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https://www.readbyqxmd.com/read/28727596/intraoperative-acute-multivessel-coronary-vasospasm-in-cardiac-allograft-a-case-report
#1
Richard Sheu, Kathleen Berfield, Stephanie Jones, Jay Pal, G Burkhard Mackensen
We present a patient who developed acute intraoperative cardiac failure requiring open cardiac message immediately after uncomplicated heart transplantation. After successful resuscitation and establishment of extracorporeal membrane oxygenation, coronary angiography showed diffuse multivessel coronary vasospasm, which responded to intracoronary and IV administration of vasodilators. Cardiac function gradually improved and the patient was discharged home after a prolonged hospital course. Cardiac allograft dysfunction associated with coronary vasospasm immediately after heart transplantation has not previously been reported...
July 19, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28706745/acute-esophageal-necrosis-in-an-alcoholic-after-successful-resuscitation-from-cardiac-arrest
#2
Amish Shah, Viveksandeep Thoguluva Chandreskar, Ravi Doobay, Arundeep Kahlon, Ioana Amzuta
INTRODUCTION: We present a patient who presented to the ICU after successful resuscitation from cardiac arrest who was subsequently diagnosed with AEN. CASE PRESENTATION: A 66-year-old female presented after cardiac arrest in which return of spontaneous circulation was achieved within 7 minutes after the initiation of CPR. She was intubated on the scene and found to have coffee ground emesis in her bathroom when found unresponsive. Due to the hemodynamically significant GI bleed, patient was started on IV proton pump inhibitor, octreotide, and levophed...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28691204/mortality-with-brainstem-seizures-from-focal-4-aminopyridine-induced-recurrent-hippocampal-seizures
#3
Muhammad Tariqus Salam, Gaspard Montandon, Roman Genov, Orrin Devinsky, Martin Del Campo, Peter L Carlen
OBJECTIVE: Sudden unexplained death in epilepsy is the leading cause of death in young adult epilepsy patients, typically occurring during the early postictal period, presumably resulting from brainstem and cardiorespiratory dysfunction. We hypothesized that ictal discharges in the brainstem disrupt the cardiorespiratory network, causing mortality. To study this hypothesis, we chose an animal model comprising focal unilateral hippocampal injection of 4-aminopyridine (4-AP), which produced focal recurrent hippocampal seizures with secondary generalization in awake, behaving rats...
July 10, 2017: Epilepsia
https://www.readbyqxmd.com/read/28678057/hyaluronidase-assisted-resuscitation-in-kenya-for-severely-dehydrated-children
#4
Hijab Zubairi, Brett D Nelson, Priyanka Tulshian, Karla Fredricks, Zaid Altawil, Sarah Mireles, Fred Odongo, Thomas F Burke
BACKGROUND: Dehydration, mainly due to diarrheal illnesses, is a leading cause of childhood mortality worldwide. Intravenous (IV) therapy is the standard of care for patients who were unable to tolerate oral rehydration; however, placing IVs in fragile, dehydrated veins can be challenging. Studies in resource-rich settings comparing hyaluronidase-assisted subcutaneous rehydration with standard IV rehydration in children have demonstrated several benefits of subcutaneous rehydration, including time and success of line placement, ease of use, satisfaction, and cost-effectiveness...
July 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28674699/long-term-deficits-in-cortical-circuit-function-after-asphyxial-cardiac-arrest-and-resuscitation-in-developing-rats
#5
Jason W Middleton, Daniel J Simons, Jennifer W Simmons, Robert S B Clark, Patrick M Kochanek, Michael Shoykhet
Cardiac arrest is a common cause of global hypoxic-ischemic brain injury. Poor neurologic outcome among cardiac arrest survivors results not only from direct cellular injury but also from subsequent long-term dysfunction of neuronal circuits. Here, we investigated the long-term impact of cardiac arrest during development on the function of cortical layer IV (L4) barrel circuits in the rat primary somatosensory cortex. We used multielectrode single-neuron recordings to examine responses of presumed excitatory L4 barrel neurons to controlled whisker stimuli in adult (8 ± 2-mo-old) rats that had undergone 9 min of asphyxial cardiac arrest and resuscitation during the third postnatal week...
