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https://www.readbyqxmd.com/read/27865776/post-cardiac-arrest-shock-treated-with-veno-arterial-extracorporeal-membrane-oxygenation-an-observational-study-and-propensity-score-analysis
#1
Wulfran Bougouin, Nadia Aissaoui, Alain Combes, Nicolas Deye, Lionel Lamhaut, Daniel Jost, Carole Maupain, Frankie Beganton, Adrien Bouglé, Nicole Karam, Florence Dumas, Eloi Marijon, Xavier Jouven, Alain Cariou
PURPOSE: Cardiogenic shock due to post-resuscitation myocardial dysfunction is a major cause of mortality among patients hospitalized after cardiac arrest (CA). Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been proposed in the most severe cases but the level of evidence is very low. We assessed characteristics, outcome and prognostic factors of patients treated with VA-ECMO for post-CA shock. METHODS: Using a large regional registry, we focused on all CA admitted in ICU...
November 17, 2016: Resuscitation
https://www.readbyqxmd.com/read/27618183/different-respiratory-rates-during-resuscitation-in-a-pediatric-animal-model-of-asphyxial-cardiac-arrest
#2
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Jesús López-Herce
AIMS: Actual resuscitation guidelines recommend 10 respirations per minute (rpm) for advanced pediatric life support. This respiratory rate (RR) is much lower than what is physiological for children. The aim of this study is to compare changes in ventilation, oxygenation, haemodynamics and return of spontaneous circulation (ROSC) rates with three RR. METHODS: An experimental model of asphyxial cardiac arrest (CA) in 46 piglets (around 9.5 kg) was performed. Resuscitation with three different RR (10, 20 and 30 rpm) was carried out...
2016: PloS One
https://www.readbyqxmd.com/read/27581739/pre-hospital-portable-monitoring-of-cerebral-regional-oxygen-saturation-rso2-in-seven-patients-with-out-of-hospital-cardiac-arrest
#3
Tomoya Hirose, Tadahiko Shiozaki, Junji Nomura, Yasuto Hamada, Keiichi Sato, Kazuya Katsura, Naoki Ehara, Akinori Wakai, Kentaro Shimizu, Mitsuo Ohnishi, Sumito Hayashida, Daikai Sadamitsu, Takeshi Shimazu
BACKGROUND: In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the pre-hospital setting. METHODS: We recently developed a portable rSO2 monitor that is small (170 × 100 × 50 mm in size and 600 g in weight) enough to carry in pre-hospital settings...
2016: BMC Research Notes
https://www.readbyqxmd.com/read/27546775/the-association-between-hemoglobin-concentration-and-neurologic-outcome-after-cardiac-arrest
#4
Nicholas J Johnson, Babette Rosselot, Sarah M Perman, Kalani Dodampahala, Munish Goyal, David F Gaieski, Anne V Grossestreuer
PURPOSE: The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients. METHODS: We conducted a retrospective cohort study using the Penn Alliance for Therapeutic Hypothermia (PATH) cardiac arrest registry. Inclusion criteria were resuscitated cardiac arrest (inhospital or out of hospital) and an Hgb value recorded within 24 hours of return of spontaneous circulation. The primary outcome was favorable neurologic status at hospital discharge...
July 17, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27473390/helium-ventilation-for-treatment-of-post-cardiac-arrest-syndrome-a-safety-and-feasibility-study
#5
Daniel Brevoord, Charlotte J P Beurskens, Walter M van den Bergh, Wim K Lagrand, Nicole P Juffermans, Jan M Binnekade, Benedikt Preckel, Janneke Horn
AIM: Besides supportive care, the only recommended treatment for comatose patients after cardiac arrest is target temperature management. Helium reduces ischaemic injury in animal models, and might ameliorate neurological injury in patients after cardiac arrest. As no studies exist on the use of helium in patients after cardiac arrest we investigated whether this is safe and feasible. METHODS: The study was an open-label single arm intervention study in a mixed-bed academic intensive care unit...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27412906/minnesota-resuscitation-consortium-s-advanced-perfusion-and-reperfusion-cardiac-life-support-strategy-for-out-of-hospital-refractory-ventricular-fibrillation
#6
Demetris Yannopoulos, Jason A Bartos, Cindy Martin, Ganesh Raveendran, Emil Missov, Marc Conterato, R J Frascone, Alexander Trembley, Kevin Sipprell, Ranjit John, Stephen George, Kathleen Carlson, Melissa E Brunsvold, Santiago Garcia, Tom P Aufderheide
BACKGROUND: In 2015, the Minnesota Resuscitation Consortium (MRC) implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory ventricular fibrillation/ventricular tachycardia (VF/VT). We report the outcomes of the initial 3-month period of operations. METHODS AND RESULTS: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol...
