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Hypothermia after cardiac arrest

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https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#1
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29769006/role-of-cardiac-catheterization-lab-post-resuscitation-in-patients-with-st-elevation-myocardial-infarction
#2
Sridhar Reddy, Kwan S Lee, Karl Kern, Kapildeo Lotun
BACKGROUND: Cardiac arrest remains a common and lethal condition associated with high morbidity and mortality. Even with improving survival rates, the successfully resuscitated post cardiac arrest patient is also at risk for poor neurological outcomes, functional status and long- term survival if not managed appropriately. Given that acute coronary occlusion has been found to be the leading cause of cardiac arrest, long-term prognosis is good in selected patients after successful out-of-hospital resuscitation and ST elevation myocardial infarction who are taken for immediate coronary angiography, treated with primary percutaneous coronary intervention and hypothermia when indicated...
May 16, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29763714/optic-nerve-sheath-diameter-measured-using-early-unenhanced-brain-computed-tomography-shows-no-correlation-with-neurological-outcomes-in-patients-undergoing-targeted-temperature-management-after-cardiac-arrest
#3
Dong Hoon Lee, Sun Hwa Lee, Je Hyeok Oh, In Soo Cho, Young Hwan Lee, Chul Han, Wook Jin Choi, You Dong Sohn
AIM: Previous studies indicated that the optic nerve sheath diameter (ONSD) measured using brain computed tomography (CT) is a prognostic factor for poor neurological outcome after cardiac arrest. However, these studies were retrospective or included a small sample size. We performed a prospective multi-centre observational study to investigate the correlation between the ONSD on early brain CT and neurological outcomes in patients undergoing targeted temperature management (TTM). METHODS: This study used data from the Korean Hypothermia Network prospective registry between November 2015 and October 2016...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29756194/efficacy-and-safety-of-prolonged-mild-therapeutic-hypothermia-treatment-in-patients-after-out-of-hospital-cardiac-arrest-preliminary-data
#4
Robert Kowalik, Ewa Szczerba, Katarzyna Żukowska, Katarzyna Szepietowska, Łukasz Kołtowski, Michał Peller, Anna Fojt, Grzegorz Opolski
No abstract text is available yet for this article.
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29739265/therapeutic-hypothermia-promotes-cerebral-blood-flow-recovery-and-brain-homeostasis-after-resuscitation-from-cardiac-arrest-in-a-rat-model
#5
Qihong Wang, Peng Miao, Hiren R Modi, Sahithi Garikapati, Raymond C Koehler, Nitish V Thakor
Laboratory and clinical studies have demonstrated that therapeutic hypothermia (TH), when applied as soon as possible after resuscitation from cardiac arrest (CA), results in better neurological outcome. This study tested the hypothesis that TH would promote cerebral blood flow (CBF) restoration and its maintenance after return of spontaneous circulation (ROSC) from CA. Twelve Wistar rats resuscitated from 7-min asphyxial CA were randomized into two groups: hypothermia group (7 H, n = 6), treated with mild TH (33-34℃) immediately after ROSC and normothermia group (7 N, n = 6,37...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29723608/osborn-waves-following-out-of-hospital-cardiac-arrest-effect-of-level-of-temperature-management-and-risk-of-arrhythmia-and-death
#6
Edina Hadziselimovic, Jakob Hartvig Thomsen, Jesper Kjaergaard, Lars Køber, Claus Graff, Steen Pehrson, Niklas Nielsen, David Erlinge, Martin Frydland, Sebastian Wiberg, Christian Hassager
BACKGROUND: The Osborn or J-wave, an upright deflection of the J-point on the electrocardiogram (ECG), is often observed during severe hypothermia. A possible relation between Osborn waves (OW) and increased risk of ventricular arrhythmia has been reported. We sought to determine whether the level of targeted temperature management (TTM) following out-of-hospital cardiac arrest (OHCA) affects the prevalence of OW and to assess the associations between OW and risk of ventricular arrhythmia and death...
April 30, 2018: Resuscitation
https://www.readbyqxmd.com/read/29723201/performance-on-the-apache-ii-saps-ii-sofa-and-the-ohca-score-of-post-cardiac-arrest-patients-treated-with-therapeutic-hypothermia
#7
Jea Yeon Choi, Jae Ho Jang, Yong Su Lim, Jee Yong Jang, Gun Lee, Hyuk Jun Yang, Jin Seong Cho, Sung Youl Hyun
OBJECTIVE: This study assessed the ability of the Acute Physiologic and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA) score, and out-of-hospital cardiac arrest (OHCA) score to predict the outcome of OHCA patients who underwent therapeutic hypothermia (TH). METHODS: This study included OHCA patients treated with TH between January 2010 and December 2013. The APACHE II score, SAPS II, and SOFA score were calculated at the time of admission and 24 h and 48 h after intensive care unit admission...
