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In-hospital cardiac arrest

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https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#1
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28641984/bi-objective-approach-for-placing-ground-and-air-ambulance-base-and-helipad-locations-in-order-to-optimize-ems-response
#2
Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28639949/comet-assay-in-evaluating-deoxyribonucleic-acid-damage-after-out-of-hospital-cardiac-arrest
#3
Radka Hazuková, Martina Rezácová, Renata Köhlerová, Tomáš Tomek, Eva Cermáková, Jaromír Kocí, Miloslav Pleskot
OBJECTIVE: This study aimed to investigate whether out-of-hospital cardiac arrest (OHCA) may induce severe DNA damage measured using comet assay in successfully resuscitated humans and to evaluate a short-term prognostic role. METHODS: In this prospective, controlled, blinded study (1/2013-1/2014), 41 patients (age, 63±14 years) successfully resuscitated from non traumatic OHCA and 10 healthy controls (age, 53±17 years) were enrolled. DNA damage [double-strand breaks (DSBs) and single-strand breaks (SSBs)] was measured using comet assay in peripheral lymphocytes sampled at admission...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28637881/physical-activity-and-prognosis-in-the-treatment-of-preserved-cardiac-function-heart-failure-with-an-aldosterone-antagonist-topcat-trial
#4
Sheila Hegde, Brian Claggett, Amil M Shah, Eldrin F Lewis, Inder S Anand, Sanjiv J Shah, Nancy K Sweitzer, James C Fang, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
Background -Physical activity (PA) is inversely associated with adverse cardiovascular (CV) outcomes in healthy populations but the impact of physical activity in patients with heart failure with preserved ejection fraction (HFpEF) is less well characterized. Methods -The baseline self-reported PA of 1751 subjects enrolled in the Americas region of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial was categorized as poor, intermediate, or ideal PA using American Heart Association (AHA) criteria...
June 21, 2017: Circulation
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#5
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#6
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28635305/factors-modifying-performance-of-a-novel-citizen-text-message-alert-system-in-improving-survival-of-out-of-hospital-cardiac-arrest
#7
Ruud Wm Pijls, Patty J Nelemans, Braim M Rahel, Anton Pm Gorgels
AIMS: Recently we found that the text message alert system increases survival of sudden out-of-hospital cardiac arrest. The aim of the present study is to explore the contribution of the system to survival specifically in resuscitation settings with prolonged delay of start of resuscitation. METHODS AND RESULTS: Data were used from consecutive patients resuscitated for out-of-hospital cardiac arrest during a two-year period in the Dutch province Limburg. Survival of 291 cases with out-of-hospital cardiac arrest where one or more volunteers attended (Scenario 2) was compared with survival of 131 cases with out-of-hospital cardiac arrest where no volunteers attended and only standard care was given (Scenario 1)...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#8
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
June 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28629472/protein-s100-as-outcome-predictor-after-out-of-hospital-cardiac-arrest-and-targeted-temperature-management-at-33%C3%A2-%C3%A2-c-and-36%C3%A2-%C3%A2-c
#9
Pascal Stammet, Josef Dankiewicz, Niklas Nielsen, François Fays, Olivier Collignon, Christian Hassager, Michael Wanscher, Johan Undèn, Jorn Wetterslev, Tommaso Pellis, Anders Aneman, Jan Hovdenes, Matt P Wise, Georges Gilson, David Erlinge, Janneke Horn, Tobias Cronberg, Michael Kuiper, Jesper Kjaergaard, Yvan Gasche, Yvan Devaux, Hans Friberg
BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28627349/-clinical-application-of-cardiopulmonary-resuscitation-with-abdominal-lifting-and-compression-in-emergency-treatment
#10
Jie Wang, Guolan Wu, Ronghua Yang, Yonghong Wang, Shunping Wang, Honglin Li, Shouhui Wang, Manguo Zhao, Xusheng Li, Yan Peng
OBJECTIVE: To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma. METHODS: Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled, and they were divided into abdominal lifting and compression group (n = 32) and unarmed abdominal compression group (n = 34) by random number table...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625194/preoperative-malnutrition-is-associated-with-increased-mortality-and-adverse-outcomes-after-paediatric-cardiac-surgery
#11
Faith Ross, Gregory Latham, Denise Joffe, Michael Richards, Jeremy Geiduschek, Michael Eisses, Douglas Thompson, Monique Radman
BACKGROUND: Malnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery. METHODS: We conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children's Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes...
June 19, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28624878/a-combination-of-three-repurposed-drugs-administered-at-reperfusion-as-a-promising-therapy-for-postischemic-brain-injury
#12
I-Chen Yu, Ping-Chang Kuo, Jui-Hung Yen, Hallel C Paraiso, Eric T Curfman, Benecia C Hong-Goka, Robert D Sweazey, Fen-Lei Chang
Cerebral ischemia leads to multifaceted injury to the brain. A polytherapeutic drug that can be administered immediately after reperfusion may increase protection to the brain by simultaneously targeting multiple deleterious cascades. This study evaluated efficacy of the combination of three clinically approved drugs: lamotrigine, minocycline, and lovastatin, using two mouse models: global and focal cerebral ischemia induced by transient occlusion of the common carotid arteries or the middle cerebral artery, respectively...
