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Jon c Rittenberger

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https://www.readbyqxmd.com/read/29288014/efficacy-of-different-cooling-technologies-for-therapeutic-temperature-management-a-prospective-intervention-study
#1
Petra Sonder, Gladys N Janssens, Albertus Beishuizen, Connie L Henry, Jon C Rittenberger, Clifton W Callaway, Cameron Dezfulian, Kees H Polderman
BACKGROUND: Mild therapeutic hypothermia (32-36 °C) is associated with improved outcomes in patients with brain injury after cardiac arrest (CA). Various devices are available to induce and maintain hypothermia, but few studies have compared the performance of these devices. We performed a prospective study to compare four frequently used cooling systems in inducing and maintaining hypothermia followed by controlled rewarming. METHODS: We performed a prospective multi-centered study in ten ICU's in three hospitals within the UPMC health system...
December 26, 2017: Resuscitation
https://www.readbyqxmd.com/read/29223601/early-coronary-angiography-and-percutaneous-coronary-intervention-are-associated-with-improved-outcomes-after-out-of-hospital-cardiac-arrest
#2
Jacob C Jentzer, Michael Scutella, Francis Pike, James Fitzgibbon, Nicholas M Krehel, Lindsay Kowalski, Clifton W Callaway, Jon C Rittenberger, Joshua C Reynolds, Gregory W Barsness, Cameron Dezfulian
AIM: Early coronary angiography (CAG) and percutaneous coronary intervention (PCI) are associated with better outcomes in subjects resuscitated from out-of-hospital cardiac arrest (OHCA). We sought to determine the relative contributions of early CAG and PCI to outcomes and adverse events after OHCA. METHODS: We analyzed 599 OHCA subjects from a prospective two-center registry. Hospital survival, functional outcomes and adverse events were compared between subjects undergoing early CAG (within 24h) with or without PCI and subjects not undergoing early CAG...
February 2018: Resuscitation
https://www.readbyqxmd.com/read/29221942/neurostimulant-use-is-associated-with-improved-survival-in-comatose-patients-after-cardiac-arrest-regardless-of-electroencephalographic-substrate
#3
Alexis Steinberg, Jon C Rittenberger, Maria Baldwin, John Faro, Alexandra Urban, Naoir Zaher, Clifton W Callaway, Jonathan Elmer
AIM: Identify EEG patterns that predict or preclude favorable response in comatose post-arrest patients receiving neurostimulants. METHODS: We examined a retrospective cohort of consecutive electroencephalography (EEG)-monitored comatose post-arrest patients. We classified the last day of EEG recording before neurostimulant administration based on continuity (continuous/discontinuous), reactivity (yes/no) and malignant patterns (periodic discharges, suppression burst, myoclonic status epilepticus or seizures; yes/no)...
December 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/29210906/temperature-management-for-out-of-hospital-cardiac-arrest
#4
Patrick J Coppler, Cameron Dezfulian, Jonathan Elmer, Jon C Rittenberger
More than 300,000 Americans suffer a cardiac arrest outside of the hospital each year and even among those who are successfully resuscitated and survive to hospital admission, outcomes remain poor. Temperature management (previously known as therapeutic hypothermia) is the only intervention that has been reproducibly demonstrated to ameliorate the neurologic injury that follows cardiac arrest. The results of a recent large randomized controlled trial have highlighted the uncertainty about temperature management strategies following cardiac arrest...
December 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29197598/effect-of-sedation-on-quantitative-electroencephalography-after-cardiac-arrest
#5
Callie M Drohan, Alessandra I Cardi, Jon C Rittenberger, Alexandra Popescu, Clifton W Callaway, Maria E Baldwin, Jonathan Elmer
BACKGROUND: Electroencephalography (EEG) has clinical and prognostic importance after cardiac arrest (CA). Recently, interest in quantitative EEG (qEEG) analysis has grown. The qualitative effects of sedation on EEG are well known, but potentially confounding effects of sedatives on qEEG after anoxic injury are poorly characterized. We hypothesize that sedation increases suppression ratio (SR) and decreases alpha/delta ratio (ADR) and amplitude-integrated EEG (aEEG), and that the magnitude of sedation effects will be associated with outcome...
November 29, 2017: Resuscitation
https://www.readbyqxmd.com/read/29033029/corrigendum-to-comparison-of-three-cognitive-exams-in-cardiac-arrest-survivors-resuscitation-116-2017-98-104
#6
Allison C Koller, Jon C Rittenberger, Melissa J Repine, Patrick W Morgan, Jeffrey Kristan, Clifton W Callaway
No abstract text is available yet for this article.
October 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/29032299/association-of-antiplatelet-therapy-with-patient-outcomes-after-out-of-hospital-cardiac-arrest
#7
Alexandro Gianforcaro, Michael Kurz, Francis X Guyette, Clifton W Callaway, Jon C Rittenberger, Jonathan Elmer
BACKGROUND: Cessation of blood flow during out-of-hospital cardiac arrest (OHCA) results in microvascular thrombosis, protracted hypoperfusion after return of spontaneous circulation and damage to vital organs. We tested the hypothesis that pre-arrest antiplatelet and anticoagulant medication use would be associated with less post-arrest organ dysfunction and better outcomes. METHODS: We included OHCA patients treated from January 2005 to October 2014 at a single academic medical center...
