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https://www.readbyqxmd.com/read/28924110/bloody-bronchial-cast-formation-due-to-alveolar-hemorrhage-associated-with-h1n1-influenza-infection
#1
Yohei Okada, Asami Okada, Hiromichi Narumiya, Ryoji Iiduka, Kanade Katsura
A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus. A pathological examination revealed that it was composed of intrabronchial and intra-alveolar hemorrhagic tissue. Unfortunately, the patient died due to severe brain ischemia; a subsequent autopsy revealed marked alveolar hemorrhage...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#2
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887695/a-nirs-death-experience-a-reduction-in-cortical-oxygenation-by-time-resolved-near-infrared-spectroscopy-preceding-cardiac-arrest
#3
C Lanks, C B Kim, H B Rossiter
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS...
September 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28870720/post-resuscitation-arterial-oxygen-and-carbon-dioxide-and-outcomes-after-out-of-hospital-cardiac-arrest
#4
Henry E Wang, David K Prince, Ian R Drennan, Brian Grunau, David Carlbom, Nicholas Johnson, Matthew Hansen, Jonathan Elmer, Jim Christenson, Peter Kudenchuk, Tom Aufderheide, Myron Weisfeldt, Ahamed Idris, Stephen Trzeciak, Michael Kurz, Jon C Rittenberger, Denise Griffiths, Jamie Jasti, Susanne May
OBJECTIVE: To determine if arterial oxygen and carbon dioxide abnormalities in the first 24hours after return of spontaneous circulation (ROSC) are associated with increased mortality in adult out-of-hospital cardiac arrest (OHCA). METHODS: We used data from the Resuscitation Outcomes Consortium (ROC), including adult OHCA with sustained ROSC ≥1hour after Emergency Department arrival and at least one arterial blood gas (ABG) measurement. Among ABGs measured during the first 24hours of hospitalization, we identified the presence of hyperoxemia (PaO2 ≥300mmHg), hypoxemia (PaO2 <60mmHg), hypercarbia (PaCO2>50mmHg) and hypocarbia (PaCO2<30mmHg)...
September 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28838526/congenital-left-ventricular-diverticulum-complicated-by-ventricular-fibrillation
#5
Manabu Yamasaki, Naoto Kawamatsu, Kunihiko Yoshino, Kohei Abe, Hiroyasu Misumi
Congenital left ventricular diverticulum (CLVD) is a rare congenital anomaly and may be associated with fatal adverse events. A previously healthy 20-year-old man collapsed as a result of sudden ventricular fibrillation (VF). Despite intractable VF, he had return of spontaneous circulation with cardiopulmonary resuscitation and subsequent introduction of venoarterial extracorporeal membrane oxygenation (ECMO). After ECMO was discontinued, cardiac magnetic resonance imaging revealed CLVD at the posterolateral wall of the left ventricle...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28795675/-clinical-application-of-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-method-for-treatment-of-patients-with-cardiac-arrest
#6
Haishan Li, Liu Ji, Jingjing Wang
OBJECTIVE: To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.). METHODS: The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28768280/chest-compressions-during-sustained-inflations-improve-recovery-when-compared-to-a-3-1-compression-ventilation-ratio-during-cardiopulmonary-resuscitation-in-a-neonatal-porcine-model-of-asphyxia
#7
Elliott S Li, Immanuel Görens, Po-Yin Cheung, Tze-Fun Lee, Min Lu, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). OBJECTIVE: To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia...
August 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#8
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#9
RANDOMIZED CONTROLLED TRIAL
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#10
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28669033/monitoring-the-brain-after-cardiac-arrest-a-new-era
#11
REVIEW
Niraj Sinha, Sam Parnia
PURPOSE OF REVIEW: Of the approximately 350,000 out-of-hospital, and 750,000 after in-hospital cardiac arrest (CA) events in the US annually approximately 5-9% and 20% respectively may achieve return of spontaneous circulation (ROSC) after attempted cardiopulmonary resuscitation (CPR). Up to 2/3 of these initial survivors may go on die in the subsequent 24-72 hours after ROSC due to a combination of (1) on-going cerebral injury, (2) myocardial dysfunction and (3) massive systemic inflammatory response...
August 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28648673/clinical-evaluation-of-active-abdominal-lifting-and-compression-cardiopulmonary-resuscitation-in-patients-with-cardiac-arrest
#12
Min Li, Wei Song, Yan-Hong Ouyang, Duo-Hu Wu, Jun Zhang, Li-Xiang Wang, Jing Li
BACKGROUND: Chest compression is a standard recommendation during cardiopulmonary resuscitation (CPR). However, chest compression cannot be effectively applied under certain situations, such as chest wall deformity, rib fracture, or hemopneumothorax. An alternative method, abdominal compression, was reported to achieve better resuscitation outcomes in these patients. MATERIALS AND METHODS: A prospective study was performed in adult patients with cardiac arrest and anticipated ineffective chest compression (thoracic trauma, chest deformity, rib fracture, and hemopneumothorax)...
