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https://www.readbyqxmd.com/read/27885446/post-cardiotomy-rescue-extracorporeal-cardiopulmonary-resuscitation-in-neonates-with-single-ventricle-after-intractable-cardiac-arrest-attrition-after-hospital-discharge-and-predictors-of-outcome
#1
Anastasios C Polimenakos, Vincent Rizzo, Chawki F El-Zein, Michel N Ilbawi
Extracorporeal cardiopulmonary resuscitation (ECPR) in children with cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) has been reported with encouraging results. We reviewed outcomes of neonates with functional single ventricle (FSV) surviving post-cardiotomy ECPR after hospital discharge. Fifty-eight patients who required post-cardiotomy extracorporeal membrane oxygenation (ECMO) since the introduction of our ECPR protocol (January 2007-December 2011) were identified. Forty-one were neonates...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27806964/phosphodiesterase-inhibitor-based-vasodilation-improves-oxygen-delivery-and-clinical-outcomes-following-stage-1-palliation
#2
Kimberly I Mills, Aditya K Kaza, Brian K Walsh, Hilary C Bond, Mackenzie Ford, David Wypij, Ravi R Thiagarajan, Melvin C Almodovar, Luis G Quinonez, Christopher W Baird, Sitaram E Emani, Frank A Pigula, James A DiNardo, John N Kheir
BACKGROUND: Systemic vasodilation using α-receptor blockade has been shown to decrease the incidence of postoperative cardiac arrest following stage 1 palliation (S1P), primarily when utilizing the modified Blalock-Taussig shunt. We studied the effects of a protocol in which milrinone was primarily used to lower systemic vascular resistance (SVR) following S1P using the right ventricular to pulmonary artery shunt, measuring its effects on oxygen delivery (DO2) profiles and clinical outcomes...
November 2, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27806794/-follow-up-of-survived-children-supported-by-extracorporeal-membrane-oxygenation
#3
Y Cheng, Z J Lu, X G Yan, J He, G F Yan, X D Cai, W J Shen, A L Jin, G P Lu
Objective: To summarize the follow-up of children treated with venoarterial extracorporeal membrane oxygenation (ECMO) by incision of internal carotid artery-vein. Method: This was a retrospective study, 10 children in whom the conventional therapy failed, but survived after treatment with ECMO technique through right internal jugular artery-venous incision and ligation after ECMO in pediatric intensive care unit (PICU) of Fudan University were followed up from December 2011 to December 2015. Primary disease situation, neurological development, growth and development, quality of life and personality development were included...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27752633/chest-compression-quality-exercise-intensity-and-energy-expenditure-during-cardiopulmonary-resuscitation-using-compression-to-ventilation-ratios-of-15-1-or-30-2-or-chest-compression-only-a-randomized-crossover-manikin-study
#4
Se-Jung Kwak, Young-Min Kim, Hee Jin Baek, Se Hong Kim, Hyeon Woo Yim
OBJECTIVE: Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). METHODS: This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR...
September 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27741068/the-use-of-extracorporeal-membrane-oxygenation-cardiopulmonary-resuscitation-in-prolonged-cardiac-arrest-in-pediatric-patients-is-it-time-to-expand-it
#5
Mohammed Absi, Susheel Tk Kumar, Hitesh Sandhu
Extracorporeal membrane oxygenation was instituted as an aid to in-hospital cardiopulmonary resuscitation (E-CPR) nearly 23 years ago, this led to remarkable improvement in survival considering the mortality rate associated with conventional cardiopulmonary resuscitation (CPR). Given this success, one begins to wonder whether the time has come for expanding the use of E-CPR to outside hospital cardiac arrests especially in the light of development of newer extracorporeal life support devices that are small, mobile, and easy to assemble...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27693756/nqo1-and-cyp450-reductase-decrease-the-systemic-exposure-of-rifampicin-quinone-and-mediate-its-redox-cycle-in-rats
#6
Fuguo Shi, Xiaobing Li, Hong Pan, Li Ding
Rifampicin (RIF) is used in regimens for infections caused by Mycobacteria accompanied by serious adverse reactions. Rifampicin-quinone (RIF-Q) is a major autoxidation product of RIF. It is not clear whether RIF-Q plays a role in RIF induced adverse reactions. Investigation of the systemic exposure of RIF-Q is helpful to better understand the role of RIF-Q in RIF induced adverse reactions. In this study, a simple and reproducible high performance liquid chromatography-mass spectrometry (LC-MS) method involving a procedure to prevent the RIF from oxidation for simultaneous quantification of RIF and RIF-Q in rat plasma has been developed and validated, and applied to elucidate the systemic exposure of RIF-Q in rats...