June 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27402395/association-of-arterial-oxygen-tension-during-in-hospital-cardiac-arrest-with-return-of-spontaneous-circulation-and-survival
#7
Jignesh K Patel, Elinor Schoenfeld, Puja B Parikh, Sam Parnia
BACKGROUND: Despite numerous advances in the delivery of resuscitative care, in-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. We sought to study the impact of arterial oxygen tension (Pao 2) on return of spontaneous circulation (ROSC) and survival to discharge in patients with IHCA. METHODS: The study population included 255 consecutive patients who underwent advanced cardiac life support-guided resuscitation from January 2012 to December 2013 for IHCA at an academic tertiary medical center...
July 11, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27383062/the-association-between-arterial-oxygen-tension-and-neurological-outcome-after-cardiac-arrest
#8
Nicholas J Johnson, Kalani Dodampahala, Babette Rosselot, Sarah M Perman, Mark E Mikkelsen, Munish Goyal, David F Gaieski, Anne V Grossestreuer
A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included...
July 6, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27344929/myocardial-perfusion-and-oxidative-stress-after-21-vs-100-oxygen-ventilation-and-uninterrupted-chest-compressions-in-severely-asphyxiated-piglets
#9
Anne Lee Solevåg, Georg M Schmölzer, Megan O'Reilly, Min Lu, Tze-Fun Lee, Lisa K Hornberger, Britt Nakstad, Po-Yin Cheung
AIM: Despite the minimal evidence, neonatal resuscitation guidelines recommend using 100% oxygen when chest compressions (CC) are needed. Uninterrupted CC in adult cardiopulmonary resuscitation (CPR) may improve CPR hemodynamics. We aimed to examine 21% oxygen (air) vs. 100% oxygen in 3:1 CC:ventilation (C:V) CPR or continuous CC with asynchronous ventilation (CCaV) in asphyxiated newborn piglets following cardiac arrest. METHODS: Piglets (1-3 days old) were progressively asphyxiated until cardiac arrest and randomized to 4 experimental groups (n=8 each): air and 3:1 C:V CPR, 100% oxygen and 3:1 C:V CPR, air and CCaV, or 100% oxygen and CCaV...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27328890/arterial-blood-gases-during-and-their-dynamic-changes-after-cardiopulmonary-resuscitation-a-prospective-clinical-study
#10
Walter Spindelboeck, Geza Gemes, Christa Strasser, Kathrin Toescher, Barbara Kores, Philipp Metnitz, Josef Haas, Gerhard Prause
PURPOSE: An arterial blood gas analysis (ABG) yields important diagnostic information in the management of cardiac arrest. This study evaluated ABG samples obtained during out-of-hospital cardiopulmonary resuscitation (OHCPR) in the setting of a prospective multicenter trial. We aimed to clarify prospectively the ABG characteristics during OHCPR, potential prognostic parameters and the ABG dynamics after return of spontaneous circulation (ROSC). METHODS: ABG samples were collected and instantly processed either under ongoing OHCPR performed according to current advanced life support guidelines or immediately after ROSC and data ware entered into a case report form along with standard CPR parameters...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27304210/return-of-spontaneous-circulation-is-not-affected-by-different-chest-compression-rates-superimposed-with-sustained-inflations-during-cardiopulmonary-resuscitation-in-newborn-piglets
#11
Elliott S Li, Po-Yin Cheung, Tze-Fun Lee, Min Lu, Megan O'Reilly, Georg M Schmölzer
OBJECTIVE: Recently, sustained inflations (SI) during chest compression (CC) have been suggested as an alternative to the current approach during neonatal resuscitation. However, the optimal rate of CC during SI has not yet been established. Our aim was to determine whether different CC rates during SI reduce time to return of spontaneous circulation (ROSC) and improve hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia. INTERVENTION AND MEASUREMENTS: Term newborn piglets were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia...
