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RPHICUTeaching2016.1-Cardiac Arrest

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15 papers 0 to 25 followers Research Papers used in aid of the in-house ICU registrar teaching programme at Royal Perth Hospital in the first half of 2016.
Niklas Nielsen, Jørn Wetterslev, Tobias Cronberg, David Erlinge, Yvan Gasche, Christian Hassager, Janneke Horn, Jan Hovdenes, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Michael Wanscher, Matt P Wise, Anders Åneman, Nawaf Al-Subaie, Søren Boesgaard, John Bro-Jeppesen, Iole Brunetti, Jan Frederik Bugge, Christopher D Hingston, Nicole P Juffermans, Matty Koopmans, Lars Køber, Jørund Langørgen, Gisela Lilja, Jacob Eifer Møller, Malin Rundgren, Christian Rylander, Ondrej Smid, Christophe Werer, Per Winkel, Hans Friberg
BACKGROUND: Unconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Therapeutic hypothermia is recommended by international guidelines, but the supporting evidence is limited, and the target temperature associated with the best outcome is unknown. Our objective was to compare two target temperatures, both intended to prevent fever. METHODS: In an international trial, we randomly assigned 950 unconscious adults after out-of-hospital cardiac arrest of presumed cardiac cause to targeted temperature management at either 33°C or 36°C...
December 5, 2013: New England Journal of Medicine
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
Sea Mi Park, Halinder S Mangat, Karen Berger, Axel J Rosengart
OBJECTIVES: Shivering after anesthesia or in the critical care setting is frequent, can be prolonged, and has the potential for serious adverse events and worsening outcomes. Furthermore, there are conflicting published data and clinical protocols on how to best treat shivering. In this study, we aimed to critically analyze the published evidence of antishivering medications. DATA SOURCES: We systematically reviewed, categorized, and analyzed all literature on antishivering medications published in English...
November 2012: Critical Care Medicine
Carsten Zobel, Christoph Adler, Anna Kranz, Catherine Seck, Roman Pfister, Martin Hellmich, Matthias Kochanek, Hannes Reuter
OBJECTIVE: Mortality in patients with cardiogenic shock after out-of-hospital cardiac arrest remains high despite advances in resuscitation and early revascularization strategies. Recent studies suggest a reduced mortality in survivors of cardiac arrest subjected to mild therapeutic hypothermia, but the underlying mechanisms are not yet clear. Because positive hemodynamic effects of mild therapeutic hypothermia have been suggested, we aimed at testing the hypothesis that patients in cardiogenic shock might benefit from mild therapeutic hypothermia...
June 2012: Critical Care Medicine
Ian G Jacobs, Judith C Finn, George A Jelinek, Harry F Oxer, Peter L Thompson
BACKGROUND: There is little evidence from clinical trials that the use of adrenaline (epinephrine) in treating cardiac arrest improves survival, despite adrenaline being considered standard of care for many decades. The aim of our study was to determine the effect of adrenaline on patient survival to hospital discharge in out of hospital cardiac arrest. METHODS: We conducted a double blind randomised placebo-controlled trial of adrenaline in out-of-hospital cardiac arrest...
September 2011: Resuscitation
Florence Dumas, David Grimaldi, Benjamin Zuber, Jérôme Fichet, Julien Charpentier, Frédéric Pène, Benoît Vivien, Olivier Varenne, Pierre Carli, Xavier Jouven, Jean-Philippe Empana, Alain Cariou
BACKGROUND: Although the level of evidence of improvement is significant in cardiac arrest patients resuscitated from a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia [VF/Vt]), the use of therapeutic mild hypothermia (TMH) is more controversial in nonshockable patients (pulseless electric activity or asystole [PEA/asystole]). We therefore assessed the prognostic value of hypothermia for neurological outcome at hospital discharge according to first-recorded cardiac rhythm in a large cohort...
March 1, 2011: Circulation
Michael Hüpfl, Harald F Selig, Peter Nagele
BACKGROUND: In out-of-hospital cardiac arrest, dispatcher-assisted chest-compression-only bystander CPR might be superior to standard bystander CPR (chest compression plus rescue ventilation), but trial findings have not shown significantly improved outcomes. We aimed to establish the association of chest-compression-only CPR with survival in patients with out-of-hospital cardiac arrest. METHODS: Medline and Embase were systematically reviewed for studies published between January, 1985, and August, 2010, in which chest-compression-only bystander CPR was compared with standard bystander CPR for adult patients with out-of-hospital cardiac arrest...
November 6, 2010: Lancet
Michael Holzer
No abstract text is available yet for this article.
