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Hypothermia after cardiac arrest

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https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#1
Salvatore Brugaletta, Giancarla Scalone, Ana Paula Dantas, Luis Ortega-Paz, Manel Garabito, Mercè Roqué, Victoria Martin, Monica Masotti, Xavier Freixa, Manel Sabaté
BACKGROUND: Therapeutic hypothermia (HT) in out-of-hospital cardiac arrest STEMI patients aims to improve their neurological prognosis, but it has been associated with slow coronary flow and cardiac thrombotic events. We sought to serially assess endothelial function during the first 48h after admission in out-of-hospital cardiac arrest STEMI patients, under therapeutic hypothermia (HT). METHODS: From January 2015 to August 2015, eighteen consecutive out-of-hospital cardiac arrest STEMI patients eligible for primary PCI received HT at admission and were included in the study (HT group)...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#2
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28053858/a-major-miss-in-prognostication-after-cardiac-arrest-burst-suppression-and-brain-healing
#3
Danielle A Becker, Nicholas D Schiff, Lance B Becker, Manisha G Holmes, Joseph J Fins, James M Horowitz, Orrin Devinsky
We report a case with therapeutic hypothermia after cardiac arrest where meaningful recovery far exceeded anticipated negative endpoints following cardiac arrest with loss of brainstem reflexes and subsequent status epilepticus. This man survived and recovered after an out-of-hospital cardiac arrest followed by a 6-week coma with absent motor responses and 5 weeks of burst suppression. Standard criteria suggested no chance of recovery. His recovery may relate to the effect of burst-suppression on EEG to rescue neurons near neuronal cell death...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28024551/end-of-life-issues-in-cardiac-critical-care-the-option-of-organ-donation
#4
REVIEW
Karim Serri, Pierre Marsolais
Despite important advances in the care of postcardiac arrest patients, severe brain injury remains one of the major causes of death in the cardiac intensive care unit. Neurological prognostication after cardiac arrest has evolved significantly since the introduction of therapeutic hypothermia. It now relies on a multimodal approach and a minimal observation period of 72 hours is usually advocated. However, when brain injury is severe and the prognosis considered dismal, patients become eligible for organ donation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#5
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28011292/utilization-of-palliative-care-services-for-cardiac-arrest-patients-undergoing-therapeutic-hypothermia-a-retrospective-analysis
#6
Emily K Zern, Michael N Young, Taylor Triana, Meng Xu, Benjamin Holmes, Nyal Borges, John A McPherson, Mohana B Karlekar
BACKGROUND: Palliative care (PC) services are integral to the care of patients with advanced medical illnesses. Given the significant morbidity and mortality associated with cardiac arrest, we sought to measure the use and impact of PC in the care of patients treated with therapeutic hypothermia (TH). METHODS: We conducted a retrospective study of 317 consecutive patients undergoing TH after cardiac arrest. We compared intensive care unit (ICU) characteristics and clinical outcomes of subjects who received PC consultation (n=125) to those who did not (n=192)...
December 21, 2016: Resuscitation
https://www.readbyqxmd.com/read/28004333/the-relationship-between-the-decreased-rate-of-initial-blood-glucose-and-neurologic-outcomes-in-survivors-of-out-of-hospital-cardiac-arrest-receiving-therapeutic-hypothermia
#7
Jae-Hyug Woo, Yong Su Lim, Hyuk Jun Yang, Sung Youl Hyun, Jin Seong Cho, Jin Joo Kim, Gun Lee
BACKGROUND: Hyperglycemia in out-of-hospital cardiac arrest (OHCA) survivors is associated with poor outcomes. However, in the control of initial hyperglycemia, an adequate strategy to improve patients' neurologic outcomes remains undetermined. Prior to the establishment of such strategy, we need to determine whether a decreased rate of initial blood glucose (BG) affects patient outcomes. METHODS: One hundred and forty-five adult non-traumatic OHCA survivors treated with therapeutic hypothermia between April 2007 and December 2011 were enrolled in this single-center retrospective cohort study...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27998282/does-therapeutic-hypothermia-during-extracorporeal-cardiopulmonary-resuscitation-preserve-cardiac-function
#8
Harald A Bergan, Per S Halvorsen, Helge Skulstad, Erik Fosse, Jan F Bugge
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (E-CPR) is increasingly used as a rescue method in the management of cardiac arrest and provides the opportunity to rapidly induce therapeutic hypothermia. The survival after a cardiac arrest is related to post-arrest cardiac function, and the application of therapeutic hypothermia post-arrest is hypothesized to improve cardiac outcome. The present animal study compares normothermic and hypothermic E-CPR considering resuscitation success, post-arrest left ventricular function and magnitude of myocardial injury...
December 20, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27989737/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#9
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
October 27, 2016: Resuscitation
https://www.readbyqxmd.com/read/27988254/targeted-temperature-management-after-cardiac-arrest-with-anaphylaxis
#10
Woon Jeong Lee, Dae Hee Kim, Seon Hee Woo, Seung Hwan Seol, Seung Pill Choi
Fatal anaphylaxis is uncommon but not rare. Extrapolated mortality rates are 0.52% of total anaphylaxis patients Bock et al. (Jan. 2001) [1]. Nevertheless, compared with the incidence of the other cardiac arrest events, the incidence of cardiac arrest due to anaphylaxis is relatively small. As a result, the effect using targeted temperature management after anaphylaxis is not clearly understood. We report the case of a 63-year-old man who developed cardiac arrest after ingestion of two pieces of peach. He was resuscitated and his circulation returned spontaneously after approximately 11min of cardiopulmonary resuscitation, but he was unresponsive and had fixed dilated pupils...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27984152/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#11
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27982758/burst-suppression-in-hypothermia-after-cardiac-arrest-because-of-drowning-treated-with-targeted-temperature-management-a-case-report
#12
Tomoya Okazaki, Toru Hifumi, Satoshi Egawa, Hideyuki Hamaya, Natsuyo Shinohara, Shohei Kawamoto, Takuma Iwaki, Kohei Tsukahara, Kenya Kawakita, Takashi Kusaka, Yasuhiro Kuroda
Outcomes of cardiac arrest (CA) because of drowning in children are generally poor, but some reports show that cases with post-CA hypothermia because of drowning exhibit good recovery when treated with targeted temperature management (TTM). However, because electroencephalogram (EEG) findings are not reported in those cases, a complete examination of brain damage has not been performed during TTM. Here we report a case of a 15-month-old boy with post-CA hypothermia recovery after treating with TTM, along with EEG findings...
December 16, 2016: Therapeutic Hypothermia and Temperature Management
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
#13
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
#14
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
#15
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
#16
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
#17
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...
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
#18
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
#19
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
#20
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...
January 2017: Resuscitation
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