October 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28870720/post-resuscitation-arterial-oxygen-and-carbon-dioxide-and-outcomes-after-out-of-hospital-cardiac-arrest
#8
Henry E Wang, David K Prince, Ian R Drennan, Brian Grunau, David J Carlbom, Nicholas Johnson, Matthew Hansen, Jonathan Elmer, Jim Christenson, Peter Kudenchuk, Tom Aufderheide, Myron Weisfeldt, Ahamed Idris, Stephen Trzeciak, Michael Kurz, Jon C Rittenberger, Denise Griffiths, Jamie Jasti, Susanne May
OBJECTIVE: To determine if arterial oxygen and carbon dioxide abnormalities in the first 24h after return of spontaneous circulation (ROSC) are associated with increased mortality in adult out-of-hospital cardiac arrest (OHCA). METHODS: We used data from the Resuscitation Outcomes Consortium (ROC), including adult OHCA with sustained ROSC ≥1h after Emergency Department arrival and at least one arterial blood gas (ABG) measurement. Among ABGs measured during the first 24h of hospitalization, we identified the presence of hyperoxemia (PaO2≥300mmHg), hypoxemia (PaO2<60mmHg), hypercarbia (PaCO2>50mmHg) and hypocarbia (PaCO2<30mmHg)...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28698007/solving-fatigue-related-problems-with-cardiac-arrest-survivors-living-in-the-community
#9
Young Joo Kim, Joan C Rogers, Ketki D Raina, Clifton W Callaway, Jon C Rittenberger, Mary Lou Leibold, Margo B Holm
AIM: The aim was to describe fatigue-related problems reported by post-cardiac arrest adults with chronic fatigue and energy conservation strategies generated using an Energy Conservation plus Problem Solving Therapy intervention. METHODS: Following an introduction to the intervention process outlined in a Participant Workbook, participants engaged in the telephone intervention by identifying one to two fatigue-related problems. They then brainstormed with the interventionist to identify potential strategies to reduce fatigue, tested them, and either modified the strategies or moved to the next problem over three to five sessions...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28552656/prevalence-natural-history-and-time-dependent-outcomes-of-a-multi-center-north-american-cohort-of-out-of-hospital-cardiac-arrest-extracorporeal-cpr-candidates
#10
Joshua C Reynolds, Brian E Grunau, Jonathan Elmer, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Ben Singer, Alastair Proudfoot, Clifton W Callaway
AIM: Estimate prevalence of ECPR-eligible subjects in a large, North American, multi-center cohort, describe natural history with conventional resuscitation, and predict optimal timing of transition to ECPR. METHODS: Secondary analysis of clinical trial enrolling adults with non-traumatic OHCA. Primary outcome was survival to discharge with favorable outcome (mRS 0-3). Subjects were additionally classified as survival with unfavorable outcome (mRS 4-5), ROSC without survival (mRS 6), or without ROSC...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28511984/comparison-of-three-cognitive-exams-in-cardiac-arrest-survivors
#11
Allison C Koller, Jon C Rittenberger, Melissa J Repine, Patrick W Morgan, Jeffrey Kristan, Clifton W Callaway
BACKGROUND: Cognitive deficits may detract from quality of life after cardiac arrest. Their pattern and prevalence are not well documented. We used the Computer Assessment of Mild Cognitive Impairment (CAMCI), the Montreal Cognitive Assessment (MOCA) and the 41 Cent Test (41CT) to assess cognitive impairment in cardiac arrest survivors and examine the exams' diagnostic accuracy. We hypothesized that the scores of these exams would indicate the presence of cognitive impairment in arrest survivors, that the overall scores on the three study assessments would correlate with one another, and that the 41CT, MOCA, and executive function element of the CAMCI would vary independently from other non-executive CAMCI components, reflecting executive function impairment after cardiac arrest...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/28334684/biochemical-signaling-by-remote-ischemic-conditioning-of-the-arm-versus-thigh-is-one-raise-of-the-cuff-enough
#12
Cameron Dezfulian, Maia Taft, Catherine Corey, Gabrielle Hill, Nicholas Krehel, Jon C Rittenberger, Frank X Guyette, Sruti Shiva
Remote Ischemic Conditioning (RIC), induced by brief cycles of ischemia and reperfusion, protects vital organs from a prolonged ischemic insult. While several biochemical mediators have been implicated in RIC's mechanism of action, it remains unclear whether the localization or "dose" of RIC affects the extent of protective signaling. In this randomized crossover study of healthy individuals, we tested whether the number of cycles of RIC and its localization (arm versus thigh) determines biochemical signaling and cytoprotection...
