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https://www.readbyqxmd.com/read/29536863/out-of-hospital-cardiac-arrest-in-hospital-intervention-strategies
#1
REVIEW
Christian Hassager, Ken Nagao, David Hildick-Smith
The prognosis after out-of-hospital cardiac arrest (OHCA) has improved in the past few decades because of advances in interventions used outside and in hospital. About half of patients who have OHCA with initial ventricular tachycardia or ventricular fibrillation and who are admitted to hospital in coma after return of spontaneous circulation will survive to discharge with a reasonable neurological status. In this Series paper we discuss in-hospital management of patients with post-cardiac-arrest syndrome. In most patients, the most important in-hospital interventions other than routine intensive care are continuous active treatment (in non-comatose and comatose patients and including circulatory support in selected patients), cooling of core temperature to 32-36°C by targeted temperature management for at least 24 h, immediate coronary angiography with or without percutaneous coronary intervention, and delay of final prognosis until at least 72 h after OHCA...
March 10, 2018: Lancet
https://www.readbyqxmd.com/read/29410284/coronary-angiographic-findings-and-outcomes-in-patients-with-sudden-cardiac-arrest-without-st-elevation-myocardial-infarction-a-swedeheart-study
#2
Axel Wester, Moman A Mohammad, Pontus Andell, Rebecca Rylance, Josef Dankiewicz, Hans Friberg, Stefan James, Elmir Omerovic, David Erlinge, Sasha Koul
BACKGROUND/AIM: Sudden cardiac arrest (SCA) has a substantial mortality rate and the acute coronary syndrome constitutes the major cause. Post-resuscitation electrocardiogram ST-elevation SCA (STE-SCA) is a strong indication for emergency coronary angiography, but the role of early angiography and PCI in patients without ST-elevation (NSTE-SCA) remains to be established. This paper aimed to describe this patient group and evaluate the prognostic effect of early PCI in a large nationwide cohort of NSTE-SCA patients undergoing coronary angiography...
February 1, 2018: Resuscitation
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#3
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29364498/synthetic-cathinones-related-fatalities-an-update
#4
S Zaami, R Giorgetti, S Pichini, F Pantano, E Marinelli, F P Busardò
OBJECTIVE: Synthetic cathinones, more commonly known as "bath salts", are synthetic drugs chemically related to cathinone, a psychostimulant found in the khat plant. They are the first most consumed products among new psychoactive substances, which cause psychostimulant and hallucinogenic effects determining a number of fatalities worldwide.  In this paper, we have systematically reviewed cases of synthetic cathinones-related fatalities analytically confirmed, which have occurred in the last few years...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29351897/transitions-between-circulatory-states-after-out-of-hospital-cardiac-arrest-protocol-for-an-observational-prospective-cohort-study
#5
Halvor Langeland, Daniel Bergum, Magnus Løberg, Knut Bjørnstad, Jan Kristian Damås, Tom Eirik Mollnes, Nils-Kristian Skjærvold, Pål Klepstad
BACKGROUND: The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure. OBJECTIVE: This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS...
January 19, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29280927/hydrogen-inhalation-is-superior-to-mild-hypothermia-for-improving-neurological-outcome-and-survival-in-a-cardiac-arrest-model-of-spontaneously-hypertensive-rat
#6
Gang Chen, Bihua Chen, Chenxi Dai, Jianjie Wang, Juan Wang, Yuanyuan Huang, Yongqin Li
BACKGROUND: Post-cardiac arrest syndrome is the consequence of whole-body ischemia-reperfusion events that lead to multiple organ failure and eventually to death. Recent animal studies demonstrated that inhalation of hydrogen greatly mitigates post-resuscitation myocardial dysfunction and brain injury. However, the influence of underlying heart disease on the efficacy of hydrogen is still unknown. In the present study, we investigated the effects of hydrogen inhalation on neurological outcome and survival in a cardiac arrest model of spontaneously hypertensive rat (SHR)...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29251667/procalcitonin-and-presepsin-as-prognostic-markers-after-out-of-hospital-cardiac-arrest
#7
Pirkka T Pekkarinen, Giuseppe Ristagno, Erika Wilkman, Serge Masson, Roberto Latini, Johanna Laurikkala, Stepani Bendel, Tero Ala-Kokko, Tero Varpula, Jukka Vaahersalo, Sari Karlsson, Marjaana Tiainen, Monica M Mion, Mario Plebani, Ville Pettilä, Markus B Skrifvars
BACKGROUND: Patients resuscitated from cardiac arrest commonly develop an inflammatory response called post-cardiac arrest syndrome that clinically resembles septic shock.Procalcitonin and presepsin are associated with inflammation. We hypothesized that these biomarkers reflect the severity of post-cardiac arrest syndrome and predict short-term haemodynamical instability and long-term neurological outcome after cardiac arrest. METHODS: As a subcohort analysis of a prospective, observational, multi-centre study "FINNRESUSCI", we obtained plasma from 277 intensive care unit (ICU) patients treated following out-of-hospital cardiac arrest (OHCA)...
