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Saket Girotra, Brahmajee K Nallamothu, John A Spertus, Yan Li, Harlan M Krumholz, Paul S Chan
BACKGROUND: Despite advances in resuscitation care in recent years, it is not clear whether survival and neurologic function after in-hospital cardiac arrest have improved over time. METHODS: We identified all adults who had an in-hospital cardiac arrest at 374 hospitals in the Get with the Guidelines-Resuscitation registry between 2000 and 2009. Using multivariable regression, we examined temporal trends in risk-adjusted rates of survival to discharge. Additional analyses explored whether trends were due to improved survival during acute resuscitation or postresuscitation care and whether they occurred at the expense of greater neurologic disability in survivors...
November 15, 2012: New England Journal of Medicine
R L DE Souza, M E Thais, G Cavallazzi, A Paim Diaz, M L Schwarzbold, A L Nau, G M Rodrigues, D S Souza, A Hohl, R Walz
BACKGROUND: Pupils' abnormalities are associated to bad prognosis in traumatic brain injury. We investigated the association between the side of pupil mydriasis and the long-term cognitive performance of patients with severe traumatic brain injury (TBI). METHODS: We analyzed the cognitive performance of patients admitted at the intensive care unit with isochoric pupils (IP, n = 28), left mydriasis (LM, n = 10), right mydriasis (RM, n = 9) evaluated in mean 2...
March 2015: Acta Anaesthesiologica Scandinavica
F Zoerner, F Lennmyr, L Wiklund, C Martijn, E Semenas
BACKGROUND: Long-term survival after cardiac arrest (CA) due to shock-refractory ventricular fibrillation (VF) is low. Clearly, there is a need for new pharmacological interventions in the setting of cardiopulmonary resuscitation (CPR) to improve outcome. Here, hemodynamic parameters and cardiac damage are compared between the treatment group (milrinone, esmolol and vasopressin) and controls (vasopressin only) during resuscitation from prolonged CA in piglets. METHODS: A total of 26 immature male piglets were subjected to 12-min VF followed by 8-min CPR...
April 2015: Acta Anaesthesiologica Scandinavica
Spyros D Mentzelopoulos, Sotirios Malachias, Christos Chamos, Demetrios Konstantopoulos, Theodora Ntaidou, Androula Papastylianou, Iosifinia Kolliantzaki, Maria Theodoridi, Helen Ischaki, Dimosthemis Makris, Epaminondas Zakynthinos, Elias Zintzaras, Sotirios Sourlas, Stavros Aloizos, Spyros G Zakynthinos
IMPORTANCE: Among patients with cardiac arrest, preliminary data have shown improved return of spontaneous circulation and survival to hospital discharge with the vasopressin-steroids-epinephrine (VSE) combination. OBJECTIVE: To determine whether combined vasopressin-epinephrine during cardiopulmonary resuscitation (CPR) and corticosteroid supplementation during and after CPR improve survival to hospital discharge with a Cerebral Performance Category (CPC) score of 1 or 2 in vasopressor-requiring, in-hospital cardiac arrest...
July 17, 2013: JAMA: the Journal of the American Medical Association
Denis Roy, Mario Talajic, Stanley Nattel, D George Wyse, Paul Dorian, Kerry L Lee, Martial G Bourassa, J Malcolm O Arnold, Alfred E Buxton, A John Camm, Stuart J Connolly, Marc Dubuc, Anique Ducharme, Peter G Guerra, Stefan H Hohnloser, Jean Lambert, Jean-Yves Le Heuzey, Gilles O'Hara, Ole Dyg Pedersen, Jean-Lucien Rouleau, Bramah N Singh, Lynne Warner Stevenson, William G Stevenson, Bernard Thibault, Albert L Waldo
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure and suggesting that the suppression of atrial fibrillation may favorably affect the outcome. However, the benefits and risks of this approach have not been adequately studied. METHODS: We conducted a multicenter, randomized trial comparing the maintenance of sinus rhythm (rhythm control) with control of the ventricular rate (rate control) in patients with a left ventricular ejection fraction of 35% or less, symptoms of congestive heart failure, and a history of atrial fibrillation...
June 19, 2008: New England Journal of Medicine
K Jokela, P Setälä, J Virta, H Huhtala, A Yli-Hankala, S Hoppu
BACKGROUND: Medical emergency team (MET) activation criteria serve as a predictor of serious adverse events on hospital wards and in the emergency department (ED). We aimed to determine whether in-hospital MET activation criteria would be useful in identifying patients at risk in pre-hospital care. METHODS: The data were collected retrospectively from 610 adult patients treated by physician-staffed helicopter emergency medical services. Pre-hospital vital signs were compared with MET activation criteria and scored accordingly to receive a simplified pre-hospital 'MET' score...
April 2015: Acta Anaesthesiologica Scandinavica
Kohei Hasegawa, Atsushi Hiraide, Yuchiao Chang, David F M Brown
IMPORTANCE: It is unclear whether advanced airway management such as endotracheal intubation or use of supraglottic airway devices in the prehospital setting improves outcomes following out-of-hospital cardiac arrest (OHCA) compared with conventional bag-valve-mask ventilation. OBJECTIVE: To test the hypothesis that prehospital advanced airway management is associated with favorable outcome after adult OHCA. DESIGN, SETTING, AND PARTICIPANTS: Prospective, nationwide, population-based study (All-Japan Utstein Registry) involving 649,654 consecutive adult patients in Japan who had an OHCA and in whom resuscitation was attempted by emergency responders with subsequent transport to medical institutions from January 2005 through December 2010...
January 16, 2013: JAMA: the Journal of the American Medical Association
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