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Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
Yuri Choi, In Ho Kwon, Jinwoo Jeong, Junyoung Chung, Younghoon Roh
OBJECTIVES: This study analyzed the incidence and characteristics of in-hospital cardiac arrest (IHCA) in Korea based on a sample group of patients that is representative of the population. METHODS: The incidence of IHCA in adults was extracted from HIRA-NIS-2009, a sample of all patients using medical services in Korea. IHCA patients were analyzed according to gender, age, type of medical institute, and classification under the 6th revision of the Korean Standard Classification of Diseases (KCD-6)...
October 2016: Healthcare Informatics Research
Magaly Engsig, Helle Søholm, Fredrik Folke, Peter J Gadegaard, Julie Therese Wiis, Rune Molin, Thomas Mohr, Frederik N Engsig
OBJECTIVE: The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. DESIGN SETTING AND PATIENTS: Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed...
2016: Clinical Epidemiology
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
AIM: Targeted temperature management (TTM) for in-hospital cardiac arrest (IHCA) is given different recommendation levels within international resuscitation guidelines. We aimed to identify whether TTM would be associated with favourable outcomes following IHCA and to determine which factors would influence the decision to implement TTM. METHODS: We conducted a retrospective observational study in a single medical centre. We included adult patients suffering IHCA between 2006 and 2014...
2016: PloS One
Yuan-Jhen Syue, Jyun-Bin Huang, Fu-Jen Cheng, Chia-Te Kung, Chao-Jui Li
Background. The survival rates of in-hospital cardiac arrests (IHCAs) are reportedly low at night, but the difference between the survival rates of cardiac origin and noncardiac origin IHCAs occurring at night remains unclear. Methods. Outcomes of IHCAs during different shifts (night, day, and evening) were compared and stratified according to the etiology (cardiac and noncardiac origin). Result. The rate of return of spontaneous circulation (ROSC) was 24.7% lower for cardiac origin IHCA and 19.4% lower for noncardiac origin IHCA in the night shift than in the other shifts...
2016: BioMed Research International
Sarah M Perman, Emily Stanton, Jasmeet Soar, Robert A Berg, Michael W Donnino, Mark E Mikkelsen, Dana P Edelson, Matthew M Churpek, Lin Yang, Raina M Merchant
BACKGROUND: In-hospital cardiac arrest (IHCA) is a major public health problem with significant mortality. A better understanding of where IHCA occurs in hospitals (intensive care unit [ICU] versus monitored ward [telemetry] versus unmonitored ward) could inform strategies for reducing preventable deaths. METHODS AND RESULTS: This is a retrospective study of adult IHCA events in the Get with the Guidelines-Resuscitation database from January 2003 to September 2010...
September 29, 2016: Journal of the American Heart Association
J Hope Kilgannon, Michael Kirchhoff, Lisa Pierce, Nicholas Aunchman, Stephen Trzeciak, Brian W Roberts
AIMS: Recent guidelines for management of cardiac arrest recommend chest compression rates of 100-120 compressions/min. However, animal studies have found cardiac output to increase with rates up to 150 compressions/min. The objective of this study was to test the association between chest compression rates during cardiopulmonary resuscitation for in-hospital cardiac arrest (IHCA) and outcome. METHODS: We conducted a prospective observational study at a single academic medical center...
September 22, 2016: Resuscitation
Chiwon Ahn, Wonhee Kim, Youngsuk Cho, Kyu-Sun Choi, Bo-Hyoung Jang, Tae Ho Lim
We performed a meta-analysis to compare the impact of extracorporeal cardiopulmonary resuscitation (ECPR) to that of conventional cardiopulmonary resuscitation (CCPR) in adult patients who experience cardiac arrest of cardiac origin. A literature search was performed using criteria set forth in a predefined protocol. Report inclusion criteria were that ECPR was compared to CCPR in adult patients with cardiac arrest of cardiac origin, and that survival and neurological outcome data were available. Exclusion criteria were reports describing non-cardiac origin arrest, review articles, editorials, and nonhuman studies...
2016: Scientific Reports
An-Yi Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Chih-Hung Wang, Wen-Jone Chen
INTRODUCTION: Monitoring the partial pressure of end-tidal carbon dioxide (PEtco2) has been advocated since 2010 as an index of resuscitation efforts. However, related research has largely focused on out-of-hospital cardiac arrest victims. In-hospital cardiac arrest (IHCA) differs in terms of etiologies and demographics, the merit of initial PEtco2 values was explored. METHODS: This was a retrospective study in a single medical center between February 2011 and August 2014...
August 27, 2016: American Journal of Emergency Medicine
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
BACKGROUND: We intended to analyse the associations between blood glucose (BG) level and clinical outcomes of in-hospital cardiac arrest (IHCA). METHODS: We conducted a retrospective observational study in a single medical centre and evaluated patients who experienced IHCA between 2006 and 2014. We used multivariable logistic regression analysis to study associations between independent variables and outcomes. We calculated the mean BG level for each patient by averaging the maximum and minimum BG levels in the first 24 h after arrest, and we used mean BG level for our final analysis...
2016: Cardiovascular Diabetology
Joonas Tirkkonen, Heidi Hellevuo, Klaus T Olkkola, Sanna Hoppu
AIM: Aetiology of in-hospital cardiac arrests (IHCAs) on general wards has not been studied. We aimed to determine the underlying causes for IHCAs by the means of autopsy records and clinical judgement of the treating consultants. Furthermore, we investigated whether aetiology and preceding vital dysfunctions are associated with long-term survival. DESIGN AND SETTING: Prospective observational study between 2009-2011 including 279 adult IHCA patients attended by medical emergency team in a Finnish university hospital's general wards...