December 14, 2017: Shock
https://www.readbyqxmd.com/read/29214676/platelet-function-monitoring-for-stent-thrombosis-in-critically-iii-patients-with-an-acute-coronary-syndrome
#8
Lisa Tilemann, Sarah K Mohr, Michael Preusch, Emanuel Chorianopoulos, Evangelos Giannitsis, Hugo A Katus, Oliver J Müller
BACKGROUND: Patients after cardiac arrest or in cardiogenic shock due to acute coronary syndrome (ACS) are at high risk for stent thrombosis (ST) and recurrent cardiovascular events after primary percutaneous coronary intervention (PCI). High post-interventional platelet reactivity (HPR) might be an additional risk factor for ST in these critically ill patients. METHODS: Between 2006 and 2016, 401 critically ill patients from a cardiologic intensive care unit underwent platelet function testing after primary PCI using whole blood impedance aggregometry...
December 6, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29207113/spontaneous-hypothermia-ameliorated-inflammation-and-neurologic-deficit-in-rat-cardiac-arrest-models-following-resuscitation
#9
Minggen Zhou, Peng Wang, Zhengfei Yang, Haidong Wu, Zitong Huan
Cardiac arrest (CA) is a leading cause of mortality worldwide. The majority of the associated mortalities are caused by post‑CA syndrome, which includes symptoms, such as neurologic damage, myocardial dysfunction and systemic inflammation. Following CA, return of spontaneous circulation (ROSC) leads to a brain reperfusion injury, which subsequently causes adverse neurologic outcomes or mortality. Therefore, investigating the underlying mechanisms of ROSC‑induced neurologic deficits and establishing potential treatments is critical to prevent and treat post‑CA syndrome...
February 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29175085/ventilator-management-and-respiratory-care-after-cardiac-arrest-oxygenation-ventilation-infection-and-injury
#10
REVIEW
Nicholas J Johnson, David J Carlbom, David F Gaieski
Return of spontaneous circulation after cardiac arrest results in a systemic inflammatory state called the post-cardiac arrest syndrome, which is characterized by oxidative stress, coagulopathy, neuronal injury, and organ dysfunction. Perturbations in oxygenation and ventilation may exacerbate secondary injury after cardiac arrest and have been shown to be associated with poor outcome. Further, patients who experience cardiac arrest are at risk for a number of other pulmonary complications. Up to 70% of patients experience early infection after cardiac arrest, and the respiratory tract is the most common source...
November 22, 2017: Chest
https://www.readbyqxmd.com/read/29173684/multidisciplinary-management-of-the-post-cardiac-arrest-patient
#11
REVIEW
Ryan D Madder, Joshua C Reynolds
Cardiac arrest afflicts more than 300,000 persons annually in North America alone. Improving outcomes after cardiac arrest requires an integrated and multidisciplinary approach to postresuscitation intensive care and subsequent recovery. This article reviews components of injury within the post-cardiac arrest syndrome, the salient features of brain-oriented intensive care, best practices in neurologic prognostication, and a rational approach to emergency revascularization and hemodynamic support.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29151422/-successful-perform-of-prolonged-cardiopulmonary-and-cerebral-resuscitation-on-repeated-cardiac-arrest-one-case-report
#12
Guanghui He, Yanping Liang, Jianjun Jing, Xiaofeng Li, Xin Jin, Yicheng Yang, Shibin Lyu, Jiaojiao Lu
Cardiac arrest (CA) is the most serious clinical emergency situation and cardiopulmonary-cerebral resuscitation (CPCR) performed on site with high quality is the optional therapy for its management. It has been reported that prolonging the resuscitation time after 30-minute failed conventional cardiopulmonary resuscitation (CPR) could improve the in-hospital survival rate of CA patients, and how to improve the out-hospital survival rate and survival quality of these patients is a research hot focus at present...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29123894/differences-in-coagulofibrinolytic-changes-between-post-cardiac-arrest-syndrome-of-cardiac-causes-and-hypoxic-insults-a-pilot-study
#13
Takeshi Wada, Satoshi Gando, Asumi Mizugaki, Akira Kodate, Yoshihiro Sadamoto, Hiromoto Murakami, Kunihiko Maekawa, Kenichi Katabami, Yuichi Ono, Mineji Hayakawa, Atsushi Sawamura, Subrina Jesmin, Masahiro Ieko
No abstract text is available yet for this article.
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29058596/efficacy-of-inhaled-hydrogen-on-neurological-outcome-following-brain-ischemia-during-post-cardiac-arrest-care-hybrid-ii-trial-study-protocol-for-a-randomized-controlled-trial
#14
Tomoyoshi Tamura, Kei Hayashida, Motoaki Sano, Shuko Onuki, Masaru Suzuki
BACKGROUND: Hydrogen gas inhalation (HI) improved survival and neurological outcomes in an animal model of post-cardiac arrest syndrome (PCAS). The feasibility and safety of HI for patients with PCAS was confirmed in a pilot study. The objective of this study is to evaluate the efficacy of HI for patients with PCAS. METHODS/DESIGN: The efficacy of inhaled HYdrogen on neurological outcome following BRain Ischemia During post-cardiac arrest care (HYBRID II) trial is an investigator-initiated, randomized, double-blind, placebo-controlled trial designed to enroll 360 adult comatose (Glasgow Coma Scale score < 8) patients who will be resuscitated following an out-of-hospital cardiac arrest of a presumed cardiac cause...
