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Latest & greatest articles for cardiac arrest
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Bystander Defibrillation for Out-of-Hospital CardiacArrest in Public vs Residential Locations Bystander-delivered defibrillation (hereinafter referred to as bystander defibrillation) of patients with out-of-hospital cardiacarrests (OHCAs) remains limited despite the widespread dissemination of automated external defibrillators (AEDs).To examine calendar changes in bystander defibrillation and subsequent survival according to a public or a residential location of the cardiacarrest after (...) nationwide initiatives in Denmark to facilitate bystander-mediated resuscitative efforts, including bystander defibrillation.This nationwide study identified 18 688 patients in Denmark with first-time OHCA from June 1, 2001, to December 31, 2012, using the Danish CardiacArrest Registry. Patients had a presumed cardiac cause of arrest that was not witnessed by emergency medical services personnel. Data were analyzed from April 1, 2015, to December 10, 2016.Nationwide initiatives to facilitate bystander
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
The use of therapeutic magnesium for neuroprotection during global cerebral ischemia associated with cardiacarrest and cardiac surgery in adults: a systematic review. Global cerebral ischemia occurs due to reduced blood supply to the brain. This is commonly caused by a cessation of myocardial activity associated with cardiacarrest and cardiac surgery. Survival is not the only important outcome because neurological dysfunction impacts on quality of life, reducing independent living. Magnesium (...) has been identified as a potential neuroprotective agent; however, its role in this context is not yet clear.The objective of this review was to present the best currently available evidence related to the neuroprotective effects of magnesium during a period of global cerebral ischemia in adults with cardiacarrest or cardiac surgery.The current review considered adults aged over 18 years who were at risk of global cerebral ischemia associated with cardiacarrest or cardiac surgery. Studies
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