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https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#1
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28669033/monitoring-the-brain-after-cardiac-arrest-a-new-era
#2
REVIEW
Niraj Sinha, Sam Parnia
PURPOSE OF REVIEW: Of the approximately 350,000 out-of-hospital, and 750,000 after in-hospital cardiac arrest (CA) events in the US annually approximately 5-9% and 20% respectively may achieve return of spontaneous circulation (ROSC) after attempted cardiopulmonary resuscitation (CPR). Up to 2/3 of these initial survivors may go on die in the subsequent 24-72 hours after ROSC due to a combination of (1) on-going cerebral injury, (2) myocardial dysfunction and (3) massive systemic inflammatory response...
August 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28648673/clinical-evaluation-of-active-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-in-patients-with-cardiac-arrest
#3
Min Li, Wei Song, Yan-Hong Ouyang, Duo-Hu Wu, Jun Zhang, Li-Xiang Wang, Jing Li
BACKGROUND: Chest compression is a standard recommendation during cardiopulmonary resuscitation (CPR). However, chest compression cannot be effectively applied under certain situations, such as chest wall deformity, rib fracture, or hemopneumothorax. An alternative method, abdominal compression, was reported to achieve better resuscitation outcomes in these patients. MATERIALS AND METHODS: A prospective study was performed in adult patients with cardiac arrest and anticipated ineffective chest compression (thoracic trauma, chest deformity, rib fracture, and hemopneumothorax)...
June 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28438718/the-effect-of-50-compared-to-100-inspired-oxygen-fraction-on-brain-oxygenation-and-post-cardiac-arrest-mitochondrial-function-in-experimental-cardiac-arrest
#4
Annika Nelskylä, Jouni Nurmi, Milla Jousi, Alexey Schramko, Eero Mervaala, Giuseppe Ristagno, Markus B Skrifvars
BACKGROUND AND AIM: We hypothesised that the use of 50% compared to 100% oxygen maintains cerebral oxygenation and ameliorates the disturbance of cardiac mitochondrial respiration during cardiopulmonary resuscitation (CPR). METHODS: Ventricular fibrillation (VF) was induced electrically in anaesthetised healthy adult pigs and left untreated for seven minutes followed by randomisation to manual ventilation with 50% or 100% oxygen and mechanical chest compressions (LUCAS(®))...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/27865776/post-cardiac-arrest-shock-treated-with-veno-arterial-extracorporeal-membrane-oxygenation-an-observational-study-and-propensity-score-analysis
#5
Wulfran Bougouin, Nadia Aissaoui, Alain Combes, Nicolas Deye, Lionel Lamhaut, Daniel Jost, Carole Maupain, Frankie Beganton, Adrien Bouglé, Nicole Karam, Florence Dumas, Eloi Marijon, Xavier Jouven, Alain Cariou
PURPOSE: Cardiogenic shock due to post-resuscitation myocardial dysfunction is a major cause of mortality among patients hospitalized after cardiac arrest (CA). Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been proposed in the most severe cases but the level of evidence is very low. We assessed characteristics, outcome and prognostic factors of patients treated with VA-ECMO for post-CA shock. METHODS: Using a large regional registry, we focused on all CA admitted in ICU...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/26913719/survival-after-cardiac-arrest-ecmo-rescue-therapy-after-amlodipine-and-metoprolol-overdose
#6
Kevin F Maskell, Nikki Miller Ferguson, Jesse Bain, Brandon K Wills
Extracorporeal membrane oxygenation (ECMO) use in poisoned patients is increasing, but is rare post cardiac arrest. We report a case of ECMO use with complete recovery in a patient who arrested twice after a cardiotoxicant overdose. A 17-year-old male presented after an unknown overdose. He rapidly became hypotensive and bradycardic and received aggressive supportive care without improvement. He was transferred to our institution and suffered a cardiac arrest shortly after arrival. Six minutes of advanced cardiac life support resulted in return of spontaneous circulation...