October 23, 2017: Trials
https://www.readbyqxmd.com/read/29055751/post-cardiac-arrest-syndrome-pathological-processes-biomarkers-and-vasopressor-support-and-potential-therapeutic-targets
#15
EDITORIAL
Spyros D Mentzelopoulos, Spyros G Zakynthinos
No abstract text is available yet for this article.
December 2017: Resuscitation
https://www.readbyqxmd.com/read/29034235/coagulofibrinolytic-changes-in-patients-with-post-cardiac-arrest-syndrome
#16
REVIEW
Takeshi Wada
Whole-body ischemia and reperfusion due to cardiac arrest and subsequent return of spontaneous circulation constitute post-cardiac arrest syndrome (PCAS), which consists of four syndromes including systemic ischemia/reperfusion responses and post-cardiac arrest brain injury. The major pathophysiologies underlying systemic ischemia/reperfusion responses are systemic inflammatory response syndrome and increased coagulation, leading to disseminated intravascular coagulation (DIC), which clinically manifests as obstruction of microcirculation and multiple organ dysfunction...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29026890/changes-in-histopathology-and-tumor-necrosis-factor-%C3%AE-levels-in-the-hearts-of-rats-following-asphyxial-cardiac-arrest
#17
Jung Hoon Lee, Tae-Kyeong Lee, In Hye Kim, Jae Chul Lee, Moo-Ho Won, Joon Ha Park, Ji Hyeon Ahn, Myoung Chul Shin, Taek Geun Ohk, Joong Bum Moon, Jun Hwi Cho, Chan Woo Park, Hyun-Jin Tae
OBJECTIVE: Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have return of spontaneous circulation (ROSC) after CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during the post CA syndrome. METHODS: We induced asphyxial CA in male Sprague-Dawley rats and determined the survival rate of these rats during the post resuscitation phase. RESULTS: Survival of the rats decreased after CA: 66...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28957432/intranasal-post-cardiac-arrest-treatment-with-orexin-a-facilitates-arousal-from-coma-and-ameliorates-neuroinflammation
#18
Hiren R Modi, Qihong Wang, Sahithi Gd, David Sherman, Elliot Greenwald, Alena V Savonenko, Romergryko G Geocadin, Nitish V Thakor
Cardiac arrest (CA) entails significant risks of coma resulting in poor neurological and behavioral outcomes after resuscitation. Significant subsequent morbidity and mortality in post-CA patients are largely due to the cerebral and cardiac dysfunction that accompanies prolonged whole-body ischemia post-CA syndrome (PCAS). PCAS results in strong inflammatory responses including neuroinflammation response leading to poor outcome. Currently, there are no proven neuroprotective therapies to improve post-CA outcomes apart from therapeutic hypothermia...
2017: PloS One
https://www.readbyqxmd.com/read/28955127/oxidative-stress-and-abnormal-cholesterol-metabolism-in-patients-with-post-cardiac-arrest-syndrome
#19
Midori Nagase, Atsushi Sakurai, Atsunori Sugita, Nozomi Matsumoto, Airi Kubo, Yusuke Miyazaki, Kosaku Kinoshita, Yorihiro Yamamoto
Patients with post-cardiac arrest syndrome (PCAS) suffer from whole body ischemia/reperfusion injury similar to that experienced by newborn babies. Increased oxidative stress was confirmed in PCAS patients (n = 40) at the time of hospitalization by a significant increase in the percentage of the oxidized form of coenzyme Q10 in total coenzyme Q10 compared to age-matched healthy controls (n = 55). Tissue oxidative damage in patients was suggested by the significant increase in plasma levels of free fatty acids (FFA) and the significant decrease in polyunsaturated fatty acid contents in total FFA...
September 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28950909/systemic-impact-on-secondary-brain-aggravation-due-to-ischemia-reperfusion-injury-in-post-cardiac-arrest-syndrome-a-prospective-observational-study-using-high-mobility-group-box-1-protein
#20
Atsunori Sugita, Kosaku Kinoshita, Atsushi Sakurai, Nobutaka Chiba, Junko Yamaguchi, Tsukasa Kuwana, Nami Sawada, Satoshi Hori
BACKGROUND: Ischemia/reperfusion injury (I/R) is an important pathophysiology of post-cardiac arrest syndrome (PCAS) against multiple organ dysfunction and mortality. The inflammatory response in PCAS causes systemic I/R. The purpose of this study was to demonstrate the pathophysiology of systemic I/R for secondary brain damage using the biomarkers high-mobility group box 1 (HMGB1), neuron-specific enolase (NSE), and interleukin-6 (IL-6). METHODS: This study was designed as a single-institution prospective observational study...
September 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
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