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Oxygen post ROSC

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
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
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
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
(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
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
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
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
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
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
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
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)...
2014: Critical Care: the Official Journal of the Critical Care Forum
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
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
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
Asger Granfeldt, Weiwei Shi, Susan L Schmarkey, Rong Jiang, C Collin Bone, J Mark Cline, Lise Wogensen, Geoffrey P Dobson, Else Tønnesen, Jakob Vinten-Johansen
AIM: Return of spontaneous circulation (ROSC) elicits ischaemia/reperfusion injury and myocardial dysfunction. The combination of adenosine and lidocaine (AL, adenocaine) has been shown to (1) inhibit neutrophil inflammatory activation and (2) improve left ventricular function after ischaemia. We hypothesized that resuscitation with adenocaine during early moments of cardiopulmonary resuscitation (CPR) attenuates leucocyte oxidant generation and myocardial dysfunction. METHODS: Pigs were randomized to: (1) sham (n=7), (2) cardiac arrest (CA; n=16), or 3) cardiac arrest+adenocaine (CA+AL; n=12)...
November 2013: Resuscitation
Pierre Bouzat, Tamarah Suys, Nathalie Sala, Mauro Oddo
AIM: Improving cerebral perfusion is an essential component of post-resuscitation care after cardiac arrest (CA), however precise recommendations in this setting are limited. We aimed to examine the effect of moderate hyperventilation (HV) and induced hypertension (IH) on non-invasive cerebral tissue oxygenation (SctO2) in patients with coma after CA monitored with near-infrared spectroscopy (NIRS) during therapeutic hypothermia (TH). METHODS: Prospective pilot study including comatose patients successfully resuscitated from out-of-hospital CA treated with TH, monitored with NIRS...
November 2013: Resuscitation
Dong Zhang, Nan Li, Ying Chen, Yu-shan Wang
OBJECTIVE: To evaluate the reproduction of a model of post resuscitation multiple organ dysfunction syndrome (PR-MODS) after cardiac arrest (CA) in rabbit, in order to provide new methods for post-CA treatment. METHODS: Thirty-five rabbits were randomly divided into three groups, the sham group (n=5), the 7-minute asphyxia group (n=15), and the 8-minute asphyxia group (n=15). The asphyxia CA model was reproduced with tracheal occlusion. After cardiopulmonary resuscitation (CPR), the ratio of recovery of spontaneous circulation (ROSC), the mortality at different time points and the incidence of systemic inflammatory response syndrome (SIRS) were observed in two asphyxia groups...
February 2013: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Dion Stub, Melissa Byrne, Vincent Pellegrino, David M Kaye
BACKGROUND: Survival after out-of-hospital cardiac arrest remains limited. It is therefore imperative to develop new resuscitation techniques. We aimed to determine the potential role of extracorporeal membrane oxygenation assisted CPR (ECPR) in an animal model of refractory ischaemic cardiac arrest. METHODS: Twelve sheep were assigned to either ECPR (n=6) or 'conventional' (n=6) resuscitation. All sheep had coronary occlusion, followed by induction of ventricular fibrillation (VF)...
June 2013: Heart, Lung & Circulation
Betsy B Dokken, Charles V Piermarini, Mary K Teachey, Michael T Gura, Christian J Dameff, Brian D Heller, Jonida Krate, Aeen M Ashgar, Lauren Querin, Jennifer L Mitchell, Ronald W Hilwig, Karl B Kern
Glucagon-like peptide-1 (GLP-1) has protective effects in the heart. We hypothesized that GLP-1 would mitigate coronary microvascular and left ventricular (LV) dysfunction if administered after cardiac arrest and resuscitation (CAR). Eighteen swine were subjected to ventricular fibrillation followed by resuscitation. Swine surviving to return of spontaneous circulation (ROSC) were randomized to receive an intravenous infusion of either human rGLP-1 (10 pmol·kg(-1)·min(-1); n = 8) or 0.9% saline (n = 8) for 4 h, beginning 1 min after ROSC...
February 15, 2013: American Journal of Physiology. Heart and Circulatory Physiology
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