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Hypothermia after cardiac arrest

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https://www.readbyqxmd.com/read/27913267/a-comparison-between-intravascular-and-traditional-cooling-for-inducing-and-maintaining-temperature-control-in-patients-following-cardiac-arrest-traditional-or-modern-therapeutic-hypothermia-after-cardiac-arrest
#1
Jeremy Rosman, Maxime Hentzien, Moustapha Dramé, Vincent Roussel, Bernard Just, Damien Jolly, Philippe Mateu
: Therapeutic temperature control has been widely used during the last decade to improve clinical outcomes. We conducted this retrospective observational study to compare traditional cooling with endovascular cooling in post-cardiac arrest comatose survivors and to compare results with current guidelines. PATIENTS AND METHODS: All patients admitted to our ICU for cardiac arrest and for whom temperature control was performed were included. Traditional cooling included cold infusions, ice packs and cooling blankets...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#2
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27907969/neuroprotection-in-critical-care-neurology
#3
Menno R Germans, Hieronymus D Boogaarts, R Loch Macdonald
Ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury-all have in common early brain injury due to brain tissue destruction, reduced cerebral blood flow and oxygen delivery, and overall substantial morbidity and mortality. The pathophysiology of brain tissue damage likely includes common cellular mechanisms. Neuroprotection has seldom, if ever, been shown to reduce early brain injury. Secondary brain injury develops after these conditions due to macroscopic events such as increased intracranial pressure and reduced cerebral blood flow, as well as cellular processes including vascular damage, inflammation, and apoptotic/necrotic cell death...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#4
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27903207/direct-cerebral-perfusion-and-cooling-in-experimental-cardiac-arrest
#5
Rinaldo Bellomo, Bruno Marino, Peter Angelopoulos, Scott Carson, Glenn Eastwood, Junko Kosaka, Naoya Iguchi, Andrew Hilton, Clive May
BACKGROUND: Cerebral protection is a key priority during cardiac arrest (CA). However, current approaches are suboptimal. OBJECTIVE: To test whether direct perfusion and cooling of the anterior cerebral circulation by means of cerebral vessel cannulation and extracorporeal membrane oxygenation (ECMO) increases cerebral oxygenation and induces cerebral hypothermia during CA. METHODS: We performed proof-of-concept animal experiments in sheep...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27887653/intravascular-versus-surface-cooling-for-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-an-analysis-of-the-ttm-trial-data
#6
Guy W Glover, Richard M Thomas, George Vamvakas, Nawaf Al-Subaie, Jules Cranshaw, Andrew Walden, Matthew P Wise, Marlies Ostermann, Emma Thomas-Jones, Tobias Cronberg, David Erlinge, Yvan Gasche, Christian Hassager, Janneke Horn, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Michael Wanscher, Jørn Wetterslev, Hans Friberg, Niklas Nielsen
BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices...
November 26, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27871588/novel-resuscitation-devices-facilitate-complete-neurologic-recovery-after-prolonged-cardiac-arrest-in-postanesthesia-care-unit
#7
Elif C Cingi, Luke A McMahon, Richard C Prielipp
Cardiac arrest in the perioperative period is associated with significant morbidity and mortality. Novel resuscitation devices may afford patients improved survival and limit neurologic injury. We report a case of cardiac arrest in the postanesthesia care unit that required an extensive period of cardiopulmonary resuscitation assisted by the ResQPOD impedance threshold device to optimize coronary perfusion and a LUCAS chest compression system to maintain optimal cardiopulmonary resuscitation while transporting the patient to the cardiac catheterization laboratory...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27865744/outcomes-of-sudden-cardiac-arrest-in-a-state-wide-integrated-resuscitation-program-results-from-the-minnesota-resuscitation-consortium
#8
Selcuk Adabag, Lucinda Hodgson, Santiago Garcia, Vidhu Anand, Ralph Frascone, Marc Conterato, Charles Lick, Keith Wesley, Brian Mahoney, Demetris Yannopoulos
BACKGROUND: Despite many advances in resuscitation science the outcomes of sudden cardiac arrest (SCA) remain poor. The Minnesota Resuscitation Consortium (MRC) is a statewide integrated resuscitation program, established in 2011, to provide standardized, evidence-based resuscitation and post-resuscitation care. The objective of this study is to assess the outcomes of a state-wide integrated resuscitation program. METHODS: We examined the trends in resuscitation metrics and outcomes in Minnesota since 2011 and compared these to the results from the national Cardiac Arrest Registry to Enhance Survival (CARES) program...
