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Post arrest cooling

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https://www.readbyqxmd.com/read/29620622/cc1-emergent-endovascular-repair-of-a-ruptured-descending-thoracic-aortic-aneurysm-in-an-arresting-patient
#1
Warren Naselsky, Charles F Evans, Brody Wehman, Bradley S Taylor
OBJECTIVE: Our goal was to present a case of emergent endovascular repair of a ruptured descending aortic aneurysm in an actively arresting patient. PATIENT: The patient was a 75-year-old woman with a known history of a 6.5-cm descending thoracic aortic aneurysm with acute onset of back pain and syncope. A computed tomographic angiogram revealed disruption of the descending thoracic aorta and a mediastinal hematoma. The patient was taken emergently to the operating room...
April 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29536863/out-of-hospital-cardiac-arrest-in-hospital-intervention-strategies
#2
REVIEW
Christian Hassager, Ken Nagao, David Hildick-Smith
The prognosis after out-of-hospital cardiac arrest (OHCA) has improved in the past few decades because of advances in interventions used outside and in hospital. About half of patients who have OHCA with initial ventricular tachycardia or ventricular fibrillation and who are admitted to hospital in coma after return of spontaneous circulation will survive to discharge with a reasonable neurological status. In this Series paper we discuss in-hospital management of patients with post-cardiac-arrest syndrome. In most patients, the most important in-hospital interventions other than routine intensive care are continuous active treatment (in non-comatose and comatose patients and including circulatory support in selected patients), cooling of core temperature to 32-36°C by targeted temperature management for at least 24 h, immediate coronary angiography with or without percutaneous coronary intervention, and delay of final prognosis until at least 72 h after OHCA...
March 10, 2018: Lancet
https://www.readbyqxmd.com/read/29534742/the-efficacy-and-safety-of-pre-hospital-cooling-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#3
Patrick J Lindsay, Danielle Buell, Damon C Scales
BACKGROUND: Mild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating TH for all eligible individuals presenting with OHCA; however, the timing of cooling initiation remains uncertain. This systematic review and meta-analysis was conducted with all available randomised controlled trials (RCTs) included to explore the efficacy and safety of initiating pre-hospital TH in patients with OHCA...
March 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29461318/post-cardiac-arrest-management-time-to-cool-it-on-cooling
#4
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29351829/inhibition-of-dynamin-related-protein-1-has-neuroprotective-effect-comparable-with-therapeutic-hypothermia-in-a-rat-model-of-cardiac-arrest
#5
Peng Wang, Yi Li, Zhengfei Yang, Tao Yu, Guanghui Zheng, Xiangshao Fang, Zitong Huang, Longyuan Jiang, Wanchun Tang
Dynamin-related protein 1 (Drp1) regulates mitochondrial fission, it has been proven that inhibition of Drp1 by mdivi-1 improves survival and attenuates cerebral ischemic injury after cardiac arrest. In this study, we compared the effects of Drp1 inhibition with therapeutic hypothermia on post-resuscitation neurologic injury in a rat model of cardiac arrest. Rats were randomized into 4 groups: mdivi-1 treatment group (n = 39), hypothermic group (n = 38), normothermic group (n = 41), and sham group (n = 12)...
April 2018: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/29284424/the-effect-of-whole-body-cooling-on-renal-function-in-post-cardiac-arrest-patients
#6
Silvia De Rosa, Massimo De Cal, Michael Joannidis, Gianluca Villa, Jose Luis Salas Pacheco, Grazia Maria Virzì, Sara Samoni, Fiorella D'ippoliti, Stefano Marcante, Federico Visconti, Antonella Lampariello, Marina Zannato, Silvio Marafon, Raffaele Bonato, Claudio Ronco
No abstract text is available yet for this article.
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29239942/targeted-temperature-management-after-cardiac-arrest-systematic-review-and-meta-analyses
#7
Rajat Kalra, Garima Arora, Nirav Patel, Rajkumar Doshi, Lorenzo Berra, Pankaj Arora, Navkaranbir S Bajaj
BACKGROUND: Targeted temperature management (TTM) with therapeutic hypothermia is an integral component of postarrest care for survivors. However, recent randomized controlled trials (RCTs) have failed to demonstrate the benefit of TTM on clinical outcomes. We sought to determine if the pooled data from available RCTs support the use of prehospital and/or in-hospital TTM after cardiac arrest. METHODS: A comprehensive search of SCOPUS, Elsevier's abstract and citation database of peer-reviewed literature, from 1966 to November 2016 was performed using predefined criteria...
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#8
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
December 2017: Resuscitation
https://www.readbyqxmd.com/read/28873073/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients-erratum
#9
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28698133/randomized-controlled-trial-of-internal-and-external-targeted-temperature-management-methods-in-post-cardiac-arrest-patients
#10
RANDOMIZED CONTROLLED TRIAL
Xinqi Look, Huihua Li, Mingwei Ng, Eric Tien Siang Lim, Sohil Pothiawala, Kenneth Boon Kiat Tan, Duu Wen Sewa, Nur Shahidah, Pin Pin Pek, Marcus Eng Hock Ong
BACKGROUND: Targeted temperature management post-cardiac arrest is currently implemented using various methods, broadly categorized as internal and external. This study aimed to evaluate survival-to-hospital discharge and neurological outcomes (Glasgow-Pittsburgh Score) of post-cardiac arrest patients undergoing internal cooling verses external cooling. METHODOLOGY: A randomized controlled trial of post-resuscitation cardiac arrest patients was conducted from October 2008-September 2014...