October 2016: Resuscitation
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
AIM: To analyse the association between gender and outcomes of in-hospital cardiac arrest (IHCA) and the influences of age and marital status on the gender-based difference in clinical outcome. METHODS: This retrospective observational study conducted in a single medical centre evaluated patients who had experienced IHCA from 2006 to 2014. Multivariate logistic regression analysis was used to study associations between independent variables and outcomes. Patients 18-49 years old were considered of reproductive age...
October 2016: Resuscitation
Monique L Anderson, Graham Nichol, David Dai, Paul S Chan, Laine Thomas, Sana M Al-Khatib, Robert A Berg, Steven M Bradley, Eric D Peterson
IMPORTANCE: Survival rates after in-hospital cardiac arrest (IHCA) vary significantly among US centers; whether this variation is owing to differences in IHCA care quality is unknown. OBJECTIVE: To evaluate hospital-level variation to determine whether hospital process composite performance measures of IHCA care quality are associated with patient outcomes. DESIGN, SETTING, AND PARTICIPANTS: Using data from the American Heart Association's Get With the Guidelines-Resuscitation (GWTG-R) program, we analyzed 35 283 patients 18 years or older with IHCA treated at 261 US hospitals from January 1, 2010, through December 31, 2012...
April 1, 2016: JAMA Cardiology
Marcus Andreas Ohlsson, Linn Maria Kennedy, Mark H Ebell, Tord Juhlin, Olle Melander
BACKGROUND: There is a great need for a simple and clinically useful instrument to help physicians estimate the probability of survival to discharge with a good neurological outcome (cerebral performance category, CPC=1) in cases of in-hospital cardiac arrest (IHCA). Our aim was to validate the "Good Outcome Following Attempted Resuscitation" (GO-FAR) score in a different country with different demographics than previously investigated. METHODS: A retrospective observational study including all cases of IHCA who were part of a cardiac arrest registry at Skåne University Hospital in Sweden 2007-2010...
October 15, 2016: International Journal of Cardiology
Jignesh K Patel, Elinor Schoenfeld, Puja B Parikh, Sam Parnia
BACKGROUND: Despite numerous advances in the delivery of resuscitative care, in-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. We sought to study the impact of arterial oxygen tension (Pao 2) on return of spontaneous circulation (ROSC) and survival to discharge in patients with IHCA. METHODS: The study population included 255 consecutive patients who underwent advanced cardiac life support-guided resuscitation from January 2012 to December 2013 for IHCA at an academic tertiary medical center...
July 11, 2016: Journal of Intensive Care Medicine
Tanush Gupta, Dhaval Kolte, Divyanshu Mohananey, Sahil Khera, Kashish Goel, Pratik Mondal, Wilbert S Aronow, Diwakar Jain, Howard A Cooper, Sei Iwai, William H Frishman, Deepak L Bhatt, Gregg C Fonarow, Julio A Panza
Previous studies have shown that obesity is paradoxically associated with improved outcomes in many cardiovascular (CV) disease states; however, whether obesity affects survival after in-hospital cardiac arrest (IHCA) has not been well examined. We queried the 2003 to 2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent cardiopulmonary resuscitation for IHCA. Obese patients were identified using the co-morbidity variable for obesity, as defined in Nationwide Inpatient Sample databases...
September 1, 2016: American Journal of Cardiology
Marion Leary, William Schweickert, Stacie Neefe, Boris Tsypenyuk, Scott Austin Falk, Daniel N Holena
BACKGROUND: How nontechnical factors such as inadequate role definition and overcrowding affect outcomes of in-hospital cardiac arrest (IHCA) is unknown. Using a bundled intervention, we sought to improve providers' role definitions and decrease overcrowding during IHCA events. OBJECTIVES: To determine if a bundled intervention consisting of a nurse/physician leadership dyad, visual cues for provider roles, and a "role check" would lead to reductions in crowding and improve perceptions of communication and team leadership...
July 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Tae Sun Ha, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Chi-Min Park, Kyeongman Jeon, Gee Young Suh
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to have survival benefit in patients who had in-hospital cardiac arrest (IHCA). However, limited data are available on the role of extracorporeal membrane oxygenation (ECMO) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate clinical outcomes and predictors of in-hospital mortality in patients who had OHCA and who underwent ECPR. METHODS: From January 2004 to December 2013, 235 patients who received ECPR were enrolled in a retrospective, single-centre, observational registry...
June 29, 2016: Emergency Medicine Journal: EMJ
Heather Wolfe, Ryan W Morgan, Aaron Donoghue, Dana E Niles, Peter Kudenchuk, Robert A Berg, Vinay M Nadkarni, Robert M Sutton
AIMS: Quality cardiopulmonary resuscitation (CPR) is associated with improved outcomes during cardiac arrest. Duty cycle (DC) represents an understudied element of CPR quality. Our objective was to quantitatively analyze DC during actual pediatric and adolescent in-hospital cardiac arrest (IHCA). METHODS: Prospective observational study of IHCA at a large academic children's hospital. CPR variables included DC (%) up to the first 10min of recorded chest compressions (CCs)...
September 2016: Resuscitation
Hui-Tzu Yeh, Wen Ray Lee, Suh-Meei Hsu, Hsiang-Fen Lai
In-Hospital cardiac arrest (IHCA) is a high risk of patient's safety issue in medical institutions, the incidence and patient's outcome of IHCA is an important indicator of ability of medical treatment and emergency medical quality of hospital. By building up the IHCA information system, we can save the time of typing and statistical data, save the consumption of paper and storage space, managers can view immediately data, track progress and confirm the correctness of the information, and Index values can be rendered immediately...
2016: Studies in Health Technology and Informatics
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