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post cardiac arrest syndrome

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https://www.readbyqxmd.com/read/28812428/microvascular-perfusion-in-cardiac-arrest-a-review-of-microcirculatory-imaging-studies
#1
Petra Krupičková, Zuzana Mormanová, Tomáš Bouček, Tomáš Belza, Jana Šmalcová, Jan Bělohlávek
Cardiac arrest represents a leading cause of mortality and morbidity in developed countries. Extracorporeal cardiopulmonary resuscitation (ECPR) increases the chances for a beneficial outcome in victims of refractory cardiac arrest. However, ECPR and post-cardiac arrest care are affected by high mortality rates due to multi-organ failure syndrome, which is closely related to microcirculatory disorders. Therefore, microcirculation represents a key target for therapeutic interventions in post-cardiac arrest patients...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28765736/factors-influencing-the-quality-of-standardized-treatment-for-patients-with-post-cardiac-arrest-syndrome
#2
Jing Lu, Lijun Liu, Jianliang Zhu, Xinying Guo
BACKGROUND AND OBJECTIVES: For the present study, we investigated the factors that influence the quality of standardized treatment for patients with post-cardiac arrest syndrome (PCAS) to improve the quality of PCAS treatment. SUBJECTS AND METHODS: We collected data on patients with cardiac arrest (CA) who were admitted to the intensive care units (ICUs) of 11 hospitals-Class II Grade A or above-in Suzhou from January to October 2013. Indexes of standardized treatment were observed within 72 hrs of CA...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28757259/endotoxemia-induces-lung-brain-coupling-and-multi-organ-injury-following-cerebral-ischemia-reperfusion
#3
Nguyen Mai, Landa Prifti, Aric Rininger, Hannah Bazarian, Marc W Halterman
Post-ischemic neurodegeneration remains the principal cause of mortality following cardiac resuscitation. Recent studies have implicated gastrointestinal ischemia in the sepsis-like response associated with the post-cardiac arrest syndrome (PCAS). However, the extent to which the resulting low-grade endotoxemia present in up to 86% of resuscitated patients affects cerebral ischemia-reperfusion injury has not been investigated. Here we report that a single injection of low-dose lipopolysaccharide (50μg/kg, IP) delivered after global cerebral ischemia (GCI) induces blood-brain barrier permeability, microglial activation, cortical injury, and functional decline in vivo, compared to ischemia alone...
July 28, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28743338/-clinical-characteristics-and-prognosis-in-patients-with-high-plasma-level-of-procalcitonin-an-analysis-in-188-patients
#4
Chuli Pan, Wei Cui, Feifei Zhou, Junwei Tu, Xiuhui Lin, Libin Li, Gensheng Zhang
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. METHODS: A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#5
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28734575/outcomes-associated-to-serum-phosphate-levels-in-patients-with-suspected-acute-coronary-syndrome
#6
Hong Xu, Marie Evans, Alessandro Gasparini, Karolina Szummer, Jonas Spaak, Johan Ärnlöv, Bengt Lindholm, Tomas Jernberg, Juan Jesús Carrero
BACKGROUND: We investigated the association between phosphate and the risk of adverse clinical outcomes in patients with manifest cardiovascular disease (CVD). METHODS: Observational study of patients hospitalized during 2006-2011 in Stockholm, Sweden, because of suspected acute coronary syndrome (ACS). The exposure was serum phosphate during the hospitalization. We modeled the association between phosphate and in-hospital death or in-hospital events (composite of myocardial infarction, cardiogenic shock, resuscitated cardiac arrest, atrial fibrillation, or atrioventricular block) as well as the one-year post-discharge risk of death or cardiovascular event (composite of myocardial re-infarction, heart failure and stroke)...
July 17, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28684012/-high-blood-pressure-during-the-autonomic-crises-in-children-in-intensive-care-unit-etiologic-circumstances-and-modality-therapeutic
#7
D D Batouche, M Benatta, R Okbani, N F Benatta
The dysautonomic (DC) or neurovegetative crisis remains an imperfectly known entity; it associates in a paroxysmal manner a reaction of sympathetic hyperreactivity that can lead to the prognosis. Our objective is to specify the etiological circumstances (DC) and their modality of treatment in pediatric intensive care unit. MATERIALS-METHODS: Descriptive study on files of children admitted in the intensive care unit of 2010-2015 who presented a DC acquired during their hospitalization...
