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Cardiac Arrest Prediction

Brin Freund, James J Gugger, Alexandra Reynolds, William O Tatum, Jan Claassen, Peter W Kaplan
PURPOSE: Periodic discharges (PDs) are EEG patterns denoting brain dysfunction and ictal tendency. Their exact meaning regarding etiology and outcomes is not well known. In particular, bilateral independent PDs (BIPDs) are poorly described. METHODS: We performed a retrospective, multicenter study evaluating neuroimaging, epileptic, clinical, and EEG correlates of BIPDs. RESULTS: Twenty-five patients studied with a mean Glasgow Coma Scale 6...
March 15, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
F Javaudin, B Leclere, J Segard, Q Le Bastard, P Pes, Y Penverne, P Le Conte, J Jenvrin, H Hubert, J Escutnaire, E Batard, E Montassier, A C Gr-Ré
INTRODUCTION: Loss of pupillary light reactivity (PLR) three days after a cardiorespiratory arrest is a prognostic factor. Its predictive value upon hospital admission remains unclear. Our objective was to determine the prognostic value of the absence of PLR upon hospital admission in patients with out-of-hospital cardiac arrest. METHODS: We prospectively included all out-of-hospital cardiac arrests occurring between July 2011 and July 2017 treated by a mobile medical team (MMT) based on data from a French cardiac arrest registry database...
March 12, 2018: Resuscitation
Yong Soo Cho, Byung Kook Lee, Dong Hun Lee, Yong Hun Jung, Sung Min Lee, Jung Soo Park, Kyung Woon Jeung
PURPOSE: The optimal timing for measurement of neutrophil gelatinase-associated lipocalin (NGAL) level to predict acute kidney injury (AKI) and prognosis in cardiac arrest (CA) survivors has not been elucidated. We aimed to compare the diagnostic and prognostic performance of NGAL levels after return of spontaneous circulation (ROSC) and at 48 h after CA. METHODS: We included 231 adult cardiac arrest survivors who underwent targeted temperature management between May 2013 and December 2016...
March 13, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Isabelle Beuchat, Daria Solari, Jan Novy, Mauro Oddo, Andrea O Rossetti
INTRODUCTION: Standardized EEG patterns according to the American Clinical Neurophysiology Society (ACNS) ("highly malignant", "malignant" and "benign") demonstrated good correlation with outcome after cardiac arrest (CA). However, this approach relates to EEGs after target temperature management (TTM), and correlation to other recognized outcome predictors remains unknown. OBJECTIVES: To investigate the relationship between categorized EEG and other outcome predictors, during and after TTM, at different temperatures...
March 9, 2018: Resuscitation
Wolfgang Muhlhofer, Jerzy P Szaflarski
PURPOSE OF REVIEW: This paper aims to review and summarize the key contributions of EEG to prognostication after cardiac arrest (CA). RECENT FINDINGS: While there are more EEG patterns predicting poor than good outcome, even EEG patterns previously considered to be "very malignant" may result in survival with a meaningful neurological outcome depending on their underlying etiology as well as the continuity and reactivity of the EEG background. Regardless of the potentially confounding factors, EEG patterns are highly specific with a relatively low false-positive rate...
March 10, 2018: Current Neurology and Neuroscience Reports
Rong Liu, Xiaoxing Liao, Xin Li, Hongyan Wei, Qing Liang, Zuopeng Zhang, Meixian Yin, Xiaoyun Zeng, Zijing Liang, Chunlin Hu
To investigate long noncoding (lnc)-RNA and mRNA expression profiles in post‑cardiac arrest (CA) brains, an external transthoracic electrical current was applied for 8 min to induce CA (the CA group). A total of 4 rats received sham-operations and served as the blank control (BC) group. Upon return of spontaneous circulation (ROSC), lncRNA and mRNA expression in the rat cerebral cortex was assayed with high‑throughput Agilent lncRNA and mRNA microarrays. In total, 37 lncRNAs were upregulated and 21 lncRNAs were downregulated in the CA group, and 258 mRNA transcripts were differentially expressed with 177 mRNAs upregulated and 81 mRNAs downregulated in the CA group...