September 26, 2016: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27667276/-the-effect-and-factors-associated-with-outcome-of-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock-patients
#7
R Q Zhu, C Z Liu, J H Lu, Y P Su, S C Wen, G J Nie, Y Z Hu, L E Zuo
Objective: To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients. Methods: Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed. The clinical status before ECMO support, ECMO timing, complications and outcome were observed and analyzed.The hemodynamic data and the amount of vasoactive drugs at 2 hours before ECMO support and at 2, 6, 24 and 48 hours after ECMO support were collected and compared...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27625333/extracorporeal-membrane-oxygenation-outcomes-in-children-with-hemophagocytic-lymphohistiocytosis
#8
Katherine Cashen, Roland L Chu, Justin Klein, Peter T Rycus, John M Costello
INTRODUCTION: Pediatric patients with hemophagocytic lymphohistiocytosis (HLH) may develop refractory respiratory or cardiac failure that warrants consideration for extracorporeal membrane oxygenation (ECMO) support. The purposes of this study were to describe the use and outcomes of ECMO in pediatric HLH patients, to identify risk factors for hospital mortality and to compare their ECMO use and outcomes to the ECMO population as a whole. METHODS: Pediatric patients (⩽ 18 years) with a diagnosis of HLH in the Extracorporeal Life Support Organization (ELSO) Registry were included...
September 13, 2016: Perfusion
https://www.readbyqxmd.com/read/27592156/effects-of-epinephrine-on-cerebral-oxygenation-during-cardiopulmonary-resuscitation-a-prospective-cohort-study
#9
Charles D Deakin, Jie Yang, Robert Nguyen, Jiawen Zhu, Stephen J Brett, Jerry P Nolan, Gavin D Perkins, David G Pogson, Sam Parnia
BACKGROUND: Epinephrine has been presumed to improve cerebral oxygen delivery during cardiopulmonary resuscitation (CPR), but animal and registry studies suggest that epinephrine-induced capillary vasoconstriction may decrease cerebral capillary blood flow and worsen neurological outcome. The effect of epinephrine on cerebral oxygenation (rSO2) during CPR has not been documented in the clinical setting. METHODS: rSO2 was measured continuously using cerebral oximetry in patients with in-hospital cardiac arrest...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27523953/practice-characteristics-of-emergency-department-extracorporeal-cardiopulmonary-resuscitation-ecpr-programs-in-the-united-states-the-current-state-of-the-art-of-emergency-department-extracorporeal-membrane-oxygenation-ed-ecmo
#10
Joseph E Tonna, Nicholas J Johnson, John Greenwood, David F Gaieski, Zachary Shinar, Joseph M Bellezo, Lance Becker, Atman P Shah, Scott T Youngquist, Michael P Mallin, James Franklin Fair, Kyle J Gunnerson, Cindy Weng, Stephen McKellar
PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO)...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27449821/extracorporeal-membrane-oxygenation-ecmo-assisted-cardiopulmonary-resuscitation-or-uncontrolled-donation-after-the-circulatory-determination-of-death-following-out-of-hospital-refractory-cardiac-arrest-an-ethical-analysis-of-an-unresolved-clinical-dilemma
#11
Anne L Dalle Ave, David M Shaw, Dale Gardiner
BACKGROUND: The availability of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (E-CPR), for use in refractory out-of hospital cardiac arrest (OHCA), is increasing. In parallel, some countries have developed uncontrolled donation after circulatory determination of death (uDCDD) programs using ECMO to preserve organs for transplantation purposes. AIM: When facing a refractory OHCA, how does the medical team choose between initiating ECMO as part of an E-CPR protocol or ECMO as part of a uDCDD protocol? METHODS: To answer these questions we conducted a literature review on E-CPR compared to uDCDD protocols using ECMO and analyzed the raised ethical issues...
