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In-hospital cardiac arrest

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https://www.readbyqxmd.com/read/29236216/long-term-outcomes-of-a%C3%A2-caucasian-cohort-presenting-with-acute-coronary-syndrome-and-or-out-of-hospital-cardiac-arrest-caused-by-coronary-spasm
#1
W Vlastra, M Piek, M A van Lavieren, M E J C Hassell, B E Claessen, G W Wijntjens, T P van de Hoef, K D Sjauw, M A Beijk, R Delewi, J J Piek
BACKGROUND: Coronary artery spasm may be the underlying mechanism in up to 10% of cases of acute coronary syndrome (ACS) and sudden cardiac death. Asian individuals exhibit a 3-times greater incidence of spasm than Caucasians; this is likely due to different types of mechanisms. Consequently, solid data is limited about the long-term prognosis in Caucasian patients presenting with ACS and/or out-of-hospital cardiac arrest (OHCA) caused by coronary spasm. METHODS: Between 2002 and 2015, thirty Caucasian patients with coronary artery spasm presenting with ACS (N = 29) and/or OHCA (N = 11) were enrolled in this prospective registry...
December 13, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29235738/twenty-year-trends-of-survival-after-in-hospital-cardiac-arrest
#2
Jad Khatib, Naama Schwartz, Naiel Bisharat
BACKGROUND: In 2006, the Israeli Ministry of Health distributed guidelines for improving cardiopulmonary resuscitation (CPR) knowledge among hospital staff. The impact of these guidelines on survival after in-hospital cardiac arrest (IHCA) is unclear. OBJECTIVES: To compare rates of incidence and survival to discharge after IHCA, preceding and subsequent to issuance of the guidelines: 1995-2005 and 2006-2015. METHODS: Data were retrieved from the computerized records of patients who had an IHCA and underwent CPR...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29235737/long-term-survival-of-discharged-patients-admitted-to-intensive-coronary-care-unit-after-out-of-hospital-cardiac-arrest
#3
Dante Antonelli, Ofir Koren, Menachem Nahir, Ehud Rozner, Nahum A Freedberg, Yoav Turgeman
BACKGROUND: Survival of patients who were discharged from the hospital following out-of-hospital cardiac arrest (OHCA) has not been well defined. OBJECTIVES: To verify predictor variables for prognosis of patients following OHCA who survived hospitalization. METHODS: We retrospectively reviewed clinical, demographic, and outcome data of consecutive patients who were hospitalized from January 1, 2009, through December 31, 2014, into the intensive coronary care unit (ICCU) after aborted OHCA and discharged alive...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29235579/the-presence-of-gasping-predicts-long-term-survival-in-out-of-hospital-cardiac-arrest-patients
#4
Jiri Knor, Roman Skulec, Dominika Seblova, Malek Jiri
BACKGROUND: The presence of gasping in out-of-hospital cardiac arrest (OHCA) patients predicts short-term prognosis. We performed a retrospective study to evaluate whether the presence of gasping at the time of Emergency Medical Service (EMS) arrival in the case OHCA patients of presumed cardian origin has any impact on six-month survival and/or sustained return of spontaneous circulation (ROSC). METHODS: We collected and analyzed Utstein Style data for all patients resuscitated for OHCA of presumed cardiac origin by the EMS of the Central Bohemian Region from July 1st, 2013 to June 30th, 2014...
December 13, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29235577/out-of-hospital-cardiac-arrest
#5
Martin Porzer, Eva Mrazkova, Miroslav Homza, Vladimir Janout
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in developed industrial countries. The global worldwide average of OHCA incidence in adults is 95.9/100,000/year. European incidences vary according to source from 16 to 119/100,000/year. The aim of this study was to provide an overview of current information on OHCA. The incidences in various populations are discussed, along with the factors affecting the prognosis and outcome of these patients. The etiology and pathophysiological mechanisms are also described, especially in relation to the most common causes - acute and chronic forms of coronary artery disease and cardiomyopathies...
December 13, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29230917/interfacial-nanoprecipitation-toward-stable-and-responsive-microbubbles-and-their-use-as-a-resuscitative-fluid
#6
Yifeng Peng, Raymond Seekell, Alexis Cole, Jemima Lamothe, Andrew Lock, Sarah van den Bosch, Xiaoqi Tang, John Kheir, Brian Polizzotti
We report a new approach to prepare stable microbubbles (MBs) via interfacial nanoprecipitation of bioabsorbable polymers at air/liquid interface. This facile method offers robust control over MBs morphology and chemo-physical properties by simple chemical modifications. This approach is amenable to large-scale manufacturing, and is useful to develop functional MBs for advanced biomedical applications. To demonstrate this, we created a MB-based intravenous oxygen carrier that undergoes pH-triggered self-elimination...
