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Cardiac Arrest Prediction

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https://www.readbyqxmd.com/read/28931652/responsive-monitoring-of-mitochondrial-redox-states-in-heart-muscle-predicts-impending-cardiac-arrest
#1
Dorothy A Perry, Joshua W Salvin, Padraic Romfh, Peili Chen, Kalyani Krishnamurthy, Lindsay M Thomson, Brian D Polizzotti, Francis X McGowan, Daryoosh Vakhshoori, John N Kheir
Assessing the adequacy of oxygen delivery to tissues is vital, particularly in the fields of intensive care medicine and surgery. As oxygen delivery to a cell becomes deficient, changes in mitochondrial redox state precede changes in cellular function. We describe a technique for the continuous monitoring of the mitochondrial redox state on the epicardial surface using resonance Raman spectroscopy. We quantify the reduced fraction of specific electron transport chain cytochromes, a metric we name the resonance Raman reduced mitochondrial ratio (3RMR)...
September 20, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28915913/neurological-outcomes-and-duration-from-cardiac-arrest-to-the-initiation-of-extracorporeal-membrane-oxygenation-in-patients-with-out-of-hospital-cardiac-arrest-a-retrospective-study
#2
Takahiro Yukawa, Masahiro Kashiura, Kazuhiro Sugiyama, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: We investigated the relationship between neurological outcomes and duration from cardiac arrest (CA) to the initiation of extracorporeal membrane oxygenation (ECMO) (CA-to-ECMO) in patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) and determined the ideal time at which ECPR should be performed. METHODS: During the time period in which this study was conducted, 3451 patients experienced OHCA...
September 16, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28910207/challenges-of-using-probabilistic-linkage-methodology-to-characterize-post-cardiac-arrest-care-in-michigan
#3
Robert Swor, Lihua Qu, Kevin Putman, Kelly N Sawyer, Robert Domeier, Jennifer Fowler, William Fales
BACKGROUND: To improve survival of patients resuscitated from out of hospital cardiac arrest (OCHA), data is needed to assess and improve inpatient post-resuscitation care. Our objective was to apply probabilistic linkage methodology to link EMS and inpatient databases and evaluate whether it may be used to describe post-arrest care in Michigan. METHODS: We performed a retrospective study to describe post-cardiac arrest care in adult OHCA patients who were transported to Michigan hospitals from July 1, 2010, to June 30, 2013...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28899911/correlation-of-end-tidal-carbon-dioxide-amplitude-spectrum-area-and-coronary-perfusion-pressure-in-a-porcine-model-of-cardiac-arrest
#4
Nicolas Segal, Anja K Metzger, Johanna C Moore, Laura India, Michael C Lick, Paul S Berger, Wanchun Tang, David G Benditt, Keith G Lurie
Amplitude Spectrum Area (AMSA) values during ventricular fibrillation (VF) correlate with myocardial energy stores and predict defibrillation success. By contrast, end tidal CO2 (ETCO2) values provide a noninvasive assessment of coronary perfusion pressure and myocardial perfusion during cardiopulmonary resuscitation (CPR). Given the importance of the timing of defibrillation shock delivery on clinical outcome, we tested the hypothesis that AMSA and ETCO2 correlate with each other and can be used interchangably to correlate with myocardial perfusion in an animal laboratory preclinical, randomized, prospective investigation...
September 2017: Physiological Reports
https://www.readbyqxmd.com/read/28891056/performance-of-the-minto-model-for-the-target-controlled-infusion-of-remifentanil-during-cardiopulmonary-bypass
#5
Y J Cho, W Y Jo, H Oh, C-H Koo, J Oh, J-Y Cho, K-S Yu, Y Jeon, T K Kim
We studied the predictive performance of the Minto pharmacokinetic model during cardiopulmonary bypass in patients undergoing cardiac surgery. Patients received remifentanil target-controlled infusion using the Minto model during total intravenous anaesthesia with propofol. From 56 patients, 275 arterial blood samples were drawn before, during and after bypass to determine the plasma concentration of remifentanil, and the predicted concentrations were recorded at each time. For pooled data, the median prediction error and median absolute prediction error were 21...
October 2017: Anaesthesia
https://www.readbyqxmd.com/read/28887695/a-nirs-death-experience-a-reduction-in-cortical-oxygenation-by-time-resolved-near-infrared-spectroscopy-preceding-cardiac-arrest
#6
C Lanks, C B Kim, H B Rossiter
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS...