June 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#13
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/28627349/-clinical-application-of-cardiopulmonary-resuscitation-with-abdominal-lifting-and-compression-in-emergency-treatment
#14
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/28625243/-experimental-study-on-effect-of-airway-pressure-on-cardiopulmonary-resuscitation
#15
Dingyu Tan, Feng Sun, Yangyang Fu, Shihuan Shao, Yazhi Zhang, Yingying Hu, Jun Xu, Huadong Zhu, Xuezhong Yu
OBJECTIVE: To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. METHODS: Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28584212/variations-of-postresuscitation-lung-function-after-thrombolysis-therapy-in-a-cardiac-arrest-porcine-model-caused-by-pulmonary-thromboembolism
#16
Jun Yang, Lian-Xing Zhao, Chun-Sheng Li, Nan Tong, Hong-Li Xiao, Le An
BACKGROUND: Study of lung function in survivor from cardiac arrest (CA) caused by pulmonary thromboembolism (PTE) was rare. The aim of this study was to investigate the variations of postresuscitation lung function after thrombolysis treatment in a CA porcine model caused by PTE. METHODS: After 2 min of untreated CA, pigs of 10-12 weeks with a weight of 30 ± 2 kg (n = 24) were treated with recombinant human tissue plasminogen activator (50 mg). Cardiopulmonary resuscitation (CPR) and ventilation were initiated after drug administration...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28562481/extracorporeal-life-support-increases-survival-after-prolonged-ventricular-fibrillation-cardiac-arrest-in-the-rat
#17
Ingrid Anna Maria Magnet, Florian Ettl, Andreas Schober, Alexandra-Maria Warenits, Daniel Grassmann, Michael Wagner, Christoph Schriefl, Christian Clodi, Ursula Teubenbacher, Sandra Högler, Wolfgang Weihs, Fritz Sterz, Andreas Janata
BACKGROUND: Extracorporeal life support (ECLS) for cardiopulmonary resuscitation (CPR) may increase end organ perfusion and thus survival when conventional CPR fails. The aim was to investigate, if after ventricular fibrillation cardiac arrest in rodents ECLS improves outcome compared to conventional CPR. METHODS: In 24 adult male Sprague-Dawley rats (460 to 510 g) resuscitation was started after 10 min of no-flow with ECLS (consisting of an open reservoir, roller pump and membrane oxygenator, connected to a cannulas in the jugular vein and femoral artery, n = 8) or CPR (mechanical chest compressions plus ventilations, n = 8) and compared to a sham group (n = 8)...
May 29, 2017: Shock
https://www.readbyqxmd.com/read/28521971/comparison-of-early-sequential-hypothermia-and-delayed-hypothermia-on-neurological-function-after-resuscitation-in-a-swine-model
#18
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
BACKGROUND: We utilized a porcine cardiac arrest model to compare early sequential hypothermia (ESH) with delayed hypothermia (DH) and no hypothermia (NH) to investigate the different effects on cerebral function after resuscitation. METHODS: After return of spontaneous circulation (ROSC), resuscitated 24 pigs divided into three groups. The ESH group implemented early sequential hypothermia immediately, and the DH group implemented delayed hypothermia at 1 h after ROSC...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28513002/one-oxygen-breath-shortened-the-time-to-return-of-spontaneous-circulation-in-severely-asphyxiated-piglets
#19
Rikard Linner, Doris Cunha-Goncalves, Valeria Perez-de-Sa
AIM: Asphyxiated neonates should be resuscitated with air, but it remains unclear if oxygen supplementation is needed in ineffectively ventilated newborn infants. We studied the return of spontaneous circulation (ROSC) with oxygen or air in an experimental model of inadequate ventilation. METHODS: Asphyxia was induced in 16 newborn piglets until their heart rate was <60 bpm or mean arterial pressure (MAP) <30 mmHg. During the first 10 minutes of resuscitation, they received one breath per minute of oxygen (n = 8) or air (n = 8)...
May 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28438718/the-effect-of-50-compared-to-100-inspired-oxygen-fraction-on-brain-oxygenation-and-post-cardiac-arrest-mitochondrial-function-in-experimental-cardiac-arrest
#20
Annika Nelskylä, Jouni Nurmi, Milla Jousi, Alexey Schramko, Eero Mervaala, Giuseppe Ristagno, Markus B Skrifvars
BACKGROUND AND AIM: We hypothesised that the use of 50% compared to 100% oxygen maintains cerebral oxygenation and ameliorates the disturbance of cardiac mitochondrial respiration during cardiopulmonary resuscitation (CPR). METHODS: Ventricular fibrillation (VF) was induced electrically in anaesthetised healthy adult pigs and left untreated for seven minutes followed by randomisation to manual ventilation with 50% or 100% oxygen and mechanical chest compressions (LUCAS(®))...
July 2017: Resuscitation
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