2018: PloS One
https://www.readbyqxmd.com/read/29713000/effects-of-inhaled-nitric-oxide-on-outcome-after-prolonged-cardiac-arrest-in-mild-therapeutic-hypothermia-treated-rats
#8
Anne Brücken, Christian Bleilevens, Philipp Berger, Kay Nolte, Nadine T Gaisa, Rolf Rossaint, Gernot Marx, Matthias Derwall, Michael Fries
Guidelines endorse targeted temperature management to reduce neurological sequelae and mortality after cardiac arrest (CA). Additional therapeutic approaches are lacking. Inhaled nitric oxide (iNO) given post systemic ischemia/reperfusion injury improves outcomes. Attenuated inflammation by iNO might be crucial in brain protection. iNO augmented mild therapeutic hypothermia (MTH) may improve outcome after CA exceeding the effect of MTH alone. Following ten minutes of CA and three minutes of cardiopulmonary resuscitation, 20 male Sprague-Dawley rats were randomized to receive MTH at 33 °C for 6hrs or MTH + 20ppm iNO for 5hrs; one group served as normothermic control...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29687446/cost-utility-of-extracorporeal-membrane-oxygenation-rewarming-in-accidentally-hypothermic-patients-a-single-centre-retrospective-study
#9
S Kosiński, T Darocha, A Czerw, P Paal, M Pasquier, P Krawczyk, R Drwiła, R Gałązkowski
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has become the treatment of choice for severely hypothermic patients in cardiac arrest or acute cardiac failure. Highly specialized ECMO centres have been established, however, no centre has ever reported the costs of extracorporeal rewarming. The aim of this study was to assess the costs of the treatment of patients in Swiss Stage III and IV rewarmed with veno-arterial ECMO. METHODS: A retrospective exploratory cohort study analysed twenty-nine consecutive patients treated for hypothermia in the Severe Accidental Hypothermia Centre in Cracow, Poland...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#10
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29657946/too-cold-to-clot-does-intraoperative-hypothermia-contribute-to-bleeding-after-aortic-surgery
#11
Louis H Stein, Gregory Rubinfeld, Leora B Balsam, Patricia Ursomanno, Abe DeAnda
Background: We determined the impact of intraoperative hypothermia on postoperative bleeding after thoracic aortic surgery. Methods: We retrospectively analyzed 98 consecutive patients who underwent aortic surgery with deep hypothermic circulatory arrest between 2010 and 2014. We evaluated lowest temperature, absolute decrease in temperature, and rewarming rate. Univariate and multivariate regression were used to determine relationships between temperature, clinical characteristics, and measures of postoperative bleeding...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29623156/prognostic-value-of-the-neurological-examination-in-cardiac-arrest-patients-after-therapeutic-hypothermia
#12
Elizabeth A Matthews, Jessica Magid-Bernstein, Evie Sobczak, Angela Velazquez, Cristina Maria Falo, Soojin Park, Jan Claassen, Sachin Agarwal
Objectives: Current prognostication guidelines for cardiac arrest (CA) survivors predate the use of therapeutic hypothermia (TH). The prognostic value and ideal timing of the neurological examination remain unknown in the setting of TH. Design: Patients (N = 291) admitted between 2007 and 2015 to Columbia University intensive care units for TH following CA had neurological examinations performed on days 1, 3, 5, and 7 postarrest. Absent pupillary light response (PLR), absent corneal reflexes (CRs), and Glasgow coma scores motor (GCS-M) no better than extension were considered poor examinations...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29604136/discontinued-stimulation-of-cardiomyocytes-provides-protection-against-hypothermia-rewarming-induced-disruption-of-excitation-contraction-coupling
#13
Young Soo Han, Niccole Schaible, Torkjel Tveita, Gary Sieck
After exposing spontaneously beating hearts as well as electrically stimulated isolated cardiomyocytes to hypothermia/rewarming (H/R), cardiac dysfunction or alterations in excitation-contraction coupling, respectively, is a consequence. In contrast, hypothermic cardiac arrest as routinely applied during cardiac surgery, will not impose any hazard to cardiac function after rewarming. We hypothesize that by maintaining asystole during H/R, cardiomyocytes will avoid Ca2+ overload due to the transient stimulation-evoked elevation of [Ca2+ ]cyto and thus, H/R-induced elevation of p-cTnI, and reduced Ca2+ sensitivity after rewarming...
March 31, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29601846/burden-of-caregiving-after-a-child-s-in-hospital-cardiac-arrest
#14
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/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/29573754/beyond-the-limits-ecpr-in-putative-fatal-circumstances
#17
Ingo Graeff, Sylvia Schacher, Stefan Lenkeit, Catherine N Widmann, Jens-Christian Schewe
The eligibility criteria for applying extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest are currently unclear. For those patients with hypothermic cardiac arrest, the European Resuscitation Council (ERC) Guidelines recommend considering ECPR only for patients with potassium <8 mmol/L and a body temperature below 32°C, whereas the American Heart Association Guidelines (AHA) do not express this in a specific manner. We report the case of an urban unwitnessed out-of-hospital cardiac arrest patient found with her head immersed in water at a temperature of 23°C...
March 25, 2018: CJEM
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
#18
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/29570428/intravascular-cooling-catheter-related-venous-thromboembolism-after-hypothermia-a-case-report-and-review-of-the-literature
#19
Xuan Wang, Brian T Moy, Brett J Hiendlmayr, Felix Krainski, W Lane Duvall, Antonio B Fernandez
Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase...
March 23, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29544369/comparison-of-three-haemodynamic-monitoring-methods-in-comatose-post-cardiac-arrest-patients
#20
Henrik Staer-Jensen, Kjetil Sunde, Espen Rostrup Nakstad, Jan Eritsland, Geir Øystein Andersen
OBJECTIVES: Haemodynamic monitoring during post arrest care is important to optimise treatment. We compared stroke volume measured by minimally-invasive monitoring devices with or without thermodilution calibration, and transthoracic echocardiography (TTE), and hypothesised that thermodilution calibration would give stroke volume index (SVI) more in agreement with TTE during targeted temperature management (TTM). DESIGN: Comatose out-of-hospital cardiac arrest survivors receiving TTM (33 °C for 24 hrs) underwent haemodynamic monitoring with arterial pulse contour analyses with (PiCCO2®) and without (FloTrac® /Vigileo® monitor® ) transpulmonary thermodilution calibration...
June 2018: Scandinavian Cardiovascular Journal: SCJ
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