September 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28874934/emergency-physician-performed-transesophageal-echocardiography-in-simulated-cardiac-arrest
#7
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28863949/impact-of-rapid-response-car-system-on-extracorporeal-life-support-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#8
Ryota Sato, Akira Kuriyama, Michitaka Nasu, Shinnji Gima, Wataru Iwanaga, Tadaaki Takada, Yusuke Kitahara, Hideto Fukui, Terutake Yonemori, Masaharu Yagi
INTRODUCTION: Extracorporeal life support (ECLS) has been reported to be more effective than conventional cardiopulmonary resuscitation (CPR). In ECLS, a shorter time from arrival to implantation of extracorporeal membrane oxygenation (ECMO; door-to-ECMO) time was predicted to be associated with better survival rates. This study aimed to examine the impact of the physician-based emergency medical services (P-EMS) using a rapid response car (RRC) on door-to-ECMO time in patients with out-of-hospital cardiac arrest (OHCA)...
August 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28862044/acute-lamotrigine-overdose-a-systematic-review-of-published-adult-and-pediatric-cases
#9
Bader Alyahya, Marjorie Friesen, Bénédicte Nauche, Martin Laliberté
CONTEXT: Lamotrigine is a broad-spectrum anticonvulsant commonly used to treat seizure and bipolar mood disorders. Evidence from case series and retrospective studies indicate that lamotrigine overdose is usually benign. However, there are reported cases of cardiac arrest and mortality following lamotrigine overdose. We undertook a systematic review of the literature on lamotrigine overdoses to better understand the clinical severity, the relevance of serum concentrations, and therapeutic interventions for overdose...
September 1, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#10
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28856660/prognostic-indicators-of-survival-and-survival-prediction-model-following-extracorporeal-cardiopulmonary-resuscitation-in-patients-with-sudden-refractory-cardiac-arrest
#11
Sung Woo Lee, Kap Su Han, Jong Su Park, Ji Sung Lee, Su Jin Kim
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) has been considered in selected candidates with potentially reversible causes during a limited period. Candidate selection and the identification of predictable conditions are important factors in determining outcomes during CPR in the emergency department (ED). The objective of this study was to determine the key indicators and develop a prediction model for survival to hospital discharge in patients with sudden cardiac arrest who received ECPR...
August 30, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28855776/the-value-of-arterial-blood-gas-parameters-for-prediction-of-mortality-in-survivors-of-out-of-hospital-cardiac-arrest
#12
Katharina Isabel von Auenmueller, Martin Christ, Benjamin Michel Sasko, Hans-Joachim Trappe
CONTEXT: Sudden cardiac death is one of the leading causes of death in Europe, and early prognostication remains challenging. There is a lack of valid parameters for the prediction of survival after cardiac arrest. AIMS: This study aims to investigate if arterial blood gas parameters correlate with mortality of patients after out-of-hospital cardiac arrest. MATERIALS AND METHODS: All patients who were admitted to our hospital after resuscitation following out-of-hospital cardiac arrest between January 1, 2008, and December 31, 2013, were included in this retrospective study...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28844935/predictive-value-of-amplitude-spectrum-area-of-ventricular-fibrillation-waveform-in-patients-with-acute-or-previous-myocardial-infarction-in-out-of-hospital-cardiac-arrest
#13
Michiel Hulleman, David D Salcido, James J Menegazzi, Patrick C Souverein, Hanno L Tan, Marieke T Blom, Rudolph W Koster
BACKGROUND: Amplitude spectrum area (AMSA) of ventricular fibrillation (VF) has been associated with survival from out-of-hospital cardiac arrest (OHCA). Ischemic heart disease has been shown to change AMSA. We studied whether the association between AMSA and survival changes with acute ST-elevation myocardial infarction (STEMI) as cause of the OHCA and/or previous MI. METHODS: Multivariate logistic regression with log-transformed AMSA of first artifact-free VF segment was used to assess the association between AMSA and survival, according to presence of STEMI or previous MI, adjusting for resuscitation characteristics, medication use and comorbidities...
August 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28843461/a-new-rule-for-terminating-resuscitation-of-out-of-hospital-cardiac-arrest-patients-in-japan-a-prospective-study
#14
(no author information available yet)
BACKGROUND: The American Heart Association and European Resuscitation Council guidelines for cardiopulmonary resuscitation present rules for termination of resuscitation (TOR) in cases of out-of-hospital cardiac arrest (OHCA). In Japan, only doctors are legally allowed TOR in OHCA cases. OBJECTIVE: This study aimed to develop a new TOR rule that suits the actual situations of the Japanese emergency medical services system. METHODS: Five different combinations of the TOR rule criteria were compared regarding specificity and positive predictive value (PPV) for 1-month survival with unfavorable neurologic outcomes...
