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Latest & greatest articles for cardiac arrest
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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?
The association between hyperoxia and patient outcomes after cardiacarrest: analysis of a high-resolution database PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Biphasic versus monophasic waveforms for transthoracic defibrillation in out-of-hospital cardiacarrest. Transthoracic defibrillation is a potentially life-saving treatment for people with ventricular fibrillation (VF) and haemodynamically unstable ventricular tachycardia (VT). In recent years, biphasic waveforms have become more commonly used for defibrillation than monophasic waveforms. Clinical trials of internal defibrillation and transthoracic defibrillation of short-duration arrhythmias (...) of up to 30 seconds have demonstrated the superiority of biphasic waveforms over monophasic waveforms. However, out-of-hospital cardiacarrest (OHCA) involves a duration of VF/VT of several minutes before defibrillation is attempted.To determine the efficacy and safety of biphasic defibrillation waveforms, compared to monophasic, for resuscitation of people experiencing out-of-hospital cardiac arrest.We searched the following electronic databases for potentially relevant studies up to 10 September
Massive haemorrhage from a haemofiltration line (Vascath) on returning from computed tomography, resulting in cardiacarrest: A coronerâ€™s request for dissemination 28979463 2017 10 05 1751-1437 17 1 2016 Feb Journal of the Intensive Care Society J Intensive Care Soc Massive haemorrhage from a haemofiltration line (Vascath) on returning from computed tomography, resulting in cardiacarrest: A coroner's request for dissemination. 82-83 10.1177/1751143715601123 Bigham Sarah S Intensive Care
Therapeutic hypothermia after out-of-hospital cardiacarrest in children 28979460 2018 11 13 1751-1437 17 1 2016 Feb Journal of the Intensive Care Society J Intensive Care Soc Therapeutic hypothermia after out-of-hospital cardiacarrest in children. 73-75 10.1177/1751143715623450 eng Journal Article Review 2016 01 05 England J Intensive Care Soc 101538668 1751-1437 2017 10 6 6 0 2016 2 1 0 0 2016 2 1 0 1 ppublish 28979460 10.1177/1751143715623450 10.1177_1751143715623450 PMC5606388 N Engl J Med
low-quality evidence). 11 5 Safety with Percutaneous Coronary Intervention? Five studies indicate that the combination of therapeutic hypothermia and primary percutaneous intervention was feasible and safe after cardiacarrest caused by acute myocardial infarction. 1 Recommendation ANZCOR suggests that percutaneous coronary intervention during TTM is feasible and safe and may be associated with improved outcome. 1 [Class B; LOE III-3, IV] ANZCOR suggests institutions or communities planning (...) . Castren M, Nordberg P, Svensson L, et al. Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC Intra Nasal Cooling Effectiveness). Circulation 2010;122:729–36 13. Nagao K, Kikushima K, Watanabe K, et al. Early induction of hypothermia during cardiacarrest improves neurological outcomes in patients with out-of-hospital cardiacarrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention. Circ J 2010;74:77–85.247. 14
of structural heart damage increasing at greater velocities. Suspected traumatic cardiacarrest due to commotio cordis should be managed according to the general principles for CPR outlined in ANZCOR Guideline 11.2, with early defibrillation of shockable rhythms accorded the same high priority (Class A; LOE IV). 7.2 Isolated major head injury Isolated traumatic brain injury (TBI) without substantial structural brain pathology has been noted in case series and animal models occasionally to cause apnoea (...) /hypokalaemia and other metabolic disorders, hypo/hyperthermia, tension pneumothorax, tamponade, toxins, and thrombosis – pulmonary / coronary) in any patient in cardiacarrest, particularly those in asystole. Following this cardiacarrest due to trauma guideline will identify and treat all these conditions, with the exceptions of hypo/hyperthermia, toxins and thrombosis. These relatively infrequent causes should be considered in a patient who has not responded to other interventions. (Class A, LOE IV
Atrio-Ventricular CA Collaborative Assessment CAD Coronary Artery Disease CABG Coronary Artery Bypass Grafting CE Conformité Européene CFDA China Food and Drug Administration CMR Cardiac Magnetic Resonance CPVT Cathecholaminergic Polymorphic Ventricular Tachycardia CT Controlled Trials CT Computed Tomography CRT-D Cardiac Resynchronisation Therapy CUR Health Problem and Current Use of the Technology domain d(s) day(s) ECG Electrocardiogram EFF Clinical Effectiveness domain EHRA European Heart Rhythm (...) Heart Association ORG Organisational aspects domain PM Pacemaker PMDA Pharmaceuticals and Medical Devices Agency PPCM Peripartum Cardiomyopathy pre-op pre-operation pt(s) patient(s) PVC Premature Ventricular Complex QoL Quality of Life REA Relative Effectiveness Assessment RCT Randomised Controlled Trials RVOT Right Ventricular Outflow Tract SA-ECG Signal-Averaged ECG SAE Serious Adverse Events SAF Safety domain SCA Sudden CardiacArrest SCD Sudden Cardiac Death SD Standard Deviation SPECT Single
Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiacarrest in patients at risk Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiacarrest in patients at risk Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiacarrest in patients at risk Ettinger S, Stanak M, Huić M, Hacek RT, Ercevic D, Grenkovic R, Wild C Record Status (...) This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Ettinger S, Stanak M, Huić M, Hacek RT, Ercevic D, Grenkovic R, Wild C. Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiacarrest in patients at risk. Vienna: Ludwig Boltzmann Institut fuer Health Technology Assessment (LBIHTA). Decision Support Document. 2016 Authors
