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In-hospital cardiac arrest

Mayureshkumar Pareek, Vandana Parmar, Jigisha Badheka, Nirmalyo Lodh
Background and Aims: Nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills to be able to implement effective interventions during in-hospital cardiac arrest. The aim of this descriptive study was to assess mortality impact after nurses' CPR training with pre-CPR training data at our institute. Methods: Training regarding CPR was given to nurses, and CPR mortality 1-year before basic life support (BLS) and advanced cardiac life support (ACLS) training were collected and compared with post-training 1-year CPR mortality...
May 2018: Indian Journal of Anaesthesia
Jessica R Balderston, Zachary M Gertz, Kenneth A Ellenbogen, Kelly P Schaaf, Joseph P Ornato
BACKGROUND: Several characteristics of the ventricular fibrillation (VF) waveform during cardiac arrest are associated with defibrillation success, including peak amplitude in the seconds prior to defibrillation. It is not known if immediate pre-defibrillation amplitude is associated with successful defibrillation, return of spontaneous circulation (ROSC) or survival to hospital discharge (SHD). METHODS: We analyzed automated external defibrillation recordings of 80 patients with out-of-hospital VF cardiac arrest who received 284 defibrillations...
July 2018: American Heart Journal
Ryan J Anderson, Sayuri P Jinadasa, Leeyen Hsu, Tiffany Bita Ghafouri, Sanjeev Tyagi, Jisha Joshua, Ariel Mueller, Daniel Talmor, Rebecca E Sell, Jeremy R Beitler
BACKGROUND: Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognostic and therapeutic value. METHODS: A two-hospital cohort was assembled of patients in shock following OHCA. Left ventricular ejection fraction (LVEF) was assessed via echocardiography or cardiac ventriculography within 1 day post arrest and used to delineate shock physiology...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
John P Jones, Tristan Ramcharan, Milind Chaudhari, Vinay Bhole, Karen Mcleod, Shankar Sadagopan, Orhan Uzun, Andrew Parry, Jan Till, Colin J McMahon, Alan G Stuart, Mark A Walsh
BACKGROUND: Although ventricular fibromas are a rare, they are the second most common type of cardiac tumor in children. While histologically benign, they have a propensity to cause malignant arrhythmias, with cardiac arrest often being the first presentation.; OBJECTIVE: To evaluate the arrhythmia risk, and management strategies for pediatric ventricular fibromas. METHODS: Fifteen centers in the British Paediatric Arrhythmia Group network were contacted to partake in the study to contribute cases...
June 12, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Jolande A Zijlstra, Rudolph W Koster, Marieke T Blom, Freddy K Lippert, Leif Svensson, Johan Herlitz, Jo Kramer-Johansen, Mattias Ringh, Mårten Rosenqvist, Thea Palsgaard Møller, Hanno L Tan, Stefanie G Beesems, Michiel Hulleman, Andreas Claesson, Fredrik Folke, Theresa Mariero Olasveengen, Mads Wissenberg, Carolina Malta Hansen, Soren Viereck, Jacob Hollenberg
BACKGROUND: In the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (AEDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. The aim of this study was to study the association between different defibrillation strategies on survival rates over time in Copenhagen, Stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-EMS defibrillation increased over time and was associated with increased survival...
June 14, 2018: Heart: Official Journal of the British Cardiac Society
Kylie H Kang, William Grubb, Komal Sawlani, Michael K Gibson, Christopher J Hoimes, Lisa R Rogers, Pierre Lavertu, Min Yao
BACKGROUND: We present a case of myositis and possible overlapping neuromuscular junction disorder following treatment with nivolumab for recurrent/metastatic head and neck squamous cell carcinoma (HNSCC). METHODS: We report a 75-year-old man with recurrent stage IVA, T1N2cM0 oral cavity HNSCC treated with weight-dosed nivolumab who presented three weeks later with severe fatigue, generalized weakness, and bilateral ptosis. Evaluation demonstrated elevated creatine kinase and myopathic motor units on electromyography, supporting a diagnosis of an underlying muscle disease...
