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Latest & greatest articles for cardiac arrest
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Early Identification of Patients With Out-of-Hospital CardiacArrest With No Chance of Survival and Consideration for Organ Donation. In patients with out-of-hospital cardiacarrest (OHCA), care requirements can conflict with the need to promptly focus efforts on organ donation in patients who are pronounced dead.To evaluate objective criteria for identifying patients with OHCA with no chance of survival during the first minutes of cardiopulmonary resuscitation to enable prompt orientation (...) not witnessed by emergency medical services personnel, nonshockable initial cardiac rhythm, and no return of spontaneous circulation before receipt of a third 1-mg dose of epinephrine), survival rate at hospital discharge among patients meeting these criteria, performance of the criteria, and number of patients eligible for organ donation.In the Paris SDEC 1-year cohort, the survival rate among the 772 patients with OHCA who met the objective criteria was 0% (95% CI, 0.0% to 0.5%), with a specificity of 100
Outcomes Following Single and Recurrent In-Hospital CardiacArrests in Children With Heart Disease: A Report From American Heart Association's Get With the Guidelines Registry-Resuscitation PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
The Extent of Myocardial Injury during Prolonged Targeted Temperature Management after Out-of-Hospital CardiacArrest The aim of this study is to evaluate the extent of myocardial injury by cardiac biomarkers during prolonged targeted temperature management of 24 hours vs 48 hours after out-of-hospital cardiac arrest.This randomized Scandinavian multicenter study compares the extent of myocardial injury quantified by area under the curve (AUC) of cardiac biomarkers during prolonged targeted (...) temperature management at 33°C ± 1°C of 24 hours and 48 hours, respectively. Through a period of 2.5 years, 161 comatose out-of-hospital cardiacarrest patients were randomized to targeted temperature management for 24 hours (n = 77) or 48 hours (n = 84). The AUC was calculated using both high-sensitivity cardiac troponin T (hs-cTnTAUC) and creatine kinase-myocardial band (CK-MBAUC) that were based upon measurements of these biomarkers every 6 hours upon admission until 96 hours after reaching target
Effect of Cyclosporine in Nonshockable Out-of-Hospital CardiacArrest: The CYRUS Randomized Clinical Trial. Experimental evidence suggests that cyclosporine prevents postcardiac arrest syndrome by attenuating the systemic ischemia reperfusion response.To determine whether early administration of cyclosporine at the time of resuscitation in patients with out-of-hospital cardiacarrest (OHCA) would prevent multiple organ failure.A multicenter, single-blind, randomized clinical trial was conducted (...) from June 22, 2010, to March 13, 2013 (Cyclosporine A in Out-of-Hospital CardiacArrest Resuscitation [CYRUS]). Sixteen intensive care units in 7 university-affiliated hospitals and 9 general hospitals in France participated. A total of 6758 patients who experienced nonshockable OHCA (ie, asystole or pulseless electrical activity) were assessed for eligibility. Analyses were performed according to the intention-to-treat analysis.Patients received an intravenous bolus injection of cyclosporine, 2.5
Association of Circulating MicroRNA-124-3p Levels With Outcomes After Out-of-Hospital CardiacArrest: A Substudy of a Randomized Clinical Trial. The value of microRNAs (miRNAs) as biomarkers has been investigated in various clinical contexts. Initial small-scale studies suggested that miRNAs might be useful indicators of outcome after cardiac arrest.To address the prognostic value of circulating miRNAs in a large cohort of comatose patients with out-of-hospital cardiac arrest.This substudy (...) of the Target Temperature Management After CardiacArrest (TTM) trial, a multicenter randomized, parallel-group, assessor-blinded clinical trial, compared the 6-month neurologic outcomes and survival of patients with cardiacarrest after targeted temperature management at 33°C or 36°C. Five hundred seventy-nine patients who survived the first 24 hours after the return of spontaneous circulation and who had blood samples available for miRNA assessment were enrolled from 29 intensive care units in 9 countries
