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In-hospital cardiac arrest

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https://www.readbyqxmd.com/read/28102924/current-practices-related-to-family-presence-during-acute-deterioration-in-adult-emergency-department-patients
#1
Megan J Youngson, Judy Currey, Julie Considine
AIMS: To explore the characteristics and interactions of clinicians, patients and family members during management of the deteriorating adult patient in the Emergency Department. BACKGROUND: Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over that last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28102532/time-to-epinephrine-in-out-of-hospital-cardiac-arrest-a-retrospective-analysis-of-intraosseous-versus-intravenous-access
#2
Elliot M Ross, Julian Mapp, Chetan Kharod, David A Wampler, Christopher Velasquez, David A Miramontes
INTRODUCTION: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. METHODS: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101942/the-use-of-hemodynamic-support-in-massive-pulmonary-embolism
#3
Neal Kumar Bhatia, Neal W Dickert, Habib Samady, Vasilis Babaliaros
Massive pulmonary embolism is life threatening and can present as cardiogenic shock and cardiac arrest. We report a case of a 47-year-old male who arrested during his postoperative hospitalization and was found to have a massive pulmonary embolism with bilateral involvement of the pulmonary arteries. Given his profound shock and right ventricular failure, an Impella RP was used to stabilize his acute right ventricular failure while percutaneous embolectomy and thrombolysis was used to treat the pulmonary embolism...
January 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28099640/cardiopulmonary-resuscitation-of-adults-with-in-hospital-cardiac-arrest-using-the-utstein-style
#4
Rose Mary Ferreira Lisboa da Silva, Bruna Adriene Gomes de Lima E Silva, Fábio Junior Modesto E Silva, Carlos Faria Santos Amaral
Objective: The objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style. Methods: This study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year. Results: The study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099639/failure-to-activate-the-in-hospital-emergency-team-causes-and-outcomes
#5
Vera Barbosa, Ernestina Gomes, Senio Vaz, Gustavo Azevedo, Gonçalo Fernandes, Amélia Ferreira, Rui Araujo
Objective: To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. Methods: A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099439/single-versus-serial-measurements-of-neuron-specific-enolase-and-prediction-of-poor-neurological-outcome-in-persistently-unconscious-patients-after-out-of-hospital-cardiac-arrest-a-ttm-trial-substudy
#6
Sebastian Wiberg, Christian Hassager, Pascal Stammet, Matilde Winther-Jensen, Jakob Hartvig Thomsen, David Erlinge, Michael Wanscher, Niklas Nielsen, Tommaso Pellis, Anders Åneman, Hans Friberg, Jan Hovdenes, Janneke Horn, Jørn Wetterslev, John Bro-Jeppesen, Matthew P Wise, Michael Kuiper, Tobias Cronberg, Yvan Gasche, Yvan Devaux, Jesper Kjaergaard
BACKGROUND: Prediction of neurological outcome is a crucial part of post cardiac arrest care and prediction in patients remaining unconscious and/or sedated after rewarming from targeted temperature management (TTM) remains difficult. Current guidelines suggest the use of serial measurements of the biomarker neuron-specific enolase (NSE) in combination with other predictors of outcome in patients admitted after out-of-hospital cardiac arrest (OHCA). This study sought to investigate the ability of NSE to predict poor outcome in patients remaining unconscious at day three after OHCA...
2017: PloS One
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#7
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28096823/comparison-of-del-nido-cardioplegia-and-st-thomas-hospital-solution-two-types-of-cardioplegia-in-adult-cardiac-surgery
#8
Prashant Mishra, Ranjit B Jadhav, Chandan Kumar Ray Mohapatra, Jayant Khandekar, Chaitanya Raut, Ganesh Kumar Ammannaya, Harsh S Seth, Jaskaran Singh, Vaibhav Shah
INTRODUCTION: St. Thomas' cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. AIM: To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. MATERIAL AND METHODS: The study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28093867/paramedic-resuscitation-competency-a-survey-of-australian-and-new-zealand-emergency-medical-services
#9
Kylie Dyson, Janet E Bray, Karen Smith, Stephen Bernard, Lahn Straney, Judith Finn
OBJECTIVE: We have previously established that paramedic exposure to out-of-hospital cardiac arrest (OHCA) is relatively rare, therefore clinical exposure cannot be relied on to maintain resuscitation competency. We aimed to identify the current practices within emergency medical services (EMS) for developing and maintaining paramedic resuscitation competency. METHODS: We developed and conducted an online cross-sectional survey of Australian and New Zealand EMS in 2015...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28092783/pulmonary-emboli-cardiac-arrest-with-cpr-complication-liver-laceration-and-massive-abdominal-bleed-a-case-report
#10
John Lundqvist, Jan G Jakobsson
INTRODUCTION: Massive pulmonary emboli may cause right ventricular failure and backward stasis with parenchymal organ swelling thus increasing the risk for laceration, e.g. if CPR is needed. PRESENTATION OF CASE: A 28-year-old Colombian female with no medical history but taking contraceptive pills and having had a recent longer flight was admitted to Danderyds hospital Emergency Department because of respiratory failure. She developed cardiac arrest in the emergence department following the emergent diagnosis of pulmonary emboli...