Warning Symptoms Are Associated With Survival From Sudden CardiacArrest. Survival after sudden cardiacarrest (SCA) remains low, and tools for improved prediction of patients at long-term risk for SCA are lacking. Alternative short-term approaches aimed at preemptive risk stratification and prevention are needed.To assess characteristics of symptoms in the 4 weeks before SCA and whether response to these symptoms is associated with better outcomes.Ongoing prospective population-based (...) %) called emergency medical services (911) to report symptoms before SCA; these persons were more likely to be patients with a history of heart disease (P < 0.001) or continuous chest pain (P < 0.001). Survival when 911 was called in response to symptoms was 32.1% (95% CI, 21.8% to 42.4%) compared with 6.0% (CI, 3.5% to 8.5%) in those who did not call (P < 0.001).Potential for recall and response bias, symptom assessment not available in 24% of patients, and missing data for some patients and SCA
Continuous or Interrupted Chest Compressions for CardiacArrest. 26552007 2015 12 23 2018 12 02 1533-4406 373 23 2015 Dec 03 The New England journal of medicine N. Engl. J. Med. Continuous or Interrupted Chest Compressions for CardiacArrest. 2278-9 10.1056/NEJMe1513415 Koster Rudolph W RW From the Department of Cardiology, Academic Medical Center, Amsterdam. eng Editorial Comment 2015 11 09 United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2015 Dec 3;373(23):2203-14 26550795 (...) Cardiopulmonary Resuscitation methods Emergency Medical Services Female Humans Male Out-of-Hospital CardiacArrest therapy Positive-Pressure Respiration 2015 11 10 6 0 2015 11 10 6 0 2015 12 24 6 0 ppublish 26552007 10.1056/NEJMe1513415
The CAHP (CardiacArrest Hospital Prognosis) score: a tool for risk stratification after out-of-hospital cardiacarrest Survival after out-of-hospital cardiacarrest (OHCA) remains disappointingly low. Among patients admitted alive, early prognostication remains challenging. This study aims to establish a stratification score for patients admitted in intensive care unit (ICU) after OHCA, according to their neurological outcome.The CAHP (CardiacArrest Hospital Prognosis) score was developed (...) from the Sudden Death Expertise Center registry (Paris, France). The primary outcome was poor neurological outcome defined as Cerebral Performance Category 3, 4, or 5 at hospital discharge. Independent prognostic factors were identified using logistic regression analysis and thresholds defined to stratify low-, moderate-, and high-risk groups. The CAHP score was validated in both a prospective and an external data set (Parisian CardiacArrest Registry). The developmental data set included 819
[Pre-hospital ECMO for refractory cardiacarrest] ECMO pour la prise en charge pré-hospitalière de l'arrêt cardiaque [Pre-hospital ECMO for refractory cardiacarrest] ECMO pour la prise en charge pré-hospitalière de l'arrêt cardiaque [Pre-hospital ECMO for refractory cardiacarrest] Comite d´Evaluation et de Diffusion des Innovations Technologiques (CEDIT) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation Comite d´Evaluation et de Diffusion des Innovations Technologiques (CEDIT). ECMO pour la prise en charge pré-hospitalière de l'arrêt cardiaque. [Pre-hospital ECMO for refractory cardiacarrest] Paris, France: Comite d´Evaluation et de Diffusion des Innovations Technologiques (CEDIT). 2015 Authors' objectives The CEDIT (hospital based HTA agency) of AP-HP (Paris University Hospital) assessed the impact and value of extracorporeal
Outcomes following out-of-hospital cardiacarrest: What is the potential for donation after circulatory death? We conducted a prospective observational study on 100 consecutive patients admitted to intensive care units at Leeds General Infirmary following out-of-hospital cardiacarrest. In the non-survivors, we reviewed their potential for organ donation via donation after circulatory death. Out of the 100 patients, 53 did not survive to hospital discharge. Out of these non-survivors, 13 died (...) very suddenly within the intensive care unit and 3 other patients subsequently died in a general ward following discharge from the intensive care unit. One patient became brainstem dead, with out-of-hospital cardiacarrest secondary to a subarachnoid haemorrhage, rather than a primary cardiac cause. This patient went on to donate via the brain death mode. The remaining 36 patients had treatment withdrawn in the intensive care unit. Of these, 29 were referred to the transplant team for potential
Aminophylline for bradyasystolic cardiacarrest in adults. In cardiac ischaemia, the accumulation of adenosine may lead to or exacerbate bradyasystole and diminish the effectiveness of catecholamines administered during resuscitation. Aminophylline is a competitive adenosine antagonist. Case studies suggest that aminophylline may be effective for atropine-resistant bradyasystolic arrest.To determine the effects of aminophylline in the treatment of patients in bradyasystolic cardiacarrest (...) Google.All randomised controlled trials comparing intravenous aminophylline with administered placebo in adults with non-traumatic, normothermic bradyasystolic cardiacarrest who were treated with standard advanced cardiac life support (ACLS).Two review authors independently reviewed the studies and extracted the included data. We contacted study authors when needed. Pooled risk ratio (RR) was estimated for each study outcome. Subgroup analysis was predefined according to the timing of aminophylline