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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430698/the-right-ventricle-is-dilated-during-resuscitation-from-cardiac-arrest-caused-by-hypovolemia-a-porcine-ultrasound-study
#2
Rasmus Aagaard, Asger Granfeldt, Morten T Bøtker, Troels Mygind-Klausen, Hans Kirkegaard, Bo Løfgren
OBJECTIVES: Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e., ventricular fibrillation). DESIGN: Thirty pigs were anesthetized and then randomized to cardiac arrest induced by three diffrent methods...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28427881/association-of-time-from-arrest-to-percutaneous-coronary-intervention-with-survival-outcomes-after-out-of-hospital-cardiac-arrest
#3
Joo Jeong, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Ki Ok Ahn
BACKGROUND: Timely post-resuscitation coronary reperfusion therapy is recommended; however, the timing of immediate coronary reperfusion for out-of-hospital cardiac arrest (OHCA) has not been established. We studied the effect of the time interval from arrest to percutaneous coronary intervention (PCI) on resuscitated OHCA patients. METHODS: All witnessed OHCA patients with a presumed cardiac etiology received successful PCI at hospitals between 2013 and 2015, excluding cases with unknown information regarding the time from arrest to PCI and survival outcomes...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28403120/detection-of-pulmonary-embolism-during-cardiac-arrest-ultrasonographic-findings-should-be-interpreted-with-caution
#4
Rasmus Aagaard, Philip Caap, Nicolaj C Hansson, Morten T Bøtker, Asger Granfeldt, Bo Løfgren
OBJECTIVES: The aim of this study was to test the hypothesis that the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary embolism, compared with hypoxia and primary arrhythmia. DESIGN: Twenty-four pigs were anesthetized and cardiac arrest was induced using three different methods. Pigs were resuscitated after 7 minutes of untreated cardiac arrest. Ultrasonographic images were obtained and the right ventricular diameter was measured...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28378150/improvement-of-lay-rescuer-chest-compressions-with-a%C3%A2-novel-audiovisual-feedback-device-a-randomized-trial
#5
A Wutzler, S von Ulmenstein, M Bannehr, K Völk, J Förster, C Storm, W Haverkamp
BACKGROUND: Bystander actions and skills determine among others the outcome of out-of-hospital cardiac arrest. However, the depth and rate of chest compressions (CC) are difficult to estimate for laypeople and poor CC quality may result. Our study aimed to evaluate the impact of a new feedback device on CC performance by laypeople. The percentage of CC with both correct rate and correct depth of all CC served as primary endpoint. METHODS: Forty-eight subjects with no medical background performed 2 min of CC on a manikin with and without a novel feedback device (TrueCPR™, Physio-Control, Redmond, Wash...
April 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28377054/complete-chest-recoil-during-laypersons-cpr-is-it-a-matter-of-weight
#6
Enrico Contri, Stefano Cornara, Alberto Somaschini, Cinzia Dossena, Michela Tonani, Francesco Epis, Elisa Zambaiti, Ferdinando Fichtner, Enrico Baldi
INTRODUCTION: Chest compressions depth and complete chest recoil are both important for high-quality Cardio-Pulmonary Resuscitation (CPR). It has been demonstrated that anthropometric variables affect chest compression depth, but there are no data about they could influence chest recoil. The aim of this study was to verify whether physical attributes influences chest recoil in lay rescuers. METHODS: We evaluated 1 minute of compression-only CPR performed by 333 laypersons immediately after a Basic Life Support and Automated External Defibrillation (BLS/AED) course...
March 25, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363619/body-mass-index-and-outcome-of-out-of-hospital-cardiac-arrest-patients-not-treated-by-targeted-temperature-management
#7
Ioanna Galatianou, George Karlis, Aristotelis Apostolopoulos, Georgios Intas, Eleftheria Chalari, Anil Gulati, Nicoletta Iacovidou, Athanasios Chalkias, Theodoros Xanthos
BACKGROUND: Obesity has been demonstrated to increase the risk of out-of-hospital cardiac arrest (OHCA) and may influence the quality and effectiveness of cardiopulmonary resuscitation. Our aim was to investigate the association between body mass index (BMI) and the outcome of OHCA victims not treated by targeted temperature management. METHODS: This was a prospective observational study of OHCA patients. The patients were categorized according to BMI into two groups: the normal BMI group (nBMI) and the elevated BMI group (eBMI)...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28356134/external-validation-of-the-rosc-after-cardiac-arrest-raca-score-in-a-physician-staffed-emergency-medical-service-system
#8
Petteri Kupari, Markus Skrifvars, Markku Kuisma
BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. METHODS: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28344186/omission-of-predilation-in-balloon-expandable-transcatheter-aortic-valve-implantation-retrospective-analysis-in-a-large-volume-center
#9
Karsten Hamm, Wilko Reents, Michael Zacher, Philipp Halbfass, Sebastian Kerber, Anno Diegeler, Bernhard Schieffer, Sebastian Barth
AIMS: We aimed to evaluate the effect of omitting predilation on feasibility, procedural results and safety in balloon-expandable TAVI. METHODS AND RESULTS: We performed an analysis of all 680 patients scheduled for a balloon expandable TAVI prosthesis between january 2011 and august 2016. Patients treated with or without predilation were compared. Procedure times decreased from 85.6±42.9 to 56.7±26.1 minutes (p<0.001), fluoroscopy times from 9.5±5.7 to 6...