Usefulness of the Myocardial Infarction and CardiacArrest Calculator as a Discriminator of Adverse Cardiac Events After Elective Hip and Knee Surgery The 2014 American College of Cardiology and American Heart Association guidelines on perioperative evaluation recommend differentiating patients at low risk (<1%) versus elevated risk (≥1%) for cardiac complications to guide appropriate preoperative testing. Among the tools recommended for estimating perioperative risk is the National Surgical (...) Quality Improvement Program (NSQIP) Myocardial Infarction and CardiacArrest (MICA) risk calculator. We investigated whether the NSQIP MICA risk calculator would accurately discriminate adverse cardiac events in a cohort of adult patients undergoing elective orthopedic surgery. We retrospectively reviewed 1,098 consecutive, elective orthopedic surgeries performed at Hershey Medical Center from January 1, 2013, to December 31, 2014. Adverse cardiac events were defined as myocardial infarction
Prognostic values of blood pH and lactate levels in patients resuscitated from outâ€ofâ€hospital cardiacarrest Early prediction of prognosis after out-of-hospital cardiacarrest (OHCA) remains difficult. High blood lactate or low pH levels may be associated with poor prognosis in OHCA patients, but these associations remain controversial. We compared blood lactate and pH levels in OHCA patients transferred to our hospital to measure their prognostic performance.We investigated
A retrospective study of inâ€hospital cardiacarrest In-hospital cardiacarrest is an important issue in health care today. Data regarding in-hospital cardiacarrest in Japan is limited. In Australia and the USA, the Rapid Response System has been implemented in many institutions and data regarding in-hospital cardiacarrest are collected to evaluate the efficacy of the Rapid Response System. This is a multicenter retrospective survey of in-hospital cardiacarrest, providing data before (...) implementing a Rapid Response System.Ten institutions planning to introduce a Rapid Response System were recruited to collect in-hospital cardiacarrest data. The Institutional Review Board at each participating institution approved this study. Data for patients admitted at each institution from April 1, 2011 until March 31, 2012 were extracted using the three keywords "closed-chest compression", "epinephrine", and "defibrillation". Patients under 18 years old, or who suffered cardiacarrest
Resuscitation Practices Associated with Survival After In-Hospital CardiacArrest: A Nationwide Survey Although survival of patients with in-hospital cardiacarrest varies markedly among hospitals, specific resuscitation practices that distinguish sites with higher cardiacarrest survival rates remain unknown.To identify resuscitation practices associated with higher rates of in-hospital cardiacarrest survival.Nationwide survey of resuscitation practices at hospitals participating in the Get (...) With the Guidelines-Resuscitation registry and with 20 or more adult in-hospital cardiacarrest cases from January 1, 2012, through December 31, 2013. Data analysis was performed from June 10 to December 22, 2015.Risk-standardized survival rates for cardiacarrest were calculated at each hospital and were then used to categorize hospitals into quintiles of performance. The association between resuscitation practices and quintiles of survival was evaluated using hierarchical proportional odds logistic regression
Strategies to improve cardiacarrest survival: a time to act 29123754 2018 11 13 2052-8817 3 2 2016 04 Acute medicine & surgery Acute Med Surg Strategies to improve cardiacarrest survival: a time to act. 61-64 10.1002/ams2.192 Shinozaki Koichiro K The Feinstein Institute for Medical Research Manhasset NY USA. Nonogi Hiroshi H Shizuoka General Hospital Shizuoka City Shizuoka Japan. Nagao Ken K Nihon University Hospital Tokyo Tokyo Japan. Becker Lance B LB The Feinstein Institute for Medical
Cardiacarrest due to massive hemorrhage from uterine adenomyosis with leiomyoma successfully treated with damage control resuscitation A 57-year-old woman was transferred to our emergency department by ambulance with cardiopulmonary arrest caused by massive genital bleeding. Cardiopulmonary resuscitation, including massive transfusion, was carried out and the return of spontaneous circulation was achieved. A giant uterine tumor was considered the source of the bleeding. Although hysterectomy
