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Latest & greatest articles for cardiac arrest
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Part Question In [adults with out-of-hospital cardiacarrest] does [pre-hospital epinephrine] affect [long-term morbidity or mortality]? Clinical Scenario A 74-year-old male presents to the emergency department with out-of-hospital cardiacarrest. Paramedics administered epinephrine prior to arrival to the hospital. The patient is unresponsive but has a faint pulse. You wonder about the long-term benefits of epinephrine which is still recommended by the American Heart Association. Search Strategy (...) % CI 2.36 to 3.54) Based on many observational studies Overall ROSC Survival to discharge RR 0.93 (95% CI 0.5 to 1.74) RR 0.69 (95% CI 0.48 to 1) Comment(s) Epinephrine is a fundamental part of advanced cardiac life support. It is said to increase coronary and cerebral perfusion. This alpha-adrenergic-mediated process is thought to contribute to ROSC in arrested patients. However, despite epinephrine's integral part in standard resuscitation protocols, there remains little evidence that epinephrine
Effectiveness of the precordial thump in restoring heart rhythm following out-of-hospital cardiacarrest BestBets: Effectiveness of the precordial thump in restoring heart rhythm following out-of-hospital cardiacarrest Effectiveness of the precordial thump in restoring heart rhythm following out-of-hospital cardiacarrest Report By: James Smith MD - Senior EM Resident Search checked by Bryan Judge MD - Residency Director Institution: Grand Rapids Medical Education Partners Date Submitted: 12th (...) August 2014 Date Completed: 25th May 2016 Last Modified: 10th February 2017 Status: Green (complete) Three Part Question In [adults with cardiacarrest from ventricular fibrillation or pulseless ventricular tachycardia] is the [precordial thump better than BLS alone] at [restoring spontaneous circulation]? Clinical Scenario A 72 year old male presents to the emergency department with pulseless ventricular tachycardia. You wonder if a precordial thump is effective in restoring the heart to a sinus
Association Between Tracheal Intubation During Adult In-Hospital CardiacArrest and Survival. Tracheal intubation is common during adult in-hospital cardiacarrest, but little is known about the association between tracheal intubation and survival in this setting.To determine whether tracheal intubation during adult in-hospital cardiacarrest is associated with survival to hospital discharge.Observational cohort study of adult patients who had an in-hospital cardiacarrest from January 2000 (...) through December 2014 included in the Get With The Guidelines-Resuscitation registry, a US-based multicenter registry of in-hospital cardiacarrest. Patients who had an invasive airway in place at the time of cardiacarrest were excluded. Patients intubated at any given minute (from 0-15 minutes) were matched with patients at risk of being intubated within the same minute (ie, still receiving resuscitation) based on a time-dependent propensity score calculated from multiple patient, event
). The incidences of blood-product use, infection, and serious adverse events, as well as 28-day mortality, did not differ significantly between groups.Among comatose children who survived in-hospital cardiacarrest, therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a favorable functional outcome at 1 year. (Funded by the National Heart, Lung, and Blood Institute; THAPCA-IH ClinicalTrials.gov number, NCT00880087 .). (...) Therapeutic Hypothermia after In-Hospital CardiacArrest in Children. Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiacarrest; however, data on temperature management after in-hospital cardiacarrest are limited.In a trial conducted at 37 children's hospitals, we compared two temperature interventions in children who had had in-hospital cardiacarrest. Within 6 hours after the return of circulation, comatose children older than 48
â€œFreeze, Donâ€™t Moveâ€: How to Arrest a Suspect in Heart Failure â€“ A Review on Available GRK2 Inhibitors Cardiovascular disease and heart failure (HF) still collect the largest toll of death in western societies and all over the world. A growing number of molecular mechanisms represent possible targets for new therapeutic strategies, which can counteract the metabolic and structural changes observed in the failing heart. G protein-coupled receptor kinase 2 (GRK2) is one of such targets (...) for which experimental and clinical evidence are established. Indeed, several strategies have been carried out in place to interface with the known GRK2 mechanisms of action in the failing heart. This review deals with results from basic and preclinical studies. It shows different strategies to inhibit GRK2 in HF in vivo (βARK-ct gene therapy, treatment with gallein, and treatment with paroxetine) and in vitro (RNA aptamer, RKIP, and peptide-based inhibitors). These strategies are based either