July 20, 2016: Resuscitation
https://www.readbyqxmd.com/read/27445805/functioning-of-microsomal-cytochrome-p450s-murburn-concept-explains-the-metabolism-of-xenobiotics-in-hepatocytes
#12
Kelath Murali Manoj, Abhinav Parashar, Sudeep K Gade, Avanthika Venkatachalam
Using oxygen and NADPH, the redox enzymes cytochrome P450 (CYP) and its reductase (CPR) work in tandem to carry out the phase I metabolism of a vast majority of drugs and xenobiotics. As per the erstwhile understanding of the catalytic cycle, binding of the substrate to CYP's heme distal pocket allows CPR to pump electrons through a CPR-CYP complex. In turn, this trigger (a thermodynamic push of electrons) leads to the activation of oxygen at CYP's heme-center, to give Compound I, a two-electron deficient enzyme reactive intermediate...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27412906/minnesota-resuscitation-consortium-s-advanced-perfusion-and-reperfusion-cardiac-life-support-strategy-for-out-of-hospital-refractory-ventricular-fibrillation
#13
Demetris Yannopoulos, Jason A Bartos, Cindy Martin, Ganesh Raveendran, Emil Missov, Marc Conterato, R J Frascone, Alexander Trembley, Kevin Sipprell, Ranjit John, Stephen George, Kathleen Carlson, Melissa E Brunsvold, Santiago Garcia, Tom P Aufderheide
BACKGROUND: In 2015, the Minnesota Resuscitation Consortium (MRC) implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory ventricular fibrillation/ventricular tachycardia (VF/VT). We report the outcomes of the initial 3-month period of operations. METHODS AND RESULTS: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol...
June 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27357822/clinical-outcomes-after-rescue-extracorporeal-cardiopulmonary-resuscitation-for-out-of-hospital-cardiac-arrest
#14
Tae Sun Ha, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Chi-Min Park, Kyeongman Jeon, Gee Young Suh
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to have survival benefit in patients who had in-hospital cardiac arrest (IHCA). However, limited data are available on the role of extracorporeal membrane oxygenation (ECMO) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate clinical outcomes and predictors of in-hospital mortality in patients who had OHCA and who underwent ECPR. METHODS: From January 2004 to December 2013, 235 patients who received ECPR were enrolled in a retrospective, single-centre, observational registry...
June 29, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27357577/the-chain-of-survival-in-hypothermic-circulatory-arrest-encouraging-preliminary-results-when-using-early-identification-risk-stratification-and-extracorporeal-rewarming
#15
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Dorota Sobczyk, Robert Gałązkowski, Jacek Piątek, Janusz Konstany-Kalandyk, Rafał Drwiła
BACKGROUND: The prognosis in hypothermic cardiac arrest is frequently good despite prolonged period of hypoperfusion and cardiopulmonary resuscitation. Apart from protective effect of hypothermia itself established protocols of treatment and novel rewarming techniques may influence on outcome. The purpose of the study was to assess the outcome of patients with hypothermic circulatory arrest treated by means of arterio-venous extracorporeal membrane oxygenation (ECMO) according to locally elaborated protocol in Severe Accidental Hypothermia Center in Cracow, Poland...