June 5, 2018: American Journal of Otolaryngology
Andrew Lockey, Yiqun Lin, Adam Cheng
OBJECTIVES: The objective of this study was to evaluate the impact of the prior participation of one or more members of the adult resuscitation team in an accredited advanced life support course on patient outcomes (return of spontaneous circulation, survival to discharge, survival to 30 days, and survival to 1 year). METHODS: A systematic search of Medline, CINAHL, Embase, ERIC, and Cochrane databases was conducted through 6 March 2018. We included randomised and observational studies in any language...
June 11, 2018: Resuscitation
Chenxi Song, Rui Fu, Kefei Dou, Jingang Yang, Haiyan Xu, Xiaojin Gao, Wei Li, Guofeng Gao, Zhiyong Zhao, Jia Liu, Yuejin Yang
Risk stratification of patients with acute myocardial infarction (AMI) is of clinical significance. Although there are many existing risk scores, periodic update is required to reflect contemporary patient profile and management. The present study aims to develop a risk model to predict in-hospital death among contemporary AMI patients as soon as possible after admission. We included 23417 AMI patients from China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014 and extracted relevant data...
June 13, 2018: Scientific Reports
Ludvig Elfwén, Rickard Lagedal, Stefan James, Martin Jonsson, Ulf Jensen, Mattias Ringh, Andreas Claesson, Jonas Oldgren, Johan Herlitz, Sten Rubertsson, Per Nordberg
BACKGROUND: The potential benefit of early coronary angiography in out-of-hospital cardiac arrest (OHCA) patients without ST elevation on ECG is unclear. The aim of this study was to evaluate the association between early coronary angiography and survival in these patients. METHODS: Nationwide observational study between 2008 and 2013. Included were patients admitted to hospital after witnessed OHCA, with shockable rhythm, age 18 to 80 years and unconscious. Patients with ST-elevation on ECG were excluded...
June 2018: American Heart Journal
Mario Krammel, Sebastian Schnaubelt, David Weidenauer, Markus Winnisch, Matthias Steininger, Jakob Eichelter, Thomas Hamp, Raphael van Tulder, Patrick Sulzgruber
BACKGROUND: The 'chain of survival'-including early call for help, early cardiopulmonary resuscitation (CPR) and early defibrillation-represents the most beneficial approach for favourable patient outcome after out-of-hospital cardiac arrest (OHCA). Despite increasing numbers of publicly accessible automated external defibrillators (AED) and interventions to increase public awareness for basic life support (BLS), the number of their use in real-life emergency situations remains low. METHODS: In this prospective population-based cross-sectional study, a total of 501 registered inhabitants of Vienna (Austria) were randomly approached via telephone calls between 08/2014 and 09/2014 and invited to answer a standardized questionnaire in order to identify public knowledge and awareness of BLS and AED-use...
2018: PloS One
Katharine Boyle, Ryan Felling, Alvin Yiu, Wejdan Battarjee, Jamie McElrath Schwartz, Cynthia Salorio, Melania M Bembea
OBJECTIVES: The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. DATA SOURCES: We conducted electronic searches of PubMed, Scopus, Web of Science, CINAHL, Cochrane, and EMBASE. STUDY SELECTION: Inclusion criteria included publication dates 2000-2016, patient ages 0-18 years, and use of standardized measures to evaluate outcomes after extracorporeal membrane oxygenation...
June 11, 2018: Pediatric Critical Care Medicine
Alejandro Pizano, Felix Ramon Montes, Marisol Carreño, Dario Echeverri, Juan Pablo Umaña
BACKGROUND: Choosing a cardioplegic solution is a significant issue in modern cardiac surgery. Although different options are available, the optimal strategy for myocardial protection has not been established. The aim of this study was to compare intraoperative and postoperative effects of histidine-tryptophan-ketoglutarate (HTK) solution with those of standard blood cardioplegia with St Thomas No 2 solution. The study was conducted using a large cohort of adult patients undergoing complex cardiac surgery...