January 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28088937/traumatic-cardiac-injury-experience-from-a-level-1-trauma-centre
#11
Biplab Mishra, Amit Gupta, Sushma Sagar, Maneesh Singhal, Subodh Kumar
PURPOSE: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. METHODS: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28087288/outcome-of-adult-patients-attended-by-rapid-response-teams-a-systematic-review-of-the-literature
#12
REVIEW
Joonas Tirkkonen, Tero Tamminen, Markus Skrifvars
BACKGROUND: An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome. METHODS: A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28087286/incidence-and-survival-outcome-according-to-heart-rhythm-during-resuscitation-attempt-in-out-of-hospital-cardiac-arrest-patients-with-presumed-cardiac-etiology
#13
Shahzleen Rajan, Fredrik Folke, Steen Møller Hansen, Carolina Malta Hansen, Kristian Kragholm, Thomas A Gerds, Freddy K Lippert, Lena Karlsson, Sidsel Møller, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen, Mads Wissenberg
BACKGROUND: Knowledge about heart rhythm conversion from non-shockable to shockable rhythm during resuscitation attempt after out-of-hospital cardiac arrest (OHCA) and following chance of survival is limited and inconsistent. METHODS: We studied 13,860 patients with presumed cardiac-caused OHCA not witnessed by the emergency medical services from the Danish Cardiac Arrest Register (2005-2012). Patients were stratified according to rhythm: shockable, converted shockable (based on receipt of subsequent defibrillation) and sustained non-shockable rhythm...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#14
Salvatore Brugaletta, Giancarla Scalone, Ana Paula Dantas, Luis Ortega-Paz, Manel Garabito, Mercè Roqué, Victoria Martin, Monica Masotti, Xavier Freixa, Manel Sabaté
BACKGROUND: Therapeutic hypothermia (HT) in out-of-hospital cardiac arrest STEMI patients aims to improve their neurological prognosis, but it has been associated with slow coronary flow and cardiac thrombotic events. We sought to serially assess endothelial function during the first 48h after admission in out-of-hospital cardiac arrest STEMI patients, under therapeutic hypothermia (HT). METHODS: From January 2015 to August 2015, eighteen consecutive out-of-hospital cardiac arrest STEMI patients eligible for primary PCI received HT at admission and were included in the study (HT group)...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087110/systematic-review-and-meta-analysis-of-randomized-controlled-trials-assessing-safety-and-efficacy-of-posterior-pericardial-drainage-in-patients-undergoing-heart-surgery
#15
Mirosław Gozdek, Wojciech Pawliszak, Wojciech Hagner, Paweł Zalewski, Janusz Kowalewski, Domenico Paparella, Thierry Carrel, Lech Anisimowicz, Mariusz Kowalewski
OBJECTIVES: To investigate the potential beneficial effects of posterior pericardial drainage in patients undergoing heart surgery. METHODS: Multiple online databases and relevant congress proceedings were screened for randomized controlled trials assessing the efficacy and safety of posterior pericardial drainage, defined as posterior pericardiotomy incision, chest tube to posterior pericardium, or both. Primary endpoint was in-hospital/30 days' cardiac tamponade...
December 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28087097/quick-epinephrine-administration-induces-favorable-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients
#16
H Ueta, H Tanaka, S Tanaka, R Sagisaka, H Takyu
OBJECTIVE: This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month. METHODOLOGY: A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16min after 119 called and adrenaline was then administered within 22min of after contact. PATIENTS DIVIDED INTO TWO GROUPS: Patients were contacted within 8min of the 119 call (n=6956), and were contacted between 8 and 16min after the call (n=6370)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28081310/a-simple-risk-score-in-acute-st-elevation-myocardial-infarction-modified-acef-age-creatinine-and-ejection-fraction-score
#17
Arzu Kalaycı, Vecih Oduncu, Çetin Geçmen, Selim Topcu, Can Yücel Karabay, İbrahim Akın İzgi, Cevat Kırma
BACKGROUND/AIM: The aim of this study was to evaluate if the modified ACEF (age, creatinine, and ejection fraction) score is a predictor of major adverse cardiac and cerebrovascular events during 1 year of follow-up in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: We retrospectively enrolled 1632 consecutive patients who were admitted to our emergency department diagnosed with STEMI within 12 h of chest pain and treated with primary PCI...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#18
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073769/aldosterone-does-not-predict-cardiovascular-events-following-acute-coronary-syndrome-in-patients-initially-without-heart-failure
#19
Reynaria Pitts, Elise Gunzburger, Christie M Ballantyne, Philip J Barter, David Kallend, Lawrence A Leiter, Eran Leitersdorf, Stephen J Nicholls, Prediman K Shah, Jean-Claude Tardif, Anders G Olsson, John J V McMurray, John Kittelson, Gregory G Schwartz
BACKGROUND: Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. METHODS AND RESULTS: To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome...
January 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28069624/external-validation-of-the-revised-cardiac-risk-index-and-update-of-its-renal-variable-to-predict-30-day-risk-of-major-cardiac-complications-after-non-cardiac-surgery-rationale-and-plan-for-analyses-of-the-vision-study
#20
Pavel S Roshanov, Michael Walsh, P J Devereaux, S Danielle MacNeil, Ngan N Lam, Ainslie M Hildebrand, Rey R Acedillo, Marko Mrkobrada, Clara K Chow, Vincent W Lee, Lehana Thabane, Amit X Garg
INTRODUCTION: The Revised Cardiac Risk Index (RCRI) is a popular classification system to estimate patients' risk of postoperative cardiac complications based on preoperative risk factors. Renal impairment, defined as serum creatinine >2.0 mg/dL (177 µmol/L), is a component of the RCRI. The estimated glomerular filtration rate has become accepted as a more accurate indicator of renal function. We will externally validate the RCRI in a modern cohort of patients undergoing non-cardiac surgery and update its renal component...
January 9, 2017: BMJ Open
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