March 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28318669/-impact-of-onsite-or-dispatched-automated-external-defibrillator-use-on-early-survival-after-sudden-cardiac-arrest-occurring-in-international-airports
#10
Elena Linda Garcia, Sherry Caffrey-Villari, Diomeda Ramirez, Jean-Luc Caron, Patrice Mannhart, Paul-Georges Reuter, Frederic Lapostolle, Frederic Adnet
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major public health challenge. Use of automated external defibrillators (AED) by laypersons improves survival of patient's victim of OHCA. The aim of our study was to compare onsite AED vs. dispatched AED management of cardiac arrest occurring in international airports. METHODS: We conducted a retrospective, observational, comparative, study on data collected from three international airports: Paris-Charles-de-Gaulle (CDG), Chicago and Madrid-Barajas...
March 15, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28267376/favorable-neurocognitive-outcome-with-low-tidal-volume-ventilation-after-cardiac-arrest
#11
Jeremy R Beitler, Tiffany Bita Ghafouri, Sayuri P Jinadasa, Ariel Mueller, Leeyen Hsu, Ryan J Anderson, Jisha Joshua, Sanjeev Tyagi, Atul Malhotra, Rebecca E Sell, Daniel Talmor
RATIONALE: Neurocognitive outcome after out-of-hospital cardiac arrest (OHCA) often is poor even when initial resuscitation succeeds. Lower tidal volumes (VT) attenuate extrapulmonary organ injury in other disease states and are neuro-protective in preclinical models of critical illness. OBJECTIVE: To evaluate the association between VT and neurocognitive outcome following OHCA. METHODS: Propensity-adjusted analysis of two-center retrospective cohort of OHCA patients who received mechanical ventilation for at least the first 48 hours of hospitalization...
March 7, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28265880/study-design-and-rationale-of-a-multicenter-open-labeled-randomized-controlled-trial-comparing-midazolam-versus-morphine-in-acute-pulmonary-edema-mimo-trial
#12
Alberto Dominguez-Rodriguez, Guillermo Burillo-Putze, Maria Del Mar Garcia-Saiz, Ana Aldea-Perona, Magali González-Colaço Harmand, Oscar Mirò, Pedro Abreu-Gonzalez
PURPOSE: Morphine has been used for several decades in cases of acute pulmonary edema (APE) due to the anxiolytic and vasodilatory properties of the drug. The non-specific depression of the central nervous system is probably the most significant factor for the changes in hemodynamics in APE. Retrospective studies have shown both negative and neutral effects in patients with APE and therefore some authors have suggested benzodiazepines as an alternative treatment. The use of intravenous morphine in the treatment of APE remains controversial...
March 7, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28265453/automated-closed-loop-resuscitation-of-multiple-hemorrhages-a-comparison-between-fuzzy-logic-and-decision-table-controllers-in-a-sheep-model
#13
Nicole Ribeiro Marques, Brent J Ford, Muzna N Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer
BACKGROUND: Hemorrhagic shock is the leading cause of trauma-related death in the military setting. Definitive surgical treatment of a combat casualty can be delayed and life-saving fluid resuscitation might be necessary in the field. Therefore, improved resuscitation strategies are critically needed for prolonged field and en route care. We developed an automated closed-loop control system capable of titrating fluid infusion to a target endpoint. We used the system to compare the performance of a decision table algorithm (DT) and a fuzzy logic controller (FL) to rescue and maintain the mean arterial pressure (MAP) at a target level during hemorrhages...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/28256020/left-atrial-anatomy-and-patient-related-factors-associated-with-adverse-outcomes-with-the-watchman-device-a-real-world-experience
#14
Shishir Murarka, Mohamad Lazkani, Soundos Moualla, Divya Ratan Verma, Ashish Pershad
OBJECTIVE: This study sought to identify patient and left atrial morphology specific factors associated with early complications for left atrial appendage occlusion with the Watchman™ (Boston Scientific, Natick, MA) device. BACKGROUND: Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation, however, long-term OAC compliance is poor. In randomized control trials, the Watchman™ device has demonstrated superiority over OAC with warfarin for all cause and cardiovascular mortality and hemorrhagic stroke...
