors of survival after IHCA. Patients and methods: Data were retrospectively collected on all adult patients who were administered cardiopulmonary resuscitation from January 1, 2013 to December 31, 2014 in Srinagarind Hospital (Thailand)...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29588978/topography-of-generalized-periodic-epileptiform-discharges-in-postanoxic-nonconvulsive-status-epilepticus
#14
Dimitris Fotis Sakellariou, George Kostantinos Kostopoulos, Mark Philip Richardson, Michalis Koutroumanidis
We studied slow (≤2.5 Hz) nonevolving generalized periodic epileptiform discharges (GPEDs) in the electroencephalogram (EEG) of comatose patients after cardiac arrest (CA) in search of evidence that could assist early diagnosis of possible hypoxic nonconvulsive status epilepticus (NCSE) and its differentiation from terminal brain anoxia (BA), which can present with a similar EEG pattern. We investigated the topography of the GPEDs in the first post-CA EEGs of 13 patients, using voltage-mapping, and compared findings between two patients with NCSE and GPEDs > 2...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#15
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29576362/the-impact-of-body-mass-index-on-post-resuscitation-survival-after-cardiac-arrest-a-meta-analysis
#16
Sotirios Kakavas, Georgios Georgiopoulos, Dimitrios Oikonomou, Dimitrios Karayiannis, Stefano Masi, Georgios Karlis, Theodoros Xanthos
BACKGROUND: Observational studies examining the association between body mass index (BMI) and the outcome of cardiac arrest (CA) shows controversial results. METHODS: We reviewed literature for studies assessing the impact of BMI on survival and neurological outcome following CA. Eligible studies were subsequently meta-analyzed and pooled odds ratios and their corresponding 95% confidence intervals for post CA survival and neurological status were derived. RESULTS: A total of 7 studies with 24,651 patients were evaluable for this meta-analysis...
April 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29572320/decreased-camp-level-and-decreased-downregulation-of-%C3%AE-1-adrenoceptor-expression-in-therapeutic-hypothermia-resuscitated-myocardium-are-associated-with-improved-post-resuscitation-myocardial-function
#17
Wei Wang, Tianfeng Hua, Hao Li, Xiaobo Wu, Jennifer Bradley, Mary Ann Peberdy, Joseph P Ornato, Wanchun Tang
BACKGROUND: Epinephrine administered during cardiopulmonary resuscitation (CPR) is associated with severe post-resuscitation myocardial dysfunction. We previously demonstrated that therapeutic hypothermia reduced the severity of post-resuscitation myocardial dysfunction caused by epinephrine; however, the relationship between myocardial adrenoceptor expression and myocardial protective effects by hypothermia remains unclear. METHODS AND RESULTS: Rats weighing between 450 and 550 g were randomized into 5 groups: (1) normothermic placebo, (2) normothermic epinephrine, (3) hypothermic placebo, (4) hypothermic epinephrine, and (5) sham (not subject to cardiac arrest and resuscitation)...
March 23, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29559755/high-frequency-percussive-ventilation-facilitates-weaning-from-extracorporeal-membrane-oxygenation-in-adults
#18
Iosif Gulkarov, James Schiffenhaus, Ivan Wong, Ashwad Afzal, Felix Khusid, Berhane Worku
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29558419/evaluation-of-two-models-of-non-penetrating-captive-bolt-devices-for-on-farm-euthanasia-of-turkeys
#19
Caitlin R Woolcott, Stephanie Torrey, Patricia V Turner, Lilia Serpa, Karen Schwean-Lardner, Tina M Widowski
On-farm euthanasia is a critical welfare issue in the poultry industry and can be particularly difficult to perform on mature turkeys due to their size. We evaluated the efficacy of two commercially available non-penetrating captive bolt devices, the Zephyr-EXL and the Turkey Euthanasia Device (TED), on 253 turkeys at three stages of production: 4-5, 10, and 15-20 weeks of age. Effectiveness of each device was measured using both ante- and post-mortem measures. Application of the Zephyr-EXL resulted in a greater success rate (immediate abolishment of brainstem reflexes) compared to the TED (97...
March 20, 2018: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/29555261/comparison-of-two-sedation-regimens-during-targeted-temperature-management-after-cardiac-arrest
#20
Marine Paul, Wulfran Bougouin, Florence Dumas, Guillaume Geri, Benoit Champigneulle, Lucie Guillemet, Omar Ben Hadj Salem, Stéphane Legriel, Jean-Daniel Chiche, Julien Charpentier, Jean-Paul Mira, Claudio Sandroni, Alain Cariou
PURPOSE: Although guidelines on post-resuscitation care recommend the use of short-acting agents for sedation during targeted temperature management (TTM) after cardiac arrest (CA), the potential advantages of this strategy have not been clinically demonstrated. METHODS: We compared two sedation regimens (propofol-remifentanil, period P2, vs midazolam-fentanyl, period P1) among comatose TTM-treated CA survivors. Management protocol, apart from sedation and neuromuscular blockers use, did not change between the two periods...
March 16, 2018: Resuscitation
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