Latest & greatest articles for cardiac arrest

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Top results for cardiac arrest

1. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. (PubMed)

Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. Moderate therapeutic hypothermia is currently recommended to improve neurologic outcomes in adults with persistent coma after resuscitated out-of-hospital cardiac arrest. However, the effectiveness of moderate therapeutic hypothermia in patients with nonshockable rhythms (asystole or pulseless electrical activity) is debated.We performed an open-label, randomized, controlled trial comparing moderate therapeutic (...) hypothermia (33°C during the first 24 hours) with targeted normothermia (37°C) in patients with coma who had been admitted to the intensive care unit (ICU) after resuscitation from cardiac arrest with nonshockable rhythm. The primary outcome was survival with a favorable neurologic outcome, assessed on day 90 after randomization with the use of the Cerebral Performance Category (CPC) scale (which ranges from 1 to 5, with higher scores indicating greater disability). We defined a favorable neurologic

2019 NEJM

2. How Effective Are Epinephrine and Vasopressin for Improving Survival Among Patients in Cardiac Arrest?

How Effective Are