February 25, 2016: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/26784134/mif-reflects-tissue-damage-rather-than-inflammation-in-post-cardiac-arrest-syndrome-in-a-real-life-cohort
#7
Julia Pohl, Christos Rammos, Matthias Totzeck, Pia Stock, Malte Kelm, Tienush Rassaf, Peter Luedike
INTRODUCTION: Following successful resuscitation from cardiac arrest (CA), neurological impairment and other types of organ dysfunction cause significant morbidity and mortality-a condition termed post-cardiac arrest syndrome. Whole-body ischemia/reperfusion with oxygen debt activates immunologic and coagulation pathways increasing the risk of multiple organ failure and infection. We here examined the role of the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF) in post-cardiac arrest syndrome...
March 2016: Resuscitation
https://www.readbyqxmd.com/read/26758060/association-between-hemoglobin-levels-and-clinical-outcomes-in-adult-patients-after-in-hospital-cardiac-arrest-a-retrospective-cohort-study
#8
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, An-Yi Wang, Nai-Chuan Chen, Wen-Jone Chen
In addition to cardiac output, oxygen delivery is determined by the amount of oxygen carried by hemoglobin, which is estimated by the product of hemoglobin level and peripheral hemoglobin oxygen saturation (SpO2). Optimal hemoglobin concentration for post-cardiac arrest syndrome (PCAS) has not yet been investigated thoroughly. We conducted a retrospective observational study in a single medical center. We included adult patients between 2006 and 2012 who experienced in-hospital cardiac arrest, and achieved sustained return of spontaneous circulation (ROSC)...
August 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26412107/regional-cerebral-oximetry-during-cardiopulmonary-resuscitation-useful-or-useless
#9
REVIEW
Cornelia Genbrugge, Jo Dens, Ingrid Meex, Willem Boer, Ward Eertmans, Marc Sabbe, Frank Jans, Cathy De Deyne
BACKGROUND: Approximately 375,000 people annually experience sudden cardiac arrest (CA) in Europe. Most patients who survive the initial hours and days after CA die of postanoxic brain damage. Current monitors, such as electrocardiography and end-tidal capnography, provide only indirect information about the condition of the brain during cardiopulmonary resuscitation (CPR). In contrast, cerebral near-infrared spectroscopy provides continuous, noninvasive, real-time information about brain oxygenation without the need for a pulsatile blood flow...
January 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26410571/changes-in-treatments-and-outcomes-among-elderly-patients-with-out-of-hospital-cardiac-arrest-between-2002-and-2012-a-post-hoc-analysis-of-the-sos-kanto-2002-and-2012
#10
COMPARATIVE STUDY
(no author information available yet)
BACKGROUND: Little is known about recent changes in pre- and in-hospital treatments and outcomes for elderly patients with out-of-hospital cardiac arrest (OHCA). METHODS: We compared data collected for the SOS-KANTO study in 2002 and 2012. We included patients aged ≥65 years who experienced OHCA of cardiac aetiology. The primary endpoint was favourable neurological outcomes 1 month after cardiac arrest. RESULTS: A total of 8,964 (2002 vs...
December 2015: Resuscitation
https://www.readbyqxmd.com/read/26307569/cerebral-oximetry-as-a-real-time-monitoring-tool-to-assess-quality-of-in-hospital-cardiopulmonary-resuscitation-and-post-cardiac-arrest-care
#11
COMPARATIVE STUDY
Akram W Ibrahim, Antoine R Trammell, Harland Austin, Kenya Barbour, Emeka Onuorah, Dorothy House, Heather L Miller, Chandila Tutt, Deborah Combs, Roger Phillips, Neal W Dickert, A Maziar Zafari
BACKGROUND: Regional cerebral oxygen saturation (rSO2) as assessed by near infrared frontal cerebral spectroscopy decreases in circulatory arrest and increases with high-quality cardiopulmonary resuscitation. We hypothesized that higher rSO2 during cardiopulmonary resuscitation and after return of spontaneous circulation (ROSC) would predict survival to discharge and neurological recovery. METHODS AND RESULTS: This prospective case series included patients experiencing in-hospital cardiac arrest...