November 16, 2016: Resuscitation
https://www.readbyqxmd.com/read/27860555/time-to-awakening-is-often-delayed-in-patients-who-receive-targeted-temperature-management-after-cardiac-arrest
#9
Katie Zanyk-McLean, Kelly N Sawyer, Ryan Paternoster, Rebekah Shievitz, William Devlin, Robert Swor
Post cardiac arrest, neuroprognostication remains a complex and clinically challenging issue for critical care providers. For this reason, our primary objective in this study was to determine the frequency of survival and favorable neurological outcomes in post-cardiac arrest patients with delayed time to awakening. To assess whether early withdrawal of care may adversely impact survival, we also sought to describe the time to withdrawal of care of non-surviving patients. We performed a retrospective study of patients resuscitated after cardiac arrest in two large academic community hospitals...
November 18, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#10
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27849689/9-therapeutic-hypothermia-after-pediatric-cardiac-arrest-in-hospital-trial
#11
Frank Moler, J Michael Dean
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847808/the-role-of-targeted-temperature-management-in-adult-patients-resuscitated-from-nonshockable-cardiac-arrests-an-updated-systematic-review-and-meta-analysis
#12
REVIEW
Lijuan Song, Liang Wei, Lei Zhang, Yubao Lu, Kaifa Wang, Yongqin Li
Routine targeted temperature management is recommended for comatose adult patients with return of spontaneous circulation after cardiac arrest. However, the role of targeted temperature management in patients resuscitated from nonshockable cardiac arrests remains uncertain. We conducted an updated systematic review and meta-analysis to evaluate the effects of targeted temperature management in this population. Medline, EMBASE, and Cochrane databases were systematically reviewed for studies published between January 2005 and March 2016, in which targeted temperature management was compared with standard care or normothermia for adult patients resuscitated from nonshockable cardiac arrests...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27834742/results-of-the-ictus-2-trial-intravascular-cooling-in-the-treatment-of-stroke-2
#13
Patrick Lyden, Thomas Hemmen, James Grotta, Karen Rapp, Karin Ernstrom, Teresa Rzesiewicz, Stephanie Parker, Mauricio Concha, Syed Hussain, Sachin Agarwal, Brett Meyer, Julie Jurf, Irfan Altafullah, Rema Raman
BACKGROUND AND PURPOSE: Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients. METHODS: Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol...
November 10, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27832332/a-successfully-treated-case-of-cardiac-arrest-after-caesarean-section-complicated-by-pheochromocytoma-crisis-and-amniotic-fluid-embolism
#14
Kenichiro Mita, Kayo Tsugita, Yoshikazu Yasuda, Yasunari Matsuki, Yurie Obata, Yuka Matsuki, Seiichi Kamisawa, Kenji Shigemi
Both pheochromocytoma and amniotic fluid embolism (AFE) are important causes of maternal mortality. We present a case of a 29-year-old woman who developed cardiac arrest after Caesarean section, complicated by both pheochromocytoma crisis and AFE. After resuscitation, the patient developed multiple organ dysfunction, rhabdomyolysis and disseminated intravascular coagulation (DIC). After institution of multidisciplinary interventions (including the use of an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous hemodiafiltration, and neuroprotective therapeutic hypothermia) the patient made a full recovery without any apparent neurological deficit...