April 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28219612/hyperoxia-and-hypertonic-saline-in-patients-with-septic-shock-hypers2s-a-two-by-two-factorial-multicentre-randomised-clinical-trial
#15
Pierre Asfar, Frédérique Schortgen, Julie Boisramé-Helms, Julien Charpentier, Emmanuel Guérot, Bruno Megarbane, David Grimaldi, Fabien Grelon, Nadia Anguel, Sigismond Lasocki, Matthieu Henry-Lagarrigue, Frédéric Gonzalez, François Legay, Christophe Guitton, Maleka Schenck, Jean Marc Doise, Jérôme Devaquet, Thierry Van Der Linden, Delphine Chatellier, Jean Philippe Rigaud, Jean Dellamonica, Fabienne Tamion, Ferhat Meziani, Alain Mercat, Didier Dreyfuss, Valérie Seegers, Peter Radermacher
BACKGROUND: There is insufficient research into the use of mechanical ventilation with increased inspiratory oxygen concentration (FiO2) and fluid resuscitation with hypertonic saline solution in patients with septic shock. We tested whether these interventions are associated with reduced mortality. METHODS: This two-by-two factorial, multicentre, randomised, clinical trial (HYPERS2S) recruited patients aged 18 years and older with septic shock who were on mechanical ventilation from 22 centres in France...
February 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28216475/the-effect-of-ticagrelor-administered-through-a-nasogastric-tube-to-comatose-patients-undergoing-acute-percutaneous-coronary-intervention-the-ticoma-study
#16
Hanna Ratcovich, Golnaz Sadjadieh, Hedvig B Andersson, Martin Frydland, Sebastian Wiberg, Nadia P Dridi, Jesper Kjaergaard, Lene Holmvang
AIMS: Patients in a coma after cardiac arrest may have adversely affected drug absorption and metabolism. This study, the first of its kind, aimed to investigate the early pharmacokinetic and pharmacodynamic effects of ticagrelor administered through a nasogastric tube (NGT) to patients resuscitated after an out of hospital cardiac arrest (OHCA) and undergoing primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Blood samples were drawn at baseline and at two, four, six, eight, 12, and 24 hours and then daily for up to five days after administration of a 180 mg ticagrelor loading dose (LD), followed by 90 mg twice daily in 44 patients...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28207628/earlier-endpoints-are-required-for-hemorrhagic-shock-trials-among-severely-injured-patients
#17
Erin E Fox, John B Holcomb, Charles E Wade, Eileen M Bulger, Barbara C Tilley
BACKGROUND: Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-h and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints...
May 2017: Shock
https://www.readbyqxmd.com/read/28185923/factors-associated-with-the-outcome-of-out-of-hospital-cardiopulmonary-arrest-among-people-over-80-years-old-in-japan
#18
Takashi Nagata, Takeru Abe, Manabu Hasegawa, Akihito Hagihara
AIM: To determine if termination of resuscitation should be considered for older individuals, we sought to identify factors associated with clinical outcome following out-of-hospital cardiac arrest (OHCA) in people ≥80 years old and over. METHODS: A prospective, population-based, observational study was conducted for ≥80-year-old individuals who experienced out-of-hospital cardiac arrest and to whom resuscitation was provided by emergency responders between January 1, 2005 and December 31, 2012 (n=377,577)...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28110000/drones-may-be-used-to-save-lives-in-out-of-hospital-cardiac-arrest-due-to-drowning
#19
A Claesson, L Svensson, P Nordberg, M Ringh, M Rosenqvist, T Djarv, J Samuelsson, O Hernborg, P Dahlbom, A Jansson, J Hollenberg
BACKGROUND: Drowning leading to out-of-hospital cardiac arrest (OHCA) and death is a major public health concern. Submersion with duration of less than 10min is associated with favorable neurological outcome and nearby bystanders play a considerable role in rescue and resuscitation. Drones can provide a visual overview of an accident scene, their potential as lifesaving tools in drowning has not been evaluated. AIM: The aim of this simulation study was to evaluate the efficiency of a drone for providing earlier location of a submerged possible drowning victim in comparison with standard procedure...
January 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28109111/-efficacy-of-high-versus-low-plasma-red-blood-cell-ratio-resuscitation-in-patients-with-severe-trauma-requiring-massive-blood-transfusion-a-meta-analysis
#20
Fang Yu, Tao Zhong, Gang Wu
OBJECTIVE: To evaluate the efficacy of high (≥1:2) and low (<1:2) plasma: red blood cell (RBC) ratio resuscitation in patients with severe trauma requiring massive blood transfusion. METHODS: The databases including the Cochrane Library, Pubmed, Web of Science, and EMBASE were systemically searched for relevant studies published between January, 2009 and April, 2016. The selection of studies, assessment of methodological quality and data extraction were performed by two researchers independently according to the inclusion and exclusion criteria...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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