June 17, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28624594/variability-in-the-initiation-of-resuscitation-attempts-by-emergency-medical-services-personnel-during-out-of-hospital-cardiac-arrest
#13
Steven C Brooks, Robert H Schmicker, Sheldon Cheskes, James Christenson, Alan Craig, Mohamud Daya, Peter J Kudenchuk, Graham Nichol, Dana Zive, Laurie J Morrison
BACKGROUND: Some patients with out-of-hospital cardiac arrest (OHCA) assessed by emergency medical services (EMS) do not receive attempts at resuscitation on the basis of perceived futility. AIMS: 1) To measure variability in the initiation of resuscitation attempts in EMS-assessed OHCA patients across EMS agencies, 2) to evaluate the association between selected EMS agency characteristics and the proportion of patients receiving resuscitation attempts, and 3) to evaluate the association between proportion receiving resuscitation attempts and survival...
June 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28624593/double-sequential-defibrillation-therapy-for-out-of-hospital-cardiac-arrests-the-london-experience
#14
Amber C Emmerson, Mark Whitbread, Rachael T Fothergill
BACKGROUND: Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF...
June 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28624592/post-anoxic-quantitative-mri-changes-may-predict-emergence-from-coma-and-functional-outcomes-at-discharge
#15
Alexandra S Reynolds, Xiaotao Guo, Elizabeth Matthews, Daniel Brodie, Leroy E Rabbani, David J Roh, Soojin Park, Jan Claassen, Mitchell S V Elkind, Binsheng Zhao, Sachin Agarwal
BACKGROUND: Traditional predictors of neurological prognosis after cardiac arrest are unreliable after targeted temperature management. Absence of pupillary reflexes remains a reliable predictor of poor outcome. Diffusion-weighted imaging has emerged as a potential predictor of recovery, and here we compare imaging characteristics to pupillary exam. METHODS: We identified 69 patients who had MRIs within seven days of arrest and used a semi-automated algorithm to perform quantitative volumetric analysis of apparent diffusion coefficient (ADC) sequences at various thresholds...
June 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28624147/characteristics-and-outcome-among-14-933-adult-cases-of-in-hospital-cardiac-arrest-a-nationwide-study-with-the-emphasis-on-gender-and-age
#16
Nooraldeen Al-Dury, Araz Rawshani, Johan Israelsson, Anneli Strömsöe, Solveig Aune, Jens Agerström, Thomas Karlsson, Annica Ravn-Fischer, Johan Herlitz
AIM: To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age. METHODS: Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49years), middle-aged (50-64years) and older (65years and above)...
June 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28622215/influence-of-gender-on-the-performance-of-cardiopulmonary-rescue-teams-a-randomized-prospective-simulator-study
#17
Simon Adrian Amacher, Cleo Schumacher, Corinne Legeret, Franziska Tschan, Norbert Karl Semmer, Stephan Marsch, Sabina Hunziker
OBJECTIVES: Little is known about the influence of gender on resuscitation performance which may improve future education in resuscitation. The aim of this study was to compare female and male rescuers in regard to cardiopulmonary resuscitation and leadership performance. DESIGN: Prospective, randomized simulator study. SETTING: High-fidelity patient simulator center of the medical ICU, University Hospitals Basel (Switzerland). SUBJECTS: Two hundred sixteen volunteer medical students (108 females and 108 males) of two Swiss universities in teams of three...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28617967/holter-monitored-sudden-cardiac-arrest-after-atrioventricular-junction-ablation
#18
Victor Waldmann, Eloi Marijon, Nicolas Combes
We present a case of sudden cardiac arrest seven hours after radiofrequency ablation of the atrioventricular junction for symptomatic permanent atrial fibrillation unresponsive to medical therapy. The Holter monitoring revealed a progressive increasing of QT interval after the procedure, highlighting the repolarization instability after acute changes in heart rates associated with modification of ventricular activation, leading to occurrence of short coupling interval ventricular extra beats and finally to a "Torsade de Pointes"...
June 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28617130/use-of-automated-external-defibrillators-saves-lives
#19
(no author information available yet)
Ambulance services in England attempt the resuscitation of almost 30,000 people who have experienced out-of-hospital cardiac arrest (OHCA) each year. Outcomes can be much improved if automated external defibrillators (AEDs) are used immediately after cardiac arrest and before emergency services arrive on the scene.
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28617118/not-enough-is-done-to-cut-risk-of-death-after-cardiac-arrest
#20
Christian Duffin
How much is being done to cut the number of people who die after cardiac arrests in public places? Not enough, says a group of cardiac experts and campaigners on the Out of Hospital Cardiac Arrest (OHCA) steering group.
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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