June 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27344929/myocardial-perfusion-and-oxidative-stress-after-21-vs-100-oxygen-ventilation-and-uninterrupted-chest-compressions-in-severely-asphyxiated-piglets
#16
Anne Lee Solevåg, Georg M Schmölzer, Megan O'Reilly, Min Lu, Tze-Fun Lee, Lisa K Hornberger, Britt Nakstad, Po-Yin Cheung
AIM: Despite the minimal evidence, neonatal resuscitation guidelines recommend using 100% oxygen when chest compressions (CC) are needed. Uninterrupted CC in adult cardiopulmonary resuscitation (CPR) may improve CPR hemodynamics. We aimed to examine 21% oxygen (air) vs. 100% oxygen in 3:1 CC:ventilation (C:V) CPR or continuous CC with asynchronous ventilation (CCaV) in asphyxiated newborn piglets following cardiac arrest. METHODS: Piglets (1-3 days old) were progressively asphyxiated until cardiac arrest and randomized to 4 experimental groups (n=8 each): air and 3:1 C:V CPR, 100% oxygen and 3:1 C:V CPR, air and CCaV, or 100% oxygen and CCaV...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27328890/arterial-blood-gases-during-and-their-dynamic-changes-after-cardiopulmonary-resuscitation-a-prospective-clinical-study
#17
Walter Spindelboeck, Geza Gemes, Christa Strasser, Kathrin Toescher, Barbara Kores, Philipp Metnitz, Josef Haas, Gerhard Prause
PURPOSE: An arterial blood gas analysis (ABG) yields important diagnostic information in the management of cardiac arrest. This study evaluated ABG samples obtained during out-of-hospital cardiopulmonary resuscitation (OHCPR) in the setting of a prospective multicenter trial. We aimed to clarify prospectively the ABG characteristics during OHCPR, potential prognostic parameters and the ABG dynamics after return of spontaneous circulation (ROSC). METHODS: ABG samples were collected and instantly processed either under ongoing OHCPR performed according to current advanced life support guidelines or immediately after ROSC and data ware entered into a case report form along with standard CPR parameters...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27318337/-outcome-of-extracorporeal-membrane-oxygenation-support-for-adult-patients-in-fuwai-hospital-during-the-last-10-years-treatment-strategy-and-risk-factors
#18
Gao Guodong, Lyu Lin, Hu Qiang, Hu Jinxiao, Hei Feilong, Ji Bingyan, Liu jinping, Yu Kun, Long Cun
OBJECTIVE: To retrospectively review the clinical data of patients receiving extracorporeal membrane oxygenation (ECMO) during the last 10 years in Fuwai Hospital in order to assess the factors associated with the outcome of patients who had undergone ECMO, as well as to summarize the clinical experience, and to adopt a treatment strategy for future clinical decision. METHODS: The clinical data of adult patients undergoing ECMO admitted to Fuwai Hospital from December 2004 to December 2014 were retrospectively analyzed...
December 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27302906/temporary-venoarterial-extracorporeal-membrane-oxygenation-ten-year-experience-at-a-cardiac-transplant-center
#19
Bao G Tran, Kim De La Cruz, Stuart Grant, Joseph Meltzer, Peyman Benharash, Ravi Dave, Abbas Ardehali, Richard Shemin, Eugene Depasquale, Ali Nsair
OBJECTIVE: Advances in extracorporeal membrane oxygenation (ECMO) have enabled rapid deployment in a wide range of clinical settings. We report our experience with venoarterial (VA) ECMO in adult patients over 10 years and aim to identify predictors of mortality. DESIGN: This is a retrospective analysis of all adult patients undergoing VA ECMO at a tertiary care center from January 1, 2004, to December 31, 2013. RESULTS: A total of 224 consecutive cases were reviewed...
June 14, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27298791/results-of-extracorporeal-cardiopulmonary-resuscitation-in-children
#20
Hong Ju Shin, Seunghwan Song, Han Ki Park, Young Hwan Park
BACKGROUND: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. METHODS: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. RESULTS: Twelve children, median age 6...
June 2016: Korean Journal of Thoracic and Cardiovascular Surgery
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