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https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#1
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29746984/recognition-of-out-of-hospital-cardiac-arrest-during-emergency-calls-and-public-awareness-of-cardiopulmonary-resuscitation-in-communities-a-multilevel-analysis
#2
Sun Young Lee, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, So Yeon Kong
BACKGROUND: For an effective dispatcher-assisted cardiopulmonary resuscitation (CPR) program, recognition of out-of-hospital cardiac arrest (OHCA) by a dispatcher is the first step in initiating bystander CPR. This study evaluated whether CPR awareness in the community is associated with recognition of arrest, dispatcher-provided CPR instructions, and bystander CPR. METHODS: All emergency medical services (EMS)-treated adult OHCAs with cardiac etiology were enrolled between 2013 and 2015, excluding cases witnessed by EMS providers...
May 7, 2018: Resuscitation
https://www.readbyqxmd.com/read/29709578/b-type-natriuretic-peptide-and-risk-of-sudden-death-in-patients-with-hypertrophic-cardiomyopathy
#3
Yuichiro Minami, Shintaro Haruki, Keigo Kanbayashi, Ryosuke Itani, Nobuhisa Hagiwara
BACKGROUND: The association between B-type natriuretic peptide (BNP) level and sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM) remains unclear. OBJECTIVE: This study evaluated the impact of elevated BNP on sudden death risk in a cohort of patients with HCM. METHODS: This study included 346 patients with HCM. Plasma BNP levels were measured at initial evaluation. RESULTS: The median (interquartile range) BNP level in the study patients was 197...
April 27, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29695512/individual-participant-data-analysis-of-two-trials-on-aldosterone-blockade-in-myocardial-infarction
#4
Farzin Beygui, Eric Van Belle, Patrick Ecollan, Jacques Machecourt, Christian W Hamm, Estaeban Lopez De Sa, Marcus Flather, Freek W A Verheugt, Eric Vicaut, Faiez Zannad, Bertram Pitt, Gilles Montalescot
BACKGROUND: Two recent randomised trials studied the benefit of mineralocorticoid receptor antagonists (MRAs) in ST-segment elevation myocardial infarction (STEMI) irrespective or in absence of heart failure. The studies were both undersized to assess hard clinical endpoints. A pooled analysis was preplanned by the steering committees. METHODS: We conducted a prespecified meta-analysis of patient-level data of patients with STEMI recruited in two multicentre superiority trials, randomised within 72 hours after symptom onset...
April 25, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29664900/accuracy-and-precision-of-scvo2-measured-with-the-cevox-device-a-prospective-study-in-patients-with-a-wide-variation-of-scvo2-values
#5
Alexander Herner, Bernhard Haller, Ulrich Mayr, Sebastian Rasch, Lea Offman, Roland Schmid, Wolfgang Huber
INTRODUCTION: Central-venous oxygen saturation (ScvO2) is a key parameter of hemodynamic monitoring and has been suggested as therapeutic goal for resuscitation. Several devices offer continuous monitoring features. The CeVOX-device (Pulsion Medical Systems) uses a fibre-optic probe inserted through a conventional central-venous catheter (CVC) to obtain continuous ScvO2. OBJECTIVES: Since there is a lack of studies validating the CeVOX, we prospectively analyzed data from 24 patients with CeVOX-monitoring...
2018: PloS One
https://www.readbyqxmd.com/read/29664893/occupational-exposure-during-emergency-department-thoracotomy-a-prospective-multi-institution-study
#6
Andrew Nunn, Priya Prakash, Kenji Inaba, Alvarez Escalante, Zoë Maher, Seiji Yamaguchi, Dennis Y Kim, James Maciel, William C Chiu, Byron Drumheller, Joshua P Hazelton, Kaushik Mukherjee, Xian Luo-Owen, Rachel M Nygaard, Ashley P Marek, Bryan C Morse, Caitlin A Fitzgerald, Patrick L Bosarge, Randeep S Jawa, Susan E Rowell, Louis J Magnotti, Adrian W Ong, Tejal S Brahmbhatt, Michael D Grossman, Mark J Seamon
BACKGROUND: Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While HIV/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. METHODS: A prospective, observational study at 16 US trauma centers was performed (2015-2016)...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29629927/physiology-directed-cardiopulmonary-resuscitation-advances-in-precision-monitoring-during-cardiac-arrest
#7
Alexandra M Marquez, Ryan W Morgan, Catherine E Ross, Robert A Berg, Robert M Sutton
PURPOSE OF REVIEW: We review the recent advances in physiologic monitoring during cardiac arrest and offer an evidence-based framework for prioritizing physiologic targets during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Current CPR guidelines recommend a uniform approach for all patients in cardiac arrest, but newer data support a precision strategy that uses the individual patient's physiology to guide resuscitation. Coronary perfusion pressure and arterial DBP are associated with survival outcomes in recent animal and human studies...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29618599/triglyceride-rich-lipoprotein-cholesterol-and-risk-of-cardiovascular-events-among-patients-receiving-statin-therapy-in-the-treating-to-new-targets-tnt-trial
#8
Antonio J Vallejo-Vaz, Rana Fayyad, S Matthijs Boekholdt, G Kees Hovingh, John J Kastelein, Shari Melamed, Philip Barter, David D Waters, Kausik K Ray
Background -Mendelian randomization data suggest genetic determinants of lifetime higher triglyceride-rich lipoprotein-cholesterol (TRL-C) are causally related to cardiovascular disease and therefore a potential therapeutic target. The relevance of TRL-C among patients receiving statins is unknown. We assessed the relationship between TRL-C and cardiovascular risk, and whether this risk was modifiable among patients receiving statins in the TNT trial. Methods -Patients with coronary heart disease [CHD] and LDL-C 130-250mg/dL entered an 8-week run-in phase with atorvastatin 10mg/day (ATV10)...