November 10, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27807612/-early-onset-pneumonia-after-successful-resuscitation-incidence-after-mild-invasive-hypothermia-therapy
#15
J W Erath, J Hodrius, P Bushoven, S Fichtlscherer, A M Zeiher, F H Seeger, J Honold
BACKGROUND: Targeted temperature management (TTM) represents an effective therapy to improve neurologic outcome in patients who survive an out-of-hospital cardiac arrest (OHCA). First publications about this therapy reported a higher incidence of infections in patients who underwent TTM induced by external cooling devices. Whether intravascular cooling devices are also associated with an increased infection rate has not been investigated so far. METHODS: In a single center retrospective study, the incidence of early onset pneumonia (EOP) in OHCA patients with or without intravascular TTM at 33 °C target temperature for 24 h who survived at least 24 h after admission was analyzed...
November 2, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27782794/clinical-effect-of-rebound-hyperthermia-after-cooling-postcardiac-arrest-a-retrospective-cohort-study
#16
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27743918/influence-of-body-mass-index-on-the-prognosis-of-patients-successfully-resuscitated-from-out-of-hospital-cardiac-arrest-treated-by-therapeutic-hypothermia
#17
Guillaume Geri, Guillaume Savary, Stéphane Legriel, Florence Dumas, Sybille Merceron, Olivier Varenne, Bernard Livarek, Olivier Richard, Jean-Paul Mira, Jean-Pierre Bedos, Jean-Philippe Empana, Alain Cariou, David Grimaldi
BACKGROUND: Obesity prevalence has dramatically increased over recent years and is associated with cardiovascular diseases, but data are lacking on its prognostic impact in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Data of all consecutive OHCA patients admitted in two cardiac arrest centers from Paris and suburbs between 2005 and 2012 were prospectively collected. Patients treated by therapeutic hypothermia (TH) were included in the analysis. Logistic and Cox regression analyses were used to quantify the association between body mass index (BMI) at hospital admission and day-30 and 1-year mortality respectively...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27737774/exploring-the-safety-and-efficacy-of-targeted-temperature-management-amongst-infants-with-out-of-hospital-cardiac-arrest-due-to-apparent-life-threatening-events
#18
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To explore the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to an apparent life threatening event (ALTE) recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest Out-of-Hospital trial. METHODS: Fifty-four infants (48h to <1year of age) with ALTE who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation were included...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27701659/association-between-therapeutic-hypothermia-and-survival-after-in-hospital-cardiac-arrest
#19
Paul S Chan, Robert A Berg, Yuanyuan Tang, Lesley H Curtis, John A Spertus
Importance: Therapeutic hypothermia is used for patients following both out-of-hospital and in-hospital cardiac arrest. However, randomized trials on its efficacy for the in-hospital setting do not exist, and comparative effectiveness data are limited. Objective: To evaluate the association between therapeutic hypothermia and survival after in-hospital cardiac arrest. Design, Setting, and Patients: In this cohort study, within the national Get With the Guidelines-Resuscitation registry, 26 183 patients successfully resuscitated from an in-hospital cardiac arrest between March 1, 2002, and December 31, 2014, and either treated or not treated with hypothermia at 355 US hospitals were identified...
October 4, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27695505/history-and-current-use-of-mild-therapeutic-hypothermia-after-cardiac-arrest
#20
Jiří Bonaventura, David Alan, Jiri Vejvoda, Jakub Honek, Josef Veselka
In spite of many years of development and implementation of pre-hospital advanced life support programmes, the survival rate of out-of-hospital cardiac arrest (OHCA) used to be very poor. Neurologic injury from cerebral hypoxia is the most common cause of death in patients with OHCA. In the past two decades, post-resuscitation care has developed many new concepts aimed at improving the neurological outcome and survival rate of patients after cardiac arrest. Systematic post-cardiac arrest care after the return of spontaneous circulation, including induced mild therapeutic hypothermia (TH) in selected patients, is aimed at significantly improving rates of long-term neurologically intact survival...
October 1, 2016: Archives of Medical Science: AMS
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