March 7, 2018: Molecular Medicine Reports
Virendra R Desai, Alejandro L Rosas, Gavin W Britz
Cerebral aneurysms have a high mortality rate when ruptured. Endovascular techniques have improved substantially in treating this pathology. However, surgical clip ligation remains the preferred option for some aneurysms. Various techniques are used intraoperatively to assist the surgeon in dissecting the aneurysmal dome free of surrounding tissue and placing a clip around the neck safely and effectively so that no nearby perforating vessels are affected and no residual remains. These techniques include temporary clip ligation, endovascular balloon occlusion and cardiac standstill...
December 2017: Stroke and Vascular Neurology
Arjun Agrawal, Rachael Snow, Erik Lehman, Faisal Aziz
OBJECTIVE: Despite advances in surgical techniques, ruptured abdominal aortic aneurysm (rAAA) remains associated with extremely high mortality. Several preoperative risk factors have been shown to predict poor prognosis after rAAA repair. Notably, a preoperative dependent functional status has previously been shown to be associated with poor outcomes after several vascular surgery procedures. The purpose of this study was to examine the effect of preoperative functional status on postoperative outcomes for patients undergoing repair of rAAA...
March 1, 2018: Journal of Vascular Surgery
Muthiah Vaduganathan, Brian L Claggett, Neal A Chatterjee, Inder S Anand, Nancy K Sweitzer, James C Fang, Eileen O'Meara, Sanjiv J Shah, Sheila M Hegde, Akshay S Desai, Eldrin F Lewis, Jean Rouleau, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
BACKGROUND: Sudden death (SD) may be an important mode of death in heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: To investigate rates and predictors of SD or aborted cardiac arrest (ACA) in HFpEF. METHODS: We studied 1,767 patients with HFpEF (EF≥45%) enrolled in the Americas region of the TOPCAT trial. We identified independent predictors of composite SD/ACA with step-wise backward selection using competing risks regression analysis accounting for non-sudden causes of death...
March 4, 2018: JACC. Heart Failure
Ward Eertmans, Cornelia Genbrugge, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans, Cathy De Deyne
BACKGROUND: We investigated the ability of bispectral index (BIS) monitoring to predict poor neurological outcome in out-of-hospital cardiac arrest (OHCA) patients fully treated according to guidelines. RESULTS: In this prospective, observational study, 77 successfully resuscitated OHCA patients were enrolled in whom BIS, suppression ratio (SR) and electromyographic (EMG) values were continuously monitored during the first 36 h after the initiation of targeted temperature management at 33 °C...
March 2, 2018: Annals of Intensive Care
Lionel Velly, Vincent Perlbarg, Thomas Boulier, Nicolas Adam, Sebastien Delphine, Charles-Edouard Luyt, Valentine Battisti, Gregory Torkomian, Charlotte Arbelot, Russell Chabanne, Betty Jean, Carol Di Perri, Steven Laureys, Giuseppe Citerio, Alessia Vargiolu, Benjamin Rohaut, Nicolas Bruder, Nadine Girard, Stein Silva, Vincent Cottenceau, Thomas Tourdias, Olivier Coulon, Bruno Riou, Lionel Naccache, Rajiv Gupta, Habib Benali, Damien Galanaud, Louis Puybasset
BACKGROUND: Prediction of neurological outcome after cardiac arrest is a major challenge. The aim of this study was to assess whether quantitative whole-brain white matter fractional anisotropy (WWM-FA) measured by diffusion tensor imaging between day 7 and day 28 after cardiac arrest can predict long-term neurological outcome. METHODS: This prospective, observational, cohort study (part of the MRI-COMA study) was done in 14 centres in France, Italy, and Belgium...
February 27, 2018: Lancet Neurology
Paolo Biban
No abstract text is available yet for this article.
March 2018: Pediatric Critical Care Medicine
Sung Wook Kim, Joo Suk Oh, Jungtaek Park, Hyun Ho Jeong, Ji Hoon Kim, Jung Hee Wee, Sang Hoon Oh, Seung Pill Choi, Kyu Nam Park
OBJECTIVES: The absence of N20 somatosensory evoked potential after cardiac arrest is related to poor outcome. However, discrimination between the low-amplitude and the absence of N20 is challenging. P25 and P30 are short-latency positive peaks with latencies between 25 and 30 ms following N20 (P25/30). P25/30 is evident even with an ambiguous N20 in patients with good outcome. Therefore, we evaluated the predictive value of P25/30 after cardiac arrest. DESIGN: A retrospective observational study...