Early Electroencephalographic Background Features Predict Outcomes in Children Resuscitated From CardiacArrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Early Electroencephalographic Findings Correlate With Neurologic Outcome in Children Following CardiacArrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With CardiacArrest: A Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Public-Access Defibrillation and Out-of-Hospital CardiacArrest in Japan. Early defibrillation plays a key role in improving survival in patients with out-of-hospital cardiacarrests due to ventricular fibrillation (ventricular-fibrillation cardiacarrests), and the use of publicly accessible automated external defibrillators (AEDs) can help to reduce the time to defibrillation for such patients. However, the effect of dissemination of public-access AEDs for ventricular-fibrillation cardiac (...) arrest at the population level has not been extensively investigated.From a nationwide, prospective, population-based registry of patients with out-of-hospital cardiacarrest in Japan, we identified patients from 2005 through 2013 with bystander-witnessed ventricular-fibrillation arrests of presumed cardiac origin in whom resuscitation was attempted. The primary outcome measure was survival at 1 month with a favorable neurologic outcome (Cerebral Performance Category of 1 or 2, on a scale from 1
Association Between Tracheal Intubation During Pediatric In-Hospital CardiacArrest and Survival. Tracheal intubation is common during pediatric in-hospital cardiacarrest, although the relationship between intubation during cardiacarrest and outcomes is unknown.To determine if intubation during pediatric in-hospital cardiacarrest is associated with improved outcomes.Observational study of data from United States hospitals in the Get With The Guidelines-Resuscitation registry. Pediatric (...) patients (<18 years) with index in-hospital cardiacarrest between January 2000 and December 2014 were included. Patients who were receiving assisted ventilation, had an invasive airway in place, or both at the time chest compressions were initiated were excluded.Tracheal intubation during cardiacarrest .The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation and neurologic outcome. A favorable neurologic outcome was defined as a score of 1
Association Between Therapeutic Hypothermia and Survival After In-Hospital CardiacArrest. Therapeutic hypothermia is used for patients following both out-of-hospital and in-hospital cardiacarrest. However, randomized trials on its efficacy for the in-hospital setting do not exist, and comparative effectiveness data are limited.To evaluate the association between therapeutic hypothermia and survival after in-hospital cardiac arrest.In this cohort study, within the national Get (...) With the Guidelines-Resuscitation registry, 26 183 patients successfully resuscitated from an in-hospital cardiacarrest between March 1, 2002, and December 31, 2014, and either treated or not treated with hypothermia at 355 US hospitals were identified. Follow-up ended February 4, 2015.Induction of therapeutic hypothermia.The primary outcome was survival to hospital discharge. The secondary outcome was favorable neurological survival, defined as a Cerebral Performance Category score of 1 or 2 (ie, without severe
Early Bispectral Index and Sedation Requirements During Therapeutic Hypothermia Predict Neurologic Recovery Following CardiacArrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiacarrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Induction of Therapeutic Hypothermia During Out-of-Hospital CardiacArrest Using a Rapid Infusion of Cold Saline: The RINSE Trial (Rapid Infusion of Cold Normal Saline) Patients successfully resuscitated by paramedics from out-of-hospital cardiacarrest often have severe neurologic injury. Laboratory and observational clinical reports have suggested that induction of therapeutic hypothermia during cardiopulmonary resuscitation (CPR) may improve neurologic outcomes. One technique for induction (...) of mild therapeutic hypothermia during CPR is a rapid infusion of large-volume cold crystalloid fluid.In this multicenter, randomized, controlled trial we assigned adults with out-of-hospital cardiacarrest undergoing CPR to either a rapid intravenous infusion of up to 2 L of cold saline or standard care. The primary outcome measure was survival at hospital discharge; secondary end points included return of a spontaneous circulation. The trial was closed early (at 48% recruitment target) due