August 2015: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26291387/regional-cerebral-oxygen-saturation-monitoring-for-predicting-interventional-outcomes-in-patients-following-out-of-hospital-cardiac-arrest-of-presumed-cardiac-cause-a-prospective-observational-multicentre-study
#12
MULTICENTER STUDY
Kei Nishiyama, Noritoshi Ito, Tomohiko Orita, Kei Hayashida, Hideki Arimoto, Satoru Beppu, Mitsuru Abe, Takashi Unoki, Tomoyuki Endo, Akira Murai, Takeshi Hatada, Noriaki Yamada, Masahiro Mizobuchi, Hideo Himeno, Kazuo Okuchi, Hideto Yasuda, Toshiaki Mochizuki, Kazuhiro Shiga, Migaku Kikuchi, Yuka Tsujimura, Tetsuo Hatanaka, Ken Nagao
AIM: This study investigated the value of regional cerebral oxygen saturation (rSO2) monitoring upon arrival at the hospital for predicting post-cardiac arrest intervention outcomes. METHODS: We enrolled 1195 patients with out-of-hospital cardiac arrest of presumed cardiac cause from the Japan-Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry. The primary endpoint was a good neurologic outcome (cerebral performance categories 1 or 2 [CPC1/2]) 90 days post-event...
November 2015: Resuscitation
https://www.readbyqxmd.com/read/26215479/characteristics-of-regional-cerebral-oxygen-saturation-levels-in-patients-with-out-of-hospital-cardiac-arrest-with-or-without-return-of-spontaneous-circulation-a-prospective-observational-multicentre-study
#13
MULTICENTER STUDY
Kei Nishiyama, Noritoshi Ito, Tomohiko Orita, Kei Hayashida, Hideki Arimoto, Mitsuru Abe, Takashi Unoki, Tomoyuki Endo, Akira Murai, Ken Ishikura, Noriaki Yamada, Masahiro Mizobuchi, Hideaki Anan, Tomorou Watanabe, Hideto Yasuda, Yosuke Homma, Kazuhiro Shiga, Michiaki Tokura, Yuka Tsujimura, Tetsuo Hatanaka, Ken Nagao
AIM: Our study aimed at filling the fundamental knowledge gap on the characteristics of regional brain oxygen saturation (rSO2) levels in out-of-hospital cardiac arrest (OHCA) patients with or without return of spontaneous circulation (ROSC) upon arrival at the hospital for estimating the quality of cardiopulmonary resuscitation and neurological prognostication in these patients. METHODS: We enrolled 1921 OHCA patients from the Japan - Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry and measured their rSO2 immediately upon arrival at the hospital by near-infrared spectroscopy using two independent forehead probes (right and left)...
November 2015: Resuscitation
https://www.readbyqxmd.com/read/25887300/haemodynamic-and-ventilator-management-in-patients-following-cardiac-arrest
#14
REVIEW
Alexis A Topjian, Robert A Berg, Fabio Silvio Taccone
PURPOSE OF REVIEW: The purpose of this study is to review the recent literature describing how to assess and treat postcardiac arrest syndrome associated haemodynamics and manage oxygenation and ventilation derangements. RECENT FINDINGS: Postcardiac arrest syndrome is a well described entity that includes systemic ischemia-reperfusion response, myocardial dysfunction and neurologic dysfunction. Continued resuscitation in the hours to days following return of spontaneous circulation (ROSC) is important to increase the likelihood of long-term survival and neurological recovery...
June 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/25757968/-effects-of-shenfu-injection-on-the-expression-of-transcription-factors-t-bet-gata-3-in-pigs-with-post-resuscitation-myocardial-dysfunction
#15
Wei Gu, Chunsheng Li, Wenpeng Yin, Xiaomin Hou
OBJECTIVE: To examine whether Shenfu injection (SFI) reduces post-resuscitation myocardial dysfunction in a pig model by modulating expression imbalance of transcription factors of regulatory T cell, namely GATA-3 and T-bet. METHODS: Thirty pigs were randomly divided into sham group (n = 6) and cardiopulmonary resuscitation (CPR) group (n = 24) according to the random number table method, and the pigs in the CPR group were randomly subdivided into normal saline (NS) group, epinephrine (EP) group, and SFI group (n = 8 per group)...