March 1, 2018: Critical Care Medicine
Mathieu Pasquier, Olivier Hugli, Peter Paal, Tomasz Darocha, Marc Blancher, Paul Husby, Tom Silfvast, Pierre-Nicolas Carron, Valentin Rousson
AIMS: Currently, the decision to initiate extracorporeal life support for patients who suffer cardiac arrest due to accidental hypothermia is essentially based on serum potassium level. Our goal was to build a prediction score in order to determine the probability of survival following rewarming of hypothermic arrested patients based on several covariates available at admission. METHODS: We included consecutive hypothermic arrested patients who underwent rewarming with extracorporeal life support...
February 23, 2018: Resuscitation
Shadnaz Asgari, Hana Moshirvaziri, Fabien Scalzo, Nima Ramezan-Arab
Cardiac arrest (CA) is the leading cause of death and disability in the United States. Early and accurate prediction of CA outcome can help clinicians and families to make a better-informed decision for the patient's healthcare. Studies have shown that electroencephalography (EEG) may assist in early prognosis of CA outcome. However, visual EEG interpretation is subjective, labor-intensive, and requires interpretation by a medical expert, i.e., neurophysiologists. These limiting factors may hinder the applicability of such testing as the prognostic method in clinical settings...
February 26, 2018: Journal of Clinical Monitoring and Computing
Hyung Ki Moon, Jinhee Jang, Kyu Nam Park, Soo Hyun Kim, Byung Kook Lee, Sang Hoon Oh, Kyung Woon Jeung, Seung Pill Choi, In Soo Cho, Chun Song Youn
INTRODUCTION: Predicting neurologic outcomes after cardiac arrest (CA) is challenging. This study tested the hypothesis that a quantitative analysis of diffusion weighted imaging (DWI) using the FMRIB Software Library (FSL) can predict neurologic outcomes after CA and can clarify the optimal apparent diffusion coefficient (ADC) thresholds for predicting poor neurologic outcomes. METHODS: Out-of-hospital CA patients treated with targeted temperature management (TTM) who underwent DWI were included in this study...
February 21, 2018: Resuscitation
Tuba Sarıaydın, Şeref Kerem Çorbacıoğlu, Yunsur Çevik, Emine Emektar
Purpose: This study evaluated whether serum lactate levels (SLL) at admission in patients with cardiac arrest (CA) can predict successful return of spontaneous circulation (ROSC) or short-term survival, especially within the first 24 h. Materials and methods: This prospective, observational study was conducted in the emergency department (ED) of a training and research hospital from April 2015 through February 2016. It included all patients older than 18 years who presented to the ED during the study period with non-traumatic out-of-hospital cardiac arrest (OHCA)...
December 2017: Turkish Journal of Emergency Medicine
James Xu, Leia Hee, Andrew Hopkins, Craig P Juergens, Sidney Lo, John K French, Christian J Mussap
BACKGROUND: Immediate cardiac catheterisation (CC) is recommended in ST-elevation myocardial infarction (STEMI) following sudden cardiac arrest (SCA). Guidelines advise urgent CC for SCA patients without-STEMI, at clinician discretion. We examined the clinical and angiographic factors predicting mortality in SCA patients having CC. METHODS: Consecutive SCA patients having CC at Liverpool Hospital, Sydney (January 2011-September 2015) were retrospectively analysed...
February 8, 2018: Heart, Lung & Circulation
Chia-Lung Kao, I-Lin Hsu
PURPOSE: Suicide becomes a serious problem in today's society and hanging is a common method of suicide. We want to find the factors which can predict the final functional outcomes of these cases. METHODS: All patients who presented to Accident and Emergency Department (ED) of the National Cheng Kung University Hospital from 1st January 2005 to 31th December 2013 with a hanging injury were included in this study. All cases were divided into good outcome group and bad outcome group according to Glasgow Outcome Scale (GOS)...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Christophe Henri Valdemar Duez, Mads Qvist Ebbesen, Krisztina Benedek, Martin Fabricius, Mary Doreen Atkins, Sandor Beniczky, Troels W Kjaer, Hans Kirkegaard, Birger Johnsen
OBJECTIVE: To assess inter-rater agreement on EEG-reactivity (EEG-R) in comatose patients and compare it with a quantitative method (QEEG-R). METHODS: Six 30-s stimulation epochs (noxious, visual and auditory) were performed during EEG on 19 neurosurgical and 11 cardiac arrest patients. Six experts analysed EEGs for reactivity using their habitual methods. QEEG-R was defined as present if ≥2/6 epochs were reactive (stimulation/rest power ratio exceeding noise level)...
February 2, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
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