December 11, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/29228878/quality-assessment-in-belgian-st-elevation-myocardial-infarction-patients-results-from-the-belgian-stemi-database
#7
Marc J Claeys, Peter R Sinnaeve, Carl Convens, Philippe Dubois, Suzanne Pourbaix, Pascal Vranckx, Sofie Gevaert, Herbert De Raedt, Christophe Beauloye, Jean-Francois Argacha, Patrick Evrard, Patrick Coussement
The present report describes the quality of care, including in hospital mortality for more than 22.000 STEMI patients admitted in 60 Belgian hospitals for the period 2008-2016. We found a strong increase in the use of primary PCI over time, particularly for patients that were admitted first in a non-PCI capable hospital, reaching a penetration rate of >95%. The transition of thrombolysis to transfer for pPCI in the setting of a STEMI network was, however, associated with an increase of the proportion of patients with prolonged (>120 min) diagnosis-to-balloon time (from 16 to 22%), suggesting still suboptimal interhospital transfer...
December 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#8
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29228101/spironolactone-and-resistant-hypertension-in-heart-failure-with-preserved-ejection-fraction
#9
P Rossignol, B Claggett, J Liu, O Vardeny, B Pitt, F Zannad, S Solomon
Background: Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown. Methods: We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mmHg on 3 or more medications, in the Americas cohort of the TOPCAT trial, in which patients with HFpEF were randomized to spironolactone vs...
December 7, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29226957/pilot-multi-centre-randomised-trial-of-the-impact-of-pre-operative-focused-cardiac-ultrasound-on-mortality-and-morbidity-in-patients-having-surgery-for-femoral-neck-fractures-echonof-2-pilot
#10
D J Canty, J Heiberg, Y Yang, A G Royse, S Margale, N Nanjappa, D Scott, A Maier, D I Sessler, A Chuan, A Palmer, A Bucknill, C French, C F Royse
Hip fracture surgery is common, usually occurs in elderly patients who have multiple comorbidities, and is associated with high morbidity and mortality. Pre-operative focused cardiac ultrasound can alter diagnosis and management, but its impact on outcome remains uncertain. This pilot study assessed feasibility and group separation for a proposed large randomised clinical trial of the impact of pre-operative focused cardiac ultrasound on patient outcome after hip fracture surgery. Adult patients requiring hip fracture surgery in four teaching hospitals in Australia were randomly allocated to receive focused cardiac ultrasound before surgery or not...
December 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29226831/public-access-defibrillation-in-hong-kong-in-2017
#11
K L Fan, C T Lui, L P Leung
The concept of public access defibrillation was proposed more than 20 years ago. Since then, various programmes have been implemented in many major cities although not all have been successful. Fourteen years ago, the question of whether Hong Kong needed public access defibrillation was raised. This article aimed to answer this question based on the best available evidence. Over the years, the clinical effectiveness of public access defibrillation in out-of-hospital cardiac arrest has been proven. Nonetheless various studies have indicated that among others, cost-effectiveness, knowledge and attitudes of the public, and incidence of ventricular fibrillation are important factors that will affect the likelihood of success of such programmes...
December 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29223601/early-coronary-angiography-and-percutaneous-coronary-intervention-are-associated-with-improved-outcomes-after-out-of-hospital-cardiac-arrest
#12
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...
December 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29223432/contemporary-risk-model-for-inhospital-major-bleeding-for-patients-with-acute-myocardial-infarction-the-acute-coronary-treatment-and-intervention-outcomes-network-action-registry%C3%A2-get-with-the-guidelines-gwtg-%C3%A2
#13
Nihar R Desai, Kevin F Kennedy, David J Cohen, Traci Connolly, Deborah B Diercks, Mauro Moscucci, Stephen Ramee, John Spertus, Tracy Y Wang, Robert L McNamara
BACKGROUND: Major bleeding is a frequent complication for patients with acute myocardial infarction (AMI) and is associated with significant morbidity and mortality. OBJECTIVE: To develop a contemporary model for inhospital major bleeding that can both support clinical decision-making and serve as a foundation for assessing hospital quality. METHODS: An inhospital major bleeding model was developed using the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG) database...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223193/quality-indicators-for-evaluating-prehospital-emergency-care-a-scoping-review
#14
Ian Howard, Peter Cameron, Lee Wallis, Maaret Castren, Veronica Lindstrom
Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC...