2016: PloS One
https://www.readbyqxmd.com/read/27255957/using-the-relationship-between-brain-tissue-regional-saturation-of-oxygen-and-mean-arterial-pressure-to-determine-the-optimal-mean-arterial-pressure-in-patients-following-cardiac-arrest-a-pilot-proof-of-concept-study
#12
Mypinder S Sekhon, Peter Smielewski, Tahara D Bhate, Penelope M Brasher, Denise Foster, David K Menon, Arun K Gupta, Marek Czosnyka, William R Henderson, Kenneth Gin, Graham Wong, Donald E Griesdale
INTRODUCTION: Prospectively assess cerebral autoregulation and optimal mean arterial pressure (MAPOPT) using the dynamic relationship between MAP and regional saturation of oxygen (rSO2) using near-infrared spectroscopy. METHODS: Feasibility study of twenty patients admitted to the intensive care unit following a cardiac arrest. All patients underwent continuous rSO2 monitoring using the INVOS(®) cerebral oximeter. ICM+(®) brain monitoring software calculates the cerebral oximetry index (COx) in real-time which is a moving Pearson correlation coefficient between 30 consecutive, 10-s averaged values of MAP and correspond rSO2 signals...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27174667/rhizome-extracts-of-curcuma-zedoaria-rosc-induce-caspase-dependant-apoptosis-via-generation-of-reactive-oxygen-species-in-filarial-parasite-setaria-digitata-in%C3%A2-vitro
#13
K S Senathilake, E H Karunanayake, S R Samarakoon, K H Tennekoon, E D de Silva
Human lymphatic filariasis (LF) is mainly caused by filarial parasite Wuchereria bancrofti and is the second leading cause of long term and permanent disability in tropical countries. To date, incapability to eliminate long lived adult parasites by current drugs remains the major challenge in the elimination of LF. Hence, in the current study, the efficacy of rhizome extracts of Curcuma zedoaria (a plant traditionally used in Sri Lanka in the management of LF) was evaluated as an effective filaricide in vitro...
August 2016: Experimental Parasitology
https://www.readbyqxmd.com/read/27071068/cerebral-oximetry-during-cardiac-arrest-a-multicenter-study-of-neurologic-outcomes-and-survival
#14
Sam Parnia, Jie Yang, Robert Nguyen, Anna Ahn, Jiawen Zhu, Loren Inigo-Santiago, Asad Nasir, Kim Golder, Shreyas Ravishankar, Pauline Bartlett, Jianjin Xu, David Pogson, Sarah Cooke, Christopher Walker, Ken Spearpoint, David Kitson, Teresa Melody, Mehboob Chilwan, Elinor Schoenfeld, Paul Richman, Barbara Mills, Nancy Wichtendahl, Jerry Nolan, Adam Singer, Stephen Brett, Gavin D Perkins, Charles D Deakin
OBJECTIVES: Cardiac arrest is associated with morbidity and mortality because of cerebral ischemia. Therefore, we tested the hypothesis that higher regional cerebral oxygenation during resuscitation is associated with improved return of spontaneous circulation, survival, and neurologic outcomes at hospital discharge. We further examined the validity of regional cerebral oxygenation as a test to predict these outcomes. DESIGN: Multicenter prospective study of in-hospital cardiac arrest...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27048406/good-neurological-outcome-despite-very-low-regional-cerebral-oxygen-saturation-during-resuscitation-a-prospective-preclinical-trial-in-29-patients
#15
Christian Storm, Alexander Wutzler, Lars Trenkmann, Alexander Krannich, Sabrina von Rheinbarben, Fridolin Luckenbach, Jens Nee, Natalie Otto, Tim Schroeder, Christoph Leithner
BACKGROUND: Noninvasive regional cerebral oxygen saturation (rSO2) measurement using near-infrared spectroscopy (NIRS) might inform on extent and duration of cerebral hypoxia during cardiopulmonary resuscitation (CPR). This information may be used to guide resuscitation efforts and may carry relevant early prognostic information. METHODS: We prospectively investigated non-traumatic out-of-hospital cardiac arrest (OHCA) patients on scene. NIRS was started either during CPR or shortly after (<2 min) return of spontaneous circulation (ROSC) by emergency medical service (EMS)...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27028004/near-infrared-spectroscopy-monitoring-during-cardiac-arrest-a-systematic-review-and-meta-analysis