May 2017: ENeuro
https://www.readbyqxmd.com/read/28670801/australian-and-new-zealand-committee-on-resuscitation-neonatal-resuscitation-guidelines-2016
#6
Helen G Liley, Lindsay Mildenhall, Peter Morley
New Australian and New Zealand Neonatal Resuscitation guidelines reflect recent advances in neonatal resuscitation science, as critically appraised by the International Liaison Committee on Resuscitation. Substantial changes since the 2010 guidelines include: (i) updates to the Newborn Resuscitation Flowchart to include a greater emphasis on maintaining normal body temperature, and to emphasise the importance of beginning assisted ventilation by 1 min in infants who have absent or ineffective spontaneous breathing; (ii) updates to the physiology of the normal perinatal transition that resuscitation is trying to restore; (iii) recommendations for more frequent reinforcement of training, and for structured feedback for resuscitation training instructors; (iv) new guidance in relation to the timing of cord clamping for preterm newborn infants; (v) recommendation to monitor body temperature on admission to newborn units as a resuscitation quality indicator; (vi) suggestion to consider electrocardiographic (ECG) monitoring (as an adjunct to oximetry) to obtain more rapid and accurate estimation of heart rate during resuscitation; (vii) removal of previous suggestions to intubate meconium-exposed, non-vigorous term infants to suction the trachea; and (viii) suggestion to establish vascular access to enable administration of intravenous adrenaline (epinephrine) as soon as chest compressions are deemed to be needed...
July 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28661972/continuous-chest-compressions-during-sustained-inflations-in-a-perinatal-asphyxial-cardiac-arrest-lamb-model
#7
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Satyan Lakshminrusimha
OBJECTIVE: Continuous chest compressions are more effective during resuscitation in adults. Sustained inflation rapidly establishes functional residual capacity in fluid-filled lungs at birth. We sought to compare the hemodynamics and success in achieving return of spontaneous circulation in an asphyxial cardiac arrest lamb model with transitioning fetal circulation and fluid-filled lungs between subjects receiving continuous chest compressions during sustained inflation and those receiving conventional 3:1 compression-to-ventilation resuscitation...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#8
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#9
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28633090/pulmonary-and-cardiac-pathology-in-sudden-unexpected-death-in-epilepsy-sudep
#10
REVIEW
Fábio A Nascimento, Zian H Tseng, Cristian Palmiere, Joseph J Maleszewski, Takayuki Shiomi, Aileen McCrillis, Orrin Devinsky
OBJECTIVE: To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. METHODS: We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period...
June 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#11
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28617763/short-term-peripheral-vasoactive-infusions-in-pediatrics-where-is-the-harm
#12
Jason T Patregnani, Anthony A Sochet, Darren Klugman
OBJECTIVE: Pediatric shock represents a major cause of morbidity and mortality in the United States. Standardization of treatment such as volume resuscitation and vasoactive administration has resulted in improved patient outcomes. Vasoactives have been anecdotally associated with peripheral IV infiltration and extravasation. There is a paucity of evidence in pediatrics to determine the ideal route of vasoactive infusions and what, if any, risk factors and harm are associated with peripheral IV infiltration and extravasation...
June 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28598905/military-use-of-txa-in-combat-trauma-does-it-matter
#13
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28597966/diurnal-variation-in-outcomes-after-out-of-hospital-cardiac-arrest-in-asian-communities-the-pan-asian-resuscitation-outcomes-study
#14
Yun Jeong Kim, Hyun Wook Ryoo, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Kyung Won Lee, Matthew Huei-Ming Ma, Patrick Chow-In Ko, Han Nee Gan, Nur Shahidah
OBJECTIVE: The present study aimed to determine whether the time of out-of-hospital cardiac arrest (OHCA) is associated with survival rate and neurological outcome after OHCA, as well as to compare the effect size of time of OHCA across six Asian regions. METHODS: We collected data from the Pan-Asian Resuscitation Outcomes Study registry, six Asian regions (Tokyo, Osaka, Aichi, Seoul, Taipei and Singapore) from 2009 to 2012. Adult OHCA cases were divided depending on the arrest time: I (00...