January 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28644823/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients
#11
K Kim, Kimberly L Pargeon, Amy S Labar, Oren Friedman, Padmaja N Kandula, Douglas R Labar
PURPOSE: Continuous video EEG is a tool to assess brain function in injuries, including cardiac arrest (CA). In post-CA therapeutic hypothermia (TH) studies, some EEG features are linked to poor prognosis, but the evolvement of EEG characteristics during two temperature phases and its significance is unclear. We systematically analyzed EEG characteristics in cooled and rewarmed phases of post-CA therapeutic hypothermia patients and investigated their correlation to patient outcome. METHODS: This is a retrospective study of EEG analyses, from a single academic center, of 20 patients who underwent CA and therapeutic hypothermia...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28492973/fast-therapeutic-hypothermia-prevents-post-cardiac-arrest-syndrome-through-cyclophilin-d-mediated-mitochondrial-permeability-transition-inhibition
#12
Vincent Jahandiez, Martin Cour, Thomas Bochaton, Maryline Abrial, Joseph Loufouat, Abdallah Gharib, Annie Varennes, Michel Ovize, Laurent Argaud
The opening of the mitochondrial permeability transition pore (PTP), which is regulated by the matrix protein cyclophilin D (CypD), plays a key role in the pathophysiology of post-cardiac arrest (CA) syndrome. We hypothesized that therapeutic hypothermia could prevent post-CA syndrome through a CypD-mediated PTP inhibition in both heart and brain. In addition, we investigated whether specific pharmacological PTP inhibition would confer additive protection to cooling. Adult male New Zealand White rabbits underwent 15 min of CA followed by 120 min of reperfusion...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28437237/proteomics-in-hypothermia-as-adjunctive-therapy-in-patients-with-st-segment-elevation-myocardial-infarction-a-chill-mi-substudy
#13
Moman A Mohammad, Marco Noc, Irene Lang, Michael Holzer, Peter Clemmensen, Ulf Jensen, Bernhard Metzler, David Erlinge
Cardiovascular and inflammatory biomarkers in therapeutic hypothermia have been studied in cardiac arrest, but data on patients with ST-segment elevation myocardial infarction (STEMI) treated with therapeutic hypothermia are currently unavailable. A multiplex proximity extension assay allowed us to measure 157 cardiovascular disease (CVD) and inflammatory disease-related biomarkers in patients from the international, multicenter, and randomized trial; CHILL-myocardial infarction (MI) and to explore the associations of cardiovascular and inflammatory biomarkers...
March 2, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28352966/cold-blooded-evaluating-brain-temperature-by-mri-during-surface-cooling-of-human-subjects
#14
Eric J Curran, Daniel L Wolfson, Richard Watts, Kalev Freeman
BACKGROUND: Targeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM...
October 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28237918/optimal-control-of-inspired-perfluorocarbon-temperature-for-ultrafast-hypothermia-induction-by-total-liquid-ventilation-in-an-adult-patient-model
#15
Mathieu Nadeau, Michael Sage, Matthias Kohlhauer, Julien Mousseau, Jonathan Vandamme, Etienne Fortin-Pellerin, Jean-Paul Praud, Renaud Tissier, Herve Walti, Philippe Micheau
GOAL: Recent preclinical studies have shown that therapeutic hypothermia induced in less than 30 min by total liquid ventilation (TLV) strongly improves the survival rate after cardiac arrest. When the lung is ventilated with a breathable perfluorocarbon liquid, the inspired perfluorocarbon allows us to control efficiently the cooling process of the organs. While TLV can rapidly cool animals, the cooling speed in humans remains unknown. The objective is to predict the efficiency and safety of ultrafast cooling by TLV in adult humans...
December 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28004331/delayed-deterioration-of-eeg-background-rhythm-post-cardiac-arrest
#16
Tadeu A Fantaneanu, Rani Sarkis, Kathleen Avery, Benjamin M Scirica, Shelley Hurwitz, Galen V Henderson, Jong Woo Lee
BACKGROUND: Electroencephalogram (EEG) background continuity is associated with a favorable prognosis in cardiac arrest patients post-therapeutic hypothermia. However, the continuous EEG in a subset of patients will undergo 'delayed EEG deterioration'; they will invariably have poor outcome. The aim of this study was to characterize this phenomenon. METHODS: We studied a prospectively collected cohort of consecutive cardiac arrest patients who underwent therapeutic hypothermia between July 2012 and May 2015...
June 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27913267/a-comparison-between-intravascular-and-traditional-cooling-for-inducing-and-maintaining-temperature-control-in-patients-following-cardiac-arrest
#17
Jérémy 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/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#18
REVIEW
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/27782794/clinical-effect-of-rebound-hyperthermia-after-cooling-postcardiac-arrest-a-retrospective-cohort-study
#19
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27622966/effect-of-hypothermia-and-targeted-temperature-management-on-drug-disposition-and-response-following-cardiac-arrest-a-comprehensive-review-of-preclinical-and-clinical-investigations
#20
REVIEW
Kacey B Anderson, Samuel M Poloyac, Patrick M Kochanek, Philip E Empey
Targeted temperature management (TTM) has been shown to reduce mortality and improve neurological outcomes in out-of-hospital cardiac arrest (CA) patients and in neonates with hypoxic-ischemic encephalopathy (HIE). TTM has also been associated with adverse drug events in the critically ill patient due to its effect on drug pharmacokinetics (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA. MEDLINE/PubMed databases were searched for publications, which include the MeSH terms hypothermia, drug metabolism, drug transport, P450, critical care, cardiac arrest, hypoxic-ischemic encephalopathy, pharmacokinetics, and pharmacodynamics between July 2006 and October 2015...
December 2016: Therapeutic Hypothermia and Temperature Management
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