#16
Alexis Cournoyer, Massimiliano Iseppon, Jean-Marc Chauny, André Denault, Sylvie Cossette, Éric Notebaert
BACKGROUND: Tissue oximetry using near-infrared spectroscopy (NIRS) is a noninvasive monitor of cerebral oxygenation. This new technology has been used during cardiac arrest (CA) because of its ability to give measures in low-blood-flow situations. The aim of this study was to assess the evidence regarding the association between the types of NIRS measurements (mean, initial, and highest values) and resuscitation outcomes (return of spontaneous circulation [ROSC], survival to discharge, and good neurologic outcome) in patients undergoing cardiopulmonary resuscitation...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26913719/survival-after-cardiac-arrest-ecmo-rescue-therapy-after-amlodipine-and-metoprolol-overdose
#17
Kevin F Maskell, Nikki Miller Ferguson, Jesse Bain, Brandon K Wills
Extracorporeal membrane oxygenation (ECMO) use in poisoned patients is increasing, but is rare post cardiac arrest. We report a case of ECMO use with complete recovery in a patient who arrested twice after a cardiotoxicant overdose. A 17-year-old male presented after an unknown overdose. He rapidly became hypotensive and bradycardic and received aggressive supportive care without improvement. He was transferred to our institution and suffered a cardiac arrest shortly after arrival. Six minutes of advanced cardiac life support resulted in return of spontaneous circulation...
February 25, 2016: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/26903288/cerebral-oxygenation-in-mechanically-ventilated-early-cardiac-arrest-survivors-the-impact-of-hypercapnia
#18
Glenn M Eastwood, Aiko Tanaka, Rinaldo Bellomo
BACKGROUND: Optimal cerebral oxygenation is considered fundamental to cerebral protection in cardiac arrest (CA) patients. Hypercapnia increases cerebral blood flow and may also improve cerebral oxygenation. It is uncertain, however, whether this effect occurs in mechanically ventilated early survivors of CA. METHODS: We enrolled mechanically ventilated resuscitated patients within 36h of their cardiac arrest. We performed a prospective double cross-over physiological study comparing the impact of normocapnia (PaCO2 35-45mmHg) vs...
May 2016: Resuscitation
https://www.readbyqxmd.com/read/26836946/extracorporeal-resuscitation-for-refractory-out-of-hospital-cardiac-arrest-in-adults-a-systematic-review-of-international-practices-and-outcomes
#19
REVIEW
Iván Ortega-Deballon, Laura Hornby, Sam D Shemie, Farhan Bhanji, Elena Guadagno
AIM: Extracorporeal resuscitation during cardiopulmonary resuscitation (ECPR) deploys rapid cardiopulmonary bypass to sustain oxygenated circulation until the return of spontaneous circulation (ROSC). The purpose of this systematic review is to address the defining elements and outcomes (quality survival and organ donation) of currently active protocols for ECPR in refractory out-of-hospital cardiac arrest (OHCA) of cardiac origin in adult patients. The results may inform policy and practices for ECPR and help clarify the corrresponding intersection with deceased organ donation...
April 2016: Resuscitation
https://www.readbyqxmd.com/read/26784134/mif-reflects-tissue-damage-rather-than-inflammation-in-post-cardiac-arrest-syndrome-in-a-real-life-cohort
#20
Julia Pohl, Christos Rammos, Matthias Totzeck, Pia Stock, Malte Kelm, Tienush Rassaf, Peter Luedike
INTRODUCTION: Following successful resuscitation from cardiac arrest (CA), neurological impairment and other types of organ dysfunction cause significant morbidity and mortality-a condition termed post-cardiac arrest syndrome. Whole-body ischemia/reperfusion with oxygen debt activates immunologic and coagulation pathways increasing the risk of multiple organ failure and infection. We here examined the role of the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF) in post-cardiac arrest syndrome...
March 2016: Resuscitation
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