April 4, 2018: Circulation
https://www.readbyqxmd.com/read/29594915/role-of-cardiac-123-i-mibg-imaging-in-predicting-arrhythmic-events-in-stable-chronic-heart-failure-patients-with-an-icd
#9
Giuseppe De Vincentis, Viviana Frantellizzi, Francesco Fedele, Alessio Farcomeni, Paola Scarparo, Nicolò Salvi, Danilo Alunni Fegatelli, Massimo Mancone, Derk O Verschure, Hein J Verberne
BACKGROUND: Despite therapeutic improvement, the prognosis of chronic heart failure (CHF) remains unfavorable partly due to arrhythmia and sudden cardiac death (SCD). This prospective study evaluated myocardial123 I-meta-iodobenzylguanidine (123 I-mIBG) scintigraphy as a predictor of arrhythmic events (AE) in CHF patients. METHODS: 170 CHF patients referred for implantable cardioverter-defibrillator (ICD) implantation for both primary and secondary prevention were enrolled...
March 28, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29555789/targeting-skeletal-muscle-tissue-oxygenation-sto-2-in-adults-with-severe-sepsis-and-septic-shock-a-randomised-controlled-trial-oto-sts-study
#10
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29544906/repeat-lactate-level-predicts-mortality-better-than-rate-of-clearance
#11
Zachary D W Dezman, Angela C Comer, Gordon S Smith, Peter F Hu, Colin F Mackenzie, Thomas M Scalea, Jon Mark Hirshon
BACKGROUND: Lactate clearance has been developed into a marker of resuscitation in trauma, but no study has compared the predictive power of the various clearance calculations. Our objective was to determine which method of calculating lactate clearance best predicted 24-hour and in-hospital mortality after injury. STUDY DESIGN: Retrospective chart review of patients admitted to a Level-1 trauma center directly from the scene of injury from 2010 to 2013 who survived >15min, had an elevated lactate at admission (≥3mmol/L), followed by another measurement within 24h of admission...
March 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29519219/morbid-obesity-impairs-adequacy-of-thoracic-compressions-in-a-simulation-based-model
#12
RANDOMIZED CONTROLLED TRIAL
P J Secombe, R Sutherland, R Johnson
Adequate cardiopulmonary resuscitation is an important predictor of survival, however, obesity provides a significant physical barrier to thoracic compressions. This study explores the effect of morbid obesity on compression adequacy. We performed a prospective randomised controlled crossover study, assessing the adequacy of thoracic compressions on a manikin modified to emulate a morbidly obese patient. Participants recruited from critical care departments were randomised to perform continuous compressions for two minutes on each manikin...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29518440/benefit-of-immediate-coronary-angiography-after-out-of-hospital-cardiac-arrest-in-france-a-nationwide-propensity-score-analysis-from-the-r%C3%A3-ac-registry
#13
Déborah Jaeger, Florence Dumas, Josephine Escutnaire, Sonia Sadoune, Adrien Lauvray, Carlos Elkhoury, Adrien Bassand, Nicolas Girerd, Pierre Yves Gueugniaud, Karim Tazarourte, Hervé Hubert, Alain Cariou, Tahar Chouihed
BACKGROUND: The survival rate of out-of-hospital cardiac arrest (OHCA) remains extremely low, generally under 10%. Post-resuscitation care, and particularly early coronary reperfusion, may improve this outcome. The main objective of the present study was to determine whether patients with immediate coronary angiography at hospital admission (CAA) had a better outcome than patients without immediate CAA. METHODS: This cohort analysis study was based on data extracted from the French National Cardiac Arrest registry (RéAC)...