August 2017: Redox Biology
https://www.readbyqxmd.com/read/28126408/characterization-of-mitochondrial-injury-after-cardiac-arrest-comica
#13
Michael W Donnino, Xiaowen Liu, Lars W Andersen, Jon C Rittenberger, Benjamin S Abella, David F Gaieski, Joseph P Ornato, Raúl J Gazmuri, Anne V Grossestreuer, Michael N Cocchi, Antonio Abbate, Amy Uber, John Clore, Mary Anne Peberdy, Clifton W Callaway
INTRODUCTION: Mitochondrial injury post-cardiac arrest has been described in pre-clinical settings but the extent to which this injury occurs in humans remains largely unknown. We hypothesized that increased levels of mitochondrial biomarkers would be associated with mortality and neurological morbidity in post-cardiac arrest subjects. METHODS: We performed a prospective multicenter study of post-cardiac arrest subjects. Inclusion criteria were comatose adults who suffered an out-of-hospital cardiac arrest...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28112624/bystander-cardiopulmonary-resuscitation-a-civic-duty
#14
Torben K Becker, Michael Bernhard, Bernd W Böttiger, Jon C Rittenberger, Mike-Frank G Epitropoulos, Sören L Becker
No abstract text is available yet for this article.
February 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/27760796/association-between-duration-of-resuscitation-and-favorable-outcome-after-out-of-hospital-cardiac-arrest-implications-for-prolonging-or-terminating-resuscitation
#15
RANDOMIZED CONTROLLED TRIAL
Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest, and case features justifying longer or shorter durations are ill defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in out-of-hospital cardiac arrest using a large, multicenter cohort. METHODS: This was a secondary analysis of a North American, single-blind, multicenter, cluster-randomized, clinical trial (ROC-PRIMED [Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed]) of consecutive adults with nontraumatic, emergency medical services-treated out-of-hospital cardiac arrest...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27650862/long-term-survival-benefit-from-treatment-at-a-specialty-center-after-cardiac-arrest
#16
Jonathan Elmer, Jon C Rittenberger, Patrick J Coppler, Francis X Guyette, Ankur A Doshi, Clifton W Callaway
INTRODUCTION: The Institute of Medicine and American Heart Association have called for tiered accreditation standards and regionalization of post-cardiac arrest care, but there is little data to support that regionalization has a durable effect on patient outcomes. We tested the effect of treatment at a high-volume center on long-term outcome after sudden cardiac arrest (SCA). METHODS: We included patients hospitalized at one of 7 medical centers in Southwestern Pennsylvania after SCA from 2005 to 2013...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27554945/continuous-eeg-monitoring-enhances-multimodal-outcome-prediction-in-hypoxic-ischemic-brain-injury
#17
Edilberto Amorim, Jon C Rittenberger, Julia J Zheng, M Brandon Westover, Maria E Baldwin, Clifton W Callaway, Alexandra Popescu
OBJECTIVE: Hypoxic brain injury is the largest contributor to disability and mortality after cardiac arrest. We aim to identify electroencephalogram (EEG) characteristics that can predict outcome on cardiac arrest patients treated with targeted temperature management (TTM). METHODS: We retrospectively examined clinical, EEG, functional outcome at discharge, and in-hospital mortality for 373 adult subjects with return of spontaneous circulation after cardiac arrest...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27521471/inhalational-neuroprotectants-a-noble-cause
#18
EDITORIAL
Jonathan Elmer, Jon C Rittenberger
No abstract text is available yet for this article.
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27419613/variability-of-post-cardiac-arrest-care-practices-among-cardiac-arrest-centers-united-states-and-south-korean-dual-network-survey-of-emergency-physician-research-principal-investigators
#19
MULTICENTER STUDY
Patrick J Coppler, Kelly N Sawyer, Chun Song Youn, Seung Pill Choi, Kyu Nam Park, Young-Min Kim, Joshua C Reynolds, David F Gaieski, Byung Kook Lee, Joo Suk Oh, Won Young Kim, Hyung Jun Moon, Benjamin S Abella, Jonathan Elmer, Clifton W Callaway, Jon C Rittenberger
There is little consensus regarding many post-cardiac arrest care parameters. Variability in such practices could confound the results and generalizability of post-arrest care research. We sought to characterize the variability in post-cardiac arrest care practice in Korea and the United States. A 54-question survey was sent to investigators participating in one of two research groups in South Korea (Korean Hypothermia Network [KORHN]) and the United States (National Post-Arrest Research Consortium [NPARC])...
March 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27377670/echocardiographic-left-ventricular-systolic-dysfunction-early-after-resuscitation-from-cardiac-arrest-does-not-predict-mortality-or-vasopressor-requirements
#20
Jacob C Jentzer, Meshe D Chonde, Asher Shafton, Hussein Abu-Daya, Didier Chalhoub, Andrew D Althouse, Jon C Rittenberger
BACKGROUND/AIMS: Echocardiographic abnormalities are common after resuscitation from cardiac arrest. The association between echocardiographic findings with vasopressor requirements and mortality are not well described. We sought to determine the associations between echocardiographic abnormalities and mortality, vasopressor requirements and organ failure after cardiac arrest. METHODS: We prospectively evaluated 55 adult subjects undergoing transthoracic echocardiography within 24h after resuscitation from cardiac arrest...
September 2016: Resuscitation
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