Defibrillation time intervals and outcomes of cardiacarrest in hospital: retrospective cohort study from Get With The Guidelines-Resuscitation registry. To describe temporal trends in the time interval between first and second attempts at defibrillation and the association between this time interval and outcomes in patients with persistent ventricular tachycardia or ventricular fibrillation (VT/VF) arrest in hospital.Retrospective cohort study172 hospitals in the United States participating (...) in the Get With The Guidelines-Resuscitation registry, 2004-12.Adults who received a second defibrillation attempt for persistent VT/VF arrest within three minutes of a first attempt.Second defibrillation attempts categorized as early (time interval of up to and including one minute between first and second defibrillation attempts) or deferred (time interval of more than one minute between first and second defibrillation attempts).Survival to hospital discharge.Among 2733 patients with persistent VT/VF
Early administration of epinephrine (adrenaline) in patients with cardiacarrest with initial shockable rhythm in hospital: propensity score matched analysis. To evaluate whether patients who experience cardiacarrest in hospital receive epinephrine (adrenaline) within the two minutes after the first defibrillation (contrary to American Heart Association guidelines) and to evaluate the association between early administration of epinephrine and outcomes in this population.Prospective (...) observational cohort study.Analysis of data from the Get With The Guidelines-Resuscitation registry, which includes data from more than 300 hospitals in the United States.Adults in hospital who experienced cardiacarrest with an initial shockable rhythm, including patients who had a first defibrillation within two minutes of the cardiacarrest and who remained in a shockable rhythm after defibrillation.Epinephrine given within two minutes after the first defibrillation.Survival to hospital discharge
Out-of-Hospital CardiacArrest - Are Drugs Ever the Answer? 27042874 2016 05 25 2018 12 02 1533-4406 374 18 2016 May 05 The New England journal of medicine N. Engl. J. Med. Out-of-Hospital CardiacArrest--Are Drugs Ever the Answer? 1781-2 10.1056/NEJMe1602790 Joglar Jose A JA From the University of Texas Southwestern Medical Center, Dallas (J.A.J.); and the University of Wisconsin School of Medicine and Public Health, Madison (R.L.P.). Page Richard L RL From the University of Texas Southwestern (...) Medical Center, Dallas (J.A.J.); and the University of Wisconsin School of Medicine and Public Health, Madison (R.L.P.). eng Editorial Comment 2016 04 04 United States N Engl J Med 0255562 0028-4793 0 Anti-Arrhythmia Agents 98PI200987 Lidocaine N3RQ532IUT Amiodarone AIM IM N Engl J Med. 2016 May 5;374(18):1711-22 27043165 Amiodarone therapeutic use Anti-Arrhythmia Agents therapeutic use Female Humans Lidocaine therapeutic use Male Out-of-Hospital CardiacArrest drug therapy 2016 4 5 6 0 2016 4 5 6 0
Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Survivors of Out-of-Hospital CardiacArrest: A Randomized Clinical Trial. Evidence from preclinical models indicates that xenon gas can prevent the development of cerebral damage after acute global hypoxic-ischemic brain injury but, thus far, these putative neuroprotective properties have not been reported in human studies.To determine the effect of inhaled xenon on ischemic white matter damage assessed with magnetic resonance (...) imaging (MRI).A randomized single-blind phase 2 clinical drug trial conducted between August 2009 and March 2015 at 2 multipurpose intensive care units in Finland. One hundred ten comatose patients (aged 24-76 years) who had experienced out-of-hospital cardiacarrest were randomized.Patients were randomly assigned to receive either inhaled xenon combined with hypothermia (33°C) for 24 hours (n = 55 in the xenon group) or hypothermia treatment alone (n = 55 in the control group).The primary end point
Pre-hospital versus in-hospital initiation of cooling for survival and neuroprotection after out-of-hospital cardiacarrest. Targeted temperature management (also known under 'therapeutic hypothermia', 'induced hypothermia'", or 'cooling') has been shown to be beneficial for neurological outcome in patients who have had successful resuscitation from sudden cardiacarrest, but it remains unclear when this intervention should be initiated.To assess the effects of pre-hospital initiation (...) of cooling on survival and neurological outcome in comparison to in-hospital initiation of cooling for adults with pre-hospital cardiac arrest.We searched CENTRAL, MEDLINE, EMBASE, CINAHL, BIOSIS, and three trials registers from inception to 5 March 2015, and carried out reference checking, citation searching, and contact with study authors to identify additional studies.We searched for randomized controlled trials (RCTs) in adults with out-of-hospital cardiacarrest comparing cooling in the pre-hospital
Association of Left Ventricular Systolic Function and Vasopressor Support With Survival Following Pediatric Out-of-Hospital CardiacArrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?