September 23, 2010: New England Journal of Medicine
J Hope Kilgannon, Alan E Jones, Nathan I Shapiro, Mark G Angelos, Barry Milcarek, Krystal Hunter, Joseph E Parrillo, Stephen Trzeciak
CONTEXT: Laboratory investigations suggest that exposure to hyperoxia after resuscitation from cardiac arrest may worsen anoxic brain injury; however, clinical data are lacking. OBJECTIVE: To test the hypothesis that postresuscitation hyperoxia is associated with increased mortality. DESIGN, SETTING, AND PATIENTS: Multicenter cohort study using the Project IMPACT critical care database of intensive care units (ICUs) at 120 US hospitals between 2001 and 2005...
June 2, 2010: JAMA: the Journal of the American Medical Association
G Bryan Young
No abstract text is available yet for this article.
August 6, 2009: New England Journal of Medicine
Bernd W Böttiger, Hans-Richard Arntz, Douglas A Chamberlain, Erich Bluhmki, Ann Belmans, Thierry Danays, Pierre A Carli, Jennifer A Adgey, Christoph Bode, Volker Wenzel
BACKGROUND: Approximately 70% of persons who have an out-of-hospital cardiac arrest have underlying acute myocardial infarction or pulmonary embolism. Therefore, thrombolysis during cardiopulmonary resuscitation may improve survival. METHODS: In a double-blind, multicenter trial, we randomly assigned adult patients with witnessed out-of-hospital cardiac arrest to receive tenecteplase or placebo during cardiopulmonary resuscitation. Adjunctive heparin or aspirin was not used...
December 18, 2008: New England Journal of Medicine
Pierre-Yves Gueugniaud, Jean-Stéphane David, Eric Chanzy, Hervé Hubert, Pierre-Yves Dubien, Patrick Mauriaucourt, Coralie Bragança, Xavier Billères, Marie-Paule Clotteau-Lambert, Patrick Fuster, Didier Thiercelin, Guillaume Debaty, Agnès Ricard-Hibon, Patrick Roux, Catherine Espesson, Emgan Querellou, Laurent Ducros, Patrick Ecollan, Laurent Halbout, Dominique Savary, Frédéric Guillaumée, Régine Maupoint, Philippe Capelle, Cécile Bracq, Philippe Dreyfus, Philippe Nouguier, Antoine Gache, Claude Meurisse, Bertrand Boulanger, Claude Lae, Jacques Metzger, Valérie Raphael, Arielle Beruben, Volker Wenzel, Comlavi Guinhouya, Christian Vilhelm, Emmanuel Marret
BACKGROUND: During the administration of advanced cardiac life support for resuscitation from cardiac arrest, a combination of vasopressin and epinephrine may be more effective than epinephrine or vasopressin alone, but evidence is insufficient to make clinical recommendations. METHODS: In a multicenter study, we randomly assigned adults with out-of-hospital cardiac arrest to receive successive injections of either 1 mg of epinephrine and 40 IU of vasopressin or 1 mg of epinephrine and saline placebo, followed by administration of the same combination of study drugs if spontaneous circulation was not restored and subsequently by additional epinephrine if needed...
July 3, 2008: New England Journal of Medicine
Stephen A Bernard, Timothy W Gray, Michael D Buist, Bruce M Jones, William Silvester, Geoff Gutteridge, Karen Smith
BACKGROUND: Cardiac arrest outside the hospital is common and has a poor outcome. Studies in laboratory animals suggest that hypothermia induced shortly after the restoration of spontaneous circulation may improve neurologic outcome, but there have been no conclusive studies in humans. In a randomized, controlled trial, we compared the effects of moderate hypothermia and normothermia in patients who remained unconscious after resuscitation from out-of-hospital cardiac arrest. METHODS: The study subjects were 77 patients who were randomly assigned to treatment with hypothermia (with the core body temperature reduced to 33 degrees C within 2 hours after the return of spontaneous circulation and maintained at that temperature for 12 hours) or normothermia...
February 21, 2002: New England Journal of Medicine
(no author information available yet)
BACKGROUND: Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment. We studied whether mild systemic hypothermia increases the rate of neurologic recovery after resuscitation from cardiac arrest due to ventricular fibrillation. METHODS: In this multicenter trial with blinded assessment of the outcome, patients who had been resuscitated after cardiac arrest due to ventricular fibrillation were randomly assigned to undergo therapeutic hypothermia (target temperature, 32 degrees C to 34 degrees C, measured in the bladder) over a period of 24 hours or to receive standard treatment with normothermia...
February 21, 2002: New England Journal of Medicine
R L Levine, M A Wayne, C C Miller
BACKGROUND: Survival after cardiac arrest occurring outside the hospital averages less than 3 percent. Unfortunately, the outcome of prolonged resuscitative attempts cannot be predicted. End-tidal carbon dioxide levels reflect cardiac output during cardiopulmonary resuscitation. We prospectively determined whether death could be predicted by monitoring end-tidal carbon dioxide during resuscitation after cardiac arrest. METHODS: We performed a prospective observational study in 150 consecutive victims of cardiac arrest outside the hospital who had electrical activity but no pulse...
July 31, 1997: New England Journal of Medicine
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