June 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28582003/controversies-in-out-of-hospital-cardiac-arrest
#8
REVIEW
Rahul P Sharma, Dion Stub
Cardiac arrest is a major cause of morbidity and mortality and accounts for nearly 500,000 deaths annually in the United States. In patients suffering out-of-hospital cardiac arrest, survival is less than 15%, with considerable regional variation. Although most deaths occur during the initial resuscitation, an increasing proportion occur in patients hospitalized after initially successful resuscitation. In these patients, the significant subsequent morbidity and mortality is due to "post cardiac arrest syndrome...
October 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28562475/duration-of-untreated-cardiac-arrest-and-clinical-relevance-of-animal-experiments-the-relationship-between-the-no-flow-duration-and-the-severity-of-post-cardiac-arrest-syndrome-in-a-porcine-model
#9
Gioanni Babini, Luigi Grassi, Ilaria Russo, Deborah Novelli, Antonio Boccardo, Anita Luciani, Francesca Fumagalli, Lidia Staszewsky, Fabio Fiordaliso, Marcella De Maglie, Monica Salio, Davide Danilo Zani, Teresa Letizia, Serge Masson, Mario Vittorio Luini, Davide Pravettoni, Eugenio Scanziani, Roberto Latini, Giuseppe Ristagno
INTRODUCTION: The study investigated the effect of untreated cardiac arrest (CA), i.e. "no-flow" time, on post-resuscitation myocardial and neurological injury, and survival in a pig model to identify an optimal duration that adequately reflects the most frequent clinical scenario. METHODS: An established model of myocardial infarction followed by CA and cardiopulmonary resuscitation was used. Twenty-two pigs were subjected to 3 no-flow durations: short (8-10 min); intermediate (12-13 min); and long (14-15 min)...
May 30, 2017: Shock
https://www.readbyqxmd.com/read/28536893/neurologic-recovery-after-cardiac-arrest-a-multifaceted-puzzle-requiring-comprehensive-coordinated-care
#10
REVIEW
Carolina B Maciel, Mary M Barden, David M Greer
Surviving cardiac arrest (CA) requires a longitudinal approach with multiple levels of responsibility, including fostering a culture of action by increasing public awareness and training, optimization of resuscitation measures including frequent updates of guidelines and their timely implementation into practice, and optimization of post-CA care. This clearly goes beyond resuscitation and targeted temperature management. Brain-directed physiologic goals should dictate the post-CA management, as accumulating evidence suggests that the degree of hypoxic brain injury is the main determinant of survival, regardless of the etiology of arrest...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28513117/routine-laboratory-indices-as-predictor-of-neurological-recovery-in-post-resuscitation-syndrome-patients-treated-with-therapeutic-hypothermia
#11
Sa'ar Minha, Tali Taraboulos, Gabby Elbaz-Greener, Eran Kalmanovich, Zvi Vered, Alex Blatt
BACKGROUND: Hypothermia is associated with improved outcome in selected survivors of cardiac arrest but no single metric enables proper prediction of neurological outcome. OBJECTIVES: To explored the association between routine laboratory indices of patients treated by hypothermia for cardiac arrest and their neurological outcome. METHODS: We retrospectively collected data from survivors of cardiac arrest treated with hypothermia for 24 hours and grouped them according to their neurological outcome to either "poor" or "favorable"...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28504565/early-intensive-statin-treatment-reduces-hard-cardiovascular-outcomes-after-acute-coronary-syndrome
#12
Gregory G Schwartz, Rana Fayyad, Michael Szarek, David DeMicco, Anders G Olsson
Background Early, intensive statin treatment is the standard of care after acute coronary syndrome (ACS). However, the benefit of this approach to prevent major adverse cardiovascular events has been demonstrated in only one randomised, placebo controlled trial. The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial demonstrated that atorvastatin 80 mg daily, compared with placebo, reduced time to first occurrence of death, non-fatal myocardial infarction, resuscitated cardiac arrest, or hospitalisation for unstable angina (stroke not included) during the 16 week period following ACS...