March 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/25417033/post-cardiac-arrest-syndrome-in-children
#16
Dominique Biarent, Christine Fonteyne, Ariane Willems, Audrey Dupont
Although sustained return of spontaneous circulation (ROSC) can be initially established after resuscitation in children, many of the children do not survive to discharge because they developped a post cardiac arrest syndrome. The post-cardiac arrest syndrome includes systemic ischaemia/reperfusion response, post-cardiac arrest brain injury, postcardiac arrest myocardial dysfunction, and persistent precipitating pathology. The main cause of death after ROSC in children is brain injury. Physiopathology and management are reviewed in regards of pediatric specificities...
2013: Current Pediatric Reviews
https://www.readbyqxmd.com/read/25168063/estimated-cerebral-oxyhemoglobin-as-a-useful-indicator-of-neuroprotection-in-patients-with-post-cardiac-arrest-syndrome-a-prospective-multicenter-observational-study
#17
MULTICENTER STUDY
Kei Hayashida, Kei Nishiyama, Masaru Suzuki, Takayuki Abe, Tomohiko Orita, Noritoshi Ito, Shingo Hori
INTRODUCTION: Little is known about oxyhemoglobin (oxy-Hb) levels in the cerebral tissue during the development of anoxic and ischemic brain injury. We hypothesized that the estimated cerebral oxy-Hb level, a product of Hb and regional cerebral oxygen saturation (rSO2), determined at hospital arrival may reflect the level of neuroprotection in patients with post-cardiac arrest syndrome (PCAS). METHODS: The Japan Prediction of neurological Outcomes in patients with Post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after out-of-hospital cardiac arrest (OHCA)...
August 29, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/24892265/the-effect-of-hyperoxia-on-survival-following-adult-cardiac-arrest-a-systematic-review-and-meta-analysis-of-observational-studies
#18
REVIEW
Chih-Hung Wang, Wei-Tien Chang, Chien-Hua Huang, Min-Shan Tsai, Ping-Hsun Yu, An-Yi Wang, Nai-Chuan Chen, Wen-Jone Chen
OBJECTIVE: Studies have shown the detrimental effect of hyperoxia in animals with return of spontaneous circulation (ROSC) after cardiac arrest. To maximize the value of existing clinical studies, we performed the systemic review and meta-analysis of human observational studies to examine the effect of hyperoxia on outcomes of post-ROSC patients. METHODS: We searched PubMed and Embase from the inception to October 2013. We selected adult observational studies that compared different levels of partial pressure of arterial oxygen (PaO2) in post-ROSC patients with mortality or neurological status at hospital discharge as outcome...
September 2014: Resuscitation
https://www.readbyqxmd.com/read/24367539/combination-of-epinephrine-with-esmolol-attenuates-post-resuscitation-myocardial-dysfunction-in-a-porcine-model-of-cardiac-arrest
#19
Qian Zhang, Chunsheng Li
BACKGROUND: Recent experimental and clinical studies have indicated that the β-adrenergic effect of epinephrine significantly increases the severity of post resuscitation myocardial dysfunction. The aim of the study was to investigate whether the short-acting β₁-selective adrenergic blocking agent, esmolol, would attenuate post resuscitation myocardial dysfunction in a porcine model of cardiac arrest. METHODS AND RESULTS: After 8 min of untreated ventricular fibrillation and 2 min of basic life support, 24 pigs were randomized to three groups (n = 8 per group), which received central venous injection of either epinephrine combined with esmolol (EE group), epinephrine (EP group), or saline (SA group)...
2013: PloS One
https://www.readbyqxmd.com/read/24361675/a-feasibility-study-of-cerebral-oximetry-monitoring-during-the-post-resuscitation-period-in-comatose-patients-following-cardiac-arrest
#20
Anna Ahn, Jie Yang, Loren Inigo-Santiago, Sam Parnia
BACKGROUND: One of the major causes of death and neurological injury after cardiac arrest is delayed ischemia combined with oxygen free radical mediated reperfusion injury. Consequently determining the optimal balance between oxygen delivery and uptake in the brain using a reliable non-invasive monitoring system during the post-resuscitation period is of importance. In this observational study, we evaluated the feasibility of using cerebral oximetry during the post-resuscitation period in order to identify changes in regional cerebral oxygen saturation (rSO2) and its association with survival to discharge...
April 2014: Resuscitation
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