December 10, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29221942/neurostimulant-use-is-associated-with-improved-survival-in-comatose-patients-after-cardiac-arrest-regardless-of-electroencephalographic-substrate
#15
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/29221550/-assessment-of-professional-practices-in-treating-cardiac-arrest
#16
REVIEW
Clara Mazon, Yamina Kerrou
An assessment of professional practices was carried out in 2013-2014 with the aim of improving the treatment of cardiac arrest in hospitals. Two methods were used: an assessment by questionnaire to evaluate theoretical knowledge and a practical assessment of external cardiac massage. The results highlight the need for greater knowledge. The use of cardiac massage must be included in continuing professional development.
December 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29220603/evaluating-dispatch-assisted-cpr-using-the-cares-registry
#17
Manali Shah, Cherie Bartram, Kevin Irwin, Kimberly Vellano, Bryan McNally, Timothy Gallagher, Robert Swor
OBJECTIVES: Dispatch-assisted cardiopulmonary resuscitation (DA-CPR) has been shown to improve cardiac arrest survival. Recent literature has proposed dispatch metrics for provision of this intervention. Our objectives are to: use the Cardiac Arrest Registry to Enhance Survival (CARES) to compare current practice to proposed DA-CPR guidelines; describe barriers to DA-CPR; and assess the association of DA-CPR with out-of-hospital cardiac arrest (OHCA) survival. METHODS: We reviewed data from structured dispatch reviews of 911 OHCA calls from 1/1/14-12/31/15...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29220414/detection-of-spontaneous-pulse-using-the-acceleration-signals-acquired-from-cpr-feedback-sensor-in-a-porcine-model-of-cardiac-arrest
#18
Liang Wei, Gang Chen, Zhengfei Yang, Tao Yu, Weilun Quan, Yongqin Li
BACKGROUND: Reliable detection of return of spontaneous circulation with minimal interruptions of chest compressions is part of high-quality cardiopulmonary resuscitation (CPR) and routinely done by checking pulsation of carotid arteries. However, manual palpation was time-consuming and unreliable even if performed by expert clinicians. Therefore, automated accurate pulse detection with minimal interruptions of chest compression is highly desirable during cardiac arrest especially in out-of-hospital settings...
2017: PloS One
https://www.readbyqxmd.com/read/29219009/micrornas-as-potential-prognosticators-of-neurological-outcome-in-out-of-hospital-cardiac-arrest-patients
#19
Sarah S Gul, Karl Huesgen, Kevin K Wang, Joseph A Tyndall
Out-of-hospital cardiac arrest survival rates have increased due to advancement in resuscitative measures, yet approximately 90% of survivors ultimately die or have severe neurologic dysfunction caused by ischemic injury. Currently, there are few early prognostic indicators of which patients have possibility of meaningful recovery. This leads to uncertainty for families and clinicians, as well as aggressive, invasive and expensive treatments despite medical futility. Several biomarkers investigated in traumatic brain injury have shown prognostication potential in ischemic brain injury...
December 8, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29217853/comprehensive-cardiopulmonary-life-support-ccls-for-cardiopulmonary-resuscitation-by-trained-paramedics-and-medics-inside-the-hospital
#20
Rakesh Garg, Syed Moied Ahmed, Mukul Chandra Kapoor, Ssc Chakra Rao, Bibhuti Bhusan Mishra, M Venkatagiri Kalandoor, Baljit Singh, Jigeeshu Vasishtha Divatia
The cardiopulmonary resuscitation (CPR) guideline of comprehensive cardiopulmonary life support (CCLS) for management of the patient with cardiopulmonary arrest in adults provides an algorithmic step-wise approach for optimal outcome of the patient inside the hospital by trained medics and paramedics. This guideline has been developed considering the infrastructure of healthcare delivery system in India. This is based on evidence in the international and national literature. In the absence of data from the Indian population, the extrapolation has been made from international data, discussed with Indian experts and modified accordingly to ensure their applicability in India...
November 2017: Indian Journal of Anaesthesia
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