August 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28492973/fast-therapeutic-hypothermia-prevents-post-cardiac-arrest-syndrome-through-cyclophilin-d-mediated-mitochondrial-permeability-transition-inhibition
#13
Vincent Jahandiez, Martin Cour, Thomas Bochaton, Maryline Abrial, Joseph Loufouat, Abdallah Gharib, Annie Varennes, Michel Ovize, Laurent Argaud
The opening of the mitochondrial permeability transition pore (PTP), which is regulated by the matrix protein cyclophilin D (CypD), plays a key role in the pathophysiology of post-cardiac arrest (CA) syndrome. We hypothesized that therapeutic hypothermia could prevent post-CA syndrome through a CypD-mediated PTP inhibition in both heart and brain. In addition, we investigated whether specific pharmacological PTP inhibition would confer additive protection to cooling. Adult male New Zealand White rabbits underwent 15 min of CA followed by 120 min of reperfusion...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28490379/a-novel-scoring-system-for-predicting-the-neurologic-prognosis-prior-to-the-initiation-of-induced-hypothermia-in-cases-of-post-cardiac-arrest-syndrome-the-cast-score
#14
Mitsuaki Nishikimi, Naoyuki Matsuda, Kota Matsui, Kunihiko Takahashi, Tadashi Ejima, Keibun Liu, Takayuki Ogura, Michiko Higashi, Hitoshi Umino, Go Makishi, Atsushi Numaguchi, Satoru Matsushima, Hideki Tokuyama, Mitsunobu Nakamura, Shigeyuki Matsui
BACKGROUND: The aim of this study was to develop a scoring system for identifying the post-cardiac arrest syndrome (PCAS) patients with a good potential for recovery prior to the initiation of induced therapeutic hypothermia. METHODS: A multi-center, retrospective, observational study was performed. Data of a total of 151 consecutive adults who underwent induced hypothermia after cardiac arrest (77 learning cases from two hospitals and 74 validation cases from two other hospitals) were analyzed...
May 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28482803/serum-neutrophil-gelatinase-associated-lipocalin-levels-predict-the-neurological-outcomes-of-out-of-hospital-cardiac-arrest-victims
#15
Tadashi Kaneko, Motoki Fujita, Yasuaki Ogino, Takahiro Yamamoto, Ryosuke Tsuruta, Shunji Kasaoka
BACKGROUND: Serum neutrophil gelatinase-associated lipocalin (NGAL) is a well-known biomarker of acute kidney injury. Serum NGAL was recently proposed as a potential predictor of mortality in post cardiac arrest syndrome (PCAS) patients following out-of-hospital cardiac arrest (OHCA). However, the potential predictive value of NGAL for neurological outcomes is unknown. Therefore, we assessed the potential predictive value of NGAL for neurological outcomes after OHCA. We also compared its predictive value with that of neuron-specific enolase (NSE) as an established biomarker...
May 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28393777/methylene-blue-for-postcardiopulmonary-bypass-vasoplegic-syndrome-a-cohort-study
#16
Michael Mazzeffi, Benjamin Hammer, Edward Chen, Mark Caridi-Scheible, James Ramsay, Christopher Paciullo
BACKGROUND: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. AIMS: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. SETTING AND DESIGN: This was conducted in a tertiary care medical center; this study was a retrospective cohort study...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#17
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28256347/right-coronary-dissection-and-left-anterior-descending-thrombus-dual-dilemma-in-a-young-cardiac-arrest-survivor
#18
Holly Morgan, Michael McCann, Alan Whelan, Richard Clugston
BACKGROUND: ST-elevation myocardial infarction (STEMI) leading to cardiac arrest is an exceptionally rare occurrence in young adults. Those affected tend to abuse sympathomimetic drugs, have strong family histories, or have a significant burden of cardiac risk factors. Another uncommon cause of STEMI is coronary artery dissection, which overwhelmingly affects middle- and older-aged women with few cardiac risk factors. CASE REPORT: A 22-year-old athlete with no medical history was admitted to our institution post-cardiac arrest with an anterior STEMI and concomitant right coronary dissection...
June 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28242292/systemic-mastocytosis-kounis-syndrome-and-coronary-intervention-case-report-and-systematic-review
#19
REVIEW
Elizabeth D Paratz, Nancy Khav, Andrew T Burns
A 72-year-old male reported a long-standing history of unexplained syncope. Stress echocardiography demonstrated inducible anterior hypokinesis, and he proceeded to percutaneous coronary intervention for an 80% stenosis of the left anterior descending artery. Thirty minutes post-procedure, he experienced a pulseless electrical activity (PEA) cardiac arrest. Urgent repeat angiography demonstrated profound coronary artery spasm consistent with Kounis syndrome. Three days later, a second PEA arrest occurred. Systemic mastocytosis was ultimately diagnosed as the cause of his recurrent syncopal episodes and cardiac arrests...
February 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28239054/critical-care-management-focused-on-optimizing-brain-function-after-cardiac-arrest
#20
REVIEW
Ryuta Nakashima, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Satoshi Egawa, Akihiko Inoue, Ryutaro Seo, Nobuhiro Inagaki, Yasuhiro Kuroda
The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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