August 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28841080/gains-of-continuing-resuscitation-in-refractory-out-of-hospital-cardiac-arrest-a-model-based-analysis-to-identify-deaths-due-to-intra-arrest-prognostication
#15
Brian Grunau, Joseph Puyat, Hubert Wong, Frank X Scheuermeyer, Joshua C Reynolds, Takahisa Kawano, Joel Singer, William Dick, James Christenson
OBJECTIVE: Prognostication bias, in which a clinician predicts a negative outcome and terminates resuscitation (TR) thereby ensuring a poor outcome, is a rarely identified limitation of out-of-hospital cardiac arrest (OHCA) research. We sought to estimate the number of deaths due to intra-arrest prognostication in a cohort of OHCA's, and use this data to estimate the incremental benefit of continuing resuscitation. METHODS: This study examined a cohort of consecutive non-traumatic EMS-treated OHCAs from a provincial ambulance service, between 2007 and 2011 inclusive...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28837291/-prehospital-misconceptions
#16
Eduardo Alcouce, Vincent Darioli, Pierre-Nicolas Carron, Mathieu Pasquier
We confronted some of the most prevalent prehospital misconceptions with the available literature. We found that: the diminution of a retrosternal pain following nitrate administration is not predictive of a cardiac origin of the pain ; survival of traumatic cardiac arrest may not be as bad as usually believed ; peripheral venous administration of vasopressors through proximal catheters during short times may be considered as a safe temporary alternative to central venous access ; using the pulse palpation usually lead to an under-estimation of the systolic blood pressure ; applying a pelvic belt at the level of the iliac crests doesn't aggravate an open-book fracture; there is no 90 mmHg threshold values below which mortality increases in traumatic brain injuries...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28830480/recorded-time-periods-of-bispectral-index-values-equal-to-zero-predict-neurological-outcome-after-out-of-hospital-cardiac-arrest
#17
Ward Eertmans, Cornelia Genbrugge, Gilles Haesevoets, Jo Dens, Willem Boer, Frank Jans, Cathy De Deyne
BACKGROUND: Prognostication in out-of-hospital cardiac arrest (OHCA) survivors is often difficult. Recent studies have shown the predictive ability of bispectral index (BIS) monitoring to assist with early neuroprognostication. The aim of this study was to investigate whether characteristics of BIS values equal to zero (BIS 0) (i.e. duration and/or uni- versus bilateral presence) instead of simply their occurrence are better indicators for poor neurological outcome after OHCA by aiming at a specificity of 100%...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28822108/semi-quantitative-metabolic-values-on-fdg-pet-ct-including-extracardiac-sites-of-disease-as-a-predictor-of-treatment-course-in-patients-with-cardiac-sarcoidosis
#18
Mitsutomi Ishiyama, Laurie A Soine, Hubert J Vesselle
BACKGROUND: Cardiac sarcoidosis is associated with major adverse cardiac events including cardiac arrest, for which anti-inflammatory treatment is indicated. Oral corticosteroid is the mainstay among treatment options; however, adverse effects are a major concern with long-term use. It would be beneficial for providers to predict treatment response and prognosis for proper management strategy of sarcoidosis, though it remains challenging. Fluorine (F)-18 fluorodeoxyglucose (FDG)-positron emission tomography(PET)/computed tomography(CT) has an advantage over anatomical imaging in providing semi-quantitative functional parameters such as standard uptake value (SUV), metabolic volume, and total lesion glycolysis (TLG), which are well-established biomarkers in oncology...
August 18, 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28819446/incremental-value-of-circulating-mir-122-5p-to-predict-outcome-after-out-of-hospital-cardiac-arrest
#19
Yvan Devaux, Antonio Salgado-Somoza, Josef Dankiewicz, Adeline Boileau, Pascal Stammet, Anna Schritz, Lu Zhang, Mélanie Vausort, Patrik Gilje, David Erlinge, Christian Hassager, Matthew P Wise, Michael Kuiper, Hans Friberg, Niklas Nielsen
Rationale. The value of microRNAs (miRNAs) as biomarkers has been addressed in various clinical contexts. Initial studies suggested that miRNAs, such as the brain-enriched miR-124-3p, might improve outcome prediction after out-of-hospital cardiac arrest. The aim of this study is to determine the prognostic value of miR-122-5p in a large cohort of comatose survivors of out-of-hospital cardiac arrest. Methods. We analyzed 590 patients from the Targeted Temperature Management trial (TTM-trial). Circulating levels of miR-122-5p were measured in serum samples obtained 48 hours after return of spontaneous circulation...
2017: Theranostics
https://www.readbyqxmd.com/read/28812241/plasma-glycoproteomic-study-of-therapeutic-hypothermia-reveals-novel-markers-predicting-neurologic-outcome-post-cardiac-arrest
#20
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
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