June 9, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28566471/emergency-treatment-of-decompensated-aortic-stenosis
#15
Dario Bongiovanni, Constantin Kühl, Sabine Bleiziffer, Lynne Stecher, Felix Poch, Martin Greif, Julinda Mehilli, Steffen Massberg, Norbert Frey, Rüdiger Lange, Karl-Ludwig Laugwitz, Gerhard Schymik, Derk Frank, Christian Kupatt
OBJECTIVE: The optimal treatment of patients with acute and severe decompensation of aortic stenosis is unclear due to recent advances in transcatheter interventions and supportive therapies. Our aim was to assess the early outcome of emergency transcatheter aortic valve implantation (eTAVI) versus emergency balloon aortic valvuloplasty (eBAV) followed by TAVI under elective circumstances. METHODS: Emergency conditions were defined as: cardiogenic shock with requirement of catecholamine therapy, severe acute dyspnoea (NYHA IV), cardiac resuscitation or mechanic respiratory support...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28497243/-kids-save-lives-resuscitation-training-for-schoolchildren-systematic-review
#16
D C Schroeder, H Ecker, S Wingen, F Semeraro, B W Böttiger
BACKGROUND: Even in western developed countries, the probability of survival after out-of-hospital cardiac arrest (OHCA) is only 6-10%. In order to improve survival after OHCA, early initiation of cardiopulmonary resuscitation (CPR) by laypersons is essential. Introduction of CPR training in schoolchildren seems to be effective to increase lay-CPR rates. OBJECTIVE: The objective of the present investigation was to elucidate educational aspects of teaching schoolchildren in CPR and to summarize campaigns related to a comprehensive establishment of lay-CPR worldwide...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28458948/primary-atypical-teratoid-rhabdoid-tumor-in-the-adult-spine
#17
Michael McGinity, Huma Siddiqui, Gulpreet Singh, Fermin Tio, Ahmed Shakir
BACKGROUND: Atypical teratoid/rhabdoid tumor (ATRT) is a highly aggressive tumor of the central nervous system (WHO grade IV), which is most frequently found intracranially in young children and infants. Only three prior cases of primary ATRT involving the adult spine were found following a literature review, and the average survival for these patients was only 20 postoperative months. CASE DESCRIPTION: A 43 year-old female presented with an acute exacerbation of chronic neck pain...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28457033/clinical-and-biochemical-characteristics-of-exertional-heat-stroke-among-paratroopers-in-agra-india
#18
Rajesh Deshwal, Dhirendra Tiwari, Raj Singh
OBJECTIVE: The purpose of this study was to assess the clinical profile, biochemical parameters and outcome in a series of 78 patients of heat stroke admitted and treated in a military hospital in India. METHODS: This was a prospective study in a military hospital. A total of 78 patients of exertional heat stroke admitted and treated over more than 2 years are reported. Cooling measures started immediately on site of occurrence, carried on during evacuation and in hospital, IV normal saline initiated, clinical symptoms and signs were noted...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28452888/the-impact-of-patient-weight-on-burn-resuscitation
#19
Nehemiah T Liu, Craig A Fenrich, Maria L Serio-Melvin, Wylan C Peterson, Leopoldo C Cancio, José Salinas
BACKGROUND: Optimal fluid resuscitation of burn patients with burns greater than 20% total body surface area is critical to prevent burn shock during the initial 24 hours to 48 hours postburn. Currently, most resuscitation formulas incorporate the patient's weight when estimating 24-hour fluid requirements. The objective of this study was to determine the impact of weight on fluid resuscitation requirements and outcomes during the initial 24 hours after admission. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, resuscitated with a computerized decision support system...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452884/the-effect-of-reboa-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-polytrauma-model
#20
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
OBJECTIVES: Despite clinical reports of poor outcomes, the degree to which REBOA exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared to partial aortic occlusion (PAO) or no intervention. METHODS: 21 swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
April 27, 2017: Journal of Trauma and Acute Care Surgery
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