May 11, 2018: Heart Surgery Forum
Hai-Wei Liu, Ya-Ling Han, Quan-Min Jin, Xiao-Zeng Wang, Ying-Yan Ma, Geng Wang, Bin Wang, Kai Xu, Yi Li, Shao-Liang Chen
Background: Very few data have been reported for ST-segment elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) occlusion, and very little is known about the results of this subgroup of patients who underwent primary percutaneous coronary intervention (PCI). The aim of this study was to determine the clinical features and outcomes of patients with STEMI who underwent primary PCI for acute ULMCA occlusion. Methods: From January 2000 to February 2014, 372 patients with STEMI caused by ULMCA acute occlusion (ULMCA-STEMI) who underwent primary PCI at one of two centers were enrolled...
June 20, 2018: Chinese Medical Journal
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with inhospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011 to 2014 (n = 607) were retrospectively reviewed to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
July 2018: Shock
Giacomo Veronese, Manlio Cipriani, Duccio Petrella, Patrizia Pedrotti, Cristina Giannattasio, Andrea Garascia, Fabrizio Oliva, Karin Klingel, Maria Frigerio, Enrico Ammirati
: Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation...
June 7, 2018: Journal of Cardiovascular Medicine
Rui Fu, Chenxi Song, Jingang Yang, Yan Wang, Bao Li, Haiyan Xu, Xiaojin Gao, Wei Li, Jia Liu, Kefei Dou, Yuejin Yang
BACKGROUND: Accurate risk stratification of non-ST segment elevation myocardial infarction (NSTEMI) patients is important due to great variability in mortality risk, but, to date, no prediction model has been available. The aim of this study was therefore to establish a risk score to predict in-hospital mortality risk in NSTEMI patients.Methods and Results:We enrolled 5,775 patients diagnosed with NSTEMI from the China Acute Myocardial Infarction (CAMI) registry and extracted relevant data...
June 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
J A Barea-Mendoza, L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, M Valiente-Fernández, A Rodríguez-Biendicho, J C Montejo González, M Chico-Fernández
BACKGROUND: Hypoperfusion plays a central role in shock states, and has been proposed as a coagulopathy trigger. The study of the rotational thromboelastometry (ROTEM) profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states. OUTCOME: To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis. DESIGN: A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest (CA)...
June 7, 2018: Medicina Intensiva
Annette Waldemar, Ingela Thylen
BACKGROUND: Family-witnessed resuscitation (FWR) offers the option for family to be present during a cardiac arrest, which has been proven to help them in their grieving process. International guidelines highlight the importance of FWR, but this has not yet been widely implemented in clinical practice in Europe. AIM: Explore nurses' and physicians' experiences and attitudes toward FWR in cardiac care units. METHODS: Cross-sectional web-based multicentre survey study including the seven university hospitals in Sweden, with 189 participants...
June 7, 2018: International Emergency Nursing
John K Yue, Angel Ordaz, Ethan A Winkler, Hansen Deng, Catherine G Suen, John F Burke, Andrew K Chan, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECTIVE: Predictors of surgical outcomes following traumatic axis (C2) fractures in octogenarians remain undercharacterized. METHODS: Patients aged ≥80-years undergoing cervical spine surgery following traumatic C2 fractures were extracted from the National Sample Program of the National Trauma Data Bank (2003-2012). Outcomes include overall inpatient complications, individual complications >1% incidence, hospital length of stay (HLOS), discharge disposition, and mortality...
June 7, 2018: World Neurosurgery
Dong Keon Lee, Yong Sung Cha, Oh Hyun Kim, Kyoung Chul Cha, Kang Hyun Lee, Sung Oh Hwang, Hyun Kim, Young Hwan Lee, Minjung Kathy Chae
BACKGROUND: An automatic simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device is an apparatus that performs CPR by providing simultaneous cyclic compressions of the thorax with a thoracic strap and compression of the sternum with a piston. OBJECTIVE: This study was conducted to compare the hemodynamic effects of CPR with an automatic SST-CPR device to those with standard CPR (STD-CPR) in cardiac arrest patients. METHODS: A randomized trial was performed on victims of out-of-hospital cardiac arrest resistant to initial 20 min of CPR after emergency department (ED) arrival...
June 6, 2018: Journal of Emergency Medicine
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