May 2018: Resuscitation
https://www.readbyqxmd.com/read/29506854/spectral-analysis-of-heart-rate-variability-predicts-mortality-and-instability-from-vascular-injury
#14
Kiavash R Koko, Brian D McCauley, John P Gaughan, Marc W Fromer, Ryan S Nolan, Ashleigh L Hagaman, Spencer A Brown, Joshua P Hazelton
BACKGROUND: Spectral analysis of continuous blood pressure and heart rate variability provides a quantitative assessment of autonomic response to hemorrhage. This may reveal markers of mortality as well as endpoints of resuscitation. METHODS: Fourteen male Yorkshire pigs, ranging in weight from 33 to 36 kg, were included in the analysis. All pigs underwent laparotomy and then sustained a standardized retrohepatic inferior vena cava injury. Animals were then allowed to progress to class 3 hemorrhagic shock and where then treated with abdominal sponge packing followed by 6 h of crystalloid resuscitation...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29489877/effect-of-a-first-responder-on-survival-outcomes-after-out-of-hospital-cardiac-arrest-occurs-during-a-period-of-exercise-in-a-public-place
#15
Seo Young Ko, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, So Yeon Kong
INTRODUCTION: The deployment of first responders in a public place is one of the interventions that is used for increasing bystander cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrests (OHCA). We studied the association between the presence of a first responder and the survival of OHCA that occurred during a period of exercise in a public place. METHODS: All of the adult OHCAs of a presumed cardiac etiology that occurred during a period of exercise in a public place and that were witnessed by a bystander between 2013 and 2015 were analyzed...
2018: PloS One
https://www.readbyqxmd.com/read/29472255/comparison-of-a-newly-established-emotional-stimulus-approach-to-a-classical-assessment-driven-approach-in-bls-training-a-randomised-controlled-trial
#16
Karl Kuckuck, Hanna Schröder, Rolf Rossaint, Lina Stieger, Stefan K Beckers, Sasa Sopka
OBJECTIVE: The study objective was to implement two strategies (short emotional stimulus vs announced practical assessment) in the teaching of resuscitation skills in order to evaluate whether one led to superior outcomes. SETTING: This study is an educational intervention provided in one German academic university hospital. PARTICIPANTS: First-yearmedical students (n=271) during the first3 weeks of their studies. INTERVENTIONS: Participants were randomly assigned to one of two groups following a sequence of random numbers: the emotional stimulus group (EG) and the assessment group (AG)...
February 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29407204/dispatcher-assisted-bystander-cardiopulmonary-resuscitation-in-rural-and-urban-areas-and-survival-outcomes-after-out-of-hospital-cardiac-arrest
#17
Jeong Ho Park, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, So Yeon Kong
OBJECTIVES: We investigated the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on survival outcomes after out-of-hospital cardiac arrests (OHCAs) that occurred in rural and urban areas. METHODS: This study was a cross-sectional study using nationwide emergency medical services (EMS)-based OHCA registry in Korea. All EMS-treated adults with OHCAs and with presumed cardiac etiology were enrolled between 2012 and 2015, excluding cases witnessed by an EMS provider...
April 2018: Resuscitation
https://www.readbyqxmd.com/read/29369077/is-there-an-optimum-duration-of-fluid-bolus-in-pediatric-septic-shock-a-critical-appraisal-of-fluid-bolus-over-15-20-versus-5-10-minutes-each-in-the-first-hour-of-resuscitation-in-children-with-septic-shock-a-randomized-controlled-trial-by-sankar-et-al-pediatr
#18
Mark J Russell, Hari Krishnan Kanthimathinathan
OBJECTIVES: To review the findings and discuss the implications of a longer duration for fluid boluses in the resuscitation of children with septic shock. DATA SOURCES: We performed a PubMed.gov search using the criteria "Fluid Bolus" and "Children" and "Septic Shock," which yielded 29 references. STUDY SELECTION: One trial compared different durations of fluid boluses in pediatric septic shock and was therefore selected for critical appraisal...
April 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#19
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29300273/self-confidence-and-level-of-knowledge-after-cardiopulmonary-resuscitation-training-in-14-to-18-year-old-schoolchildren-a-randomised-interventional-controlled-prospective-study-in-secondary-schools-in-germany
#20
Sabine Wingen, Daniel C Schroeder, Hannes Ecker, Susanne Steinhauser, Sibel Altin, Stephanie Stock, Alex Lechleuthner, Andreas Hohn, Bernd W Böttiger
BACKGROUND: Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society. OBJECTIVE(S): The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improved CPR knowledge and self-confidence were investigated. DESIGN: Prospective, randomised-interventional controlled study...
January 2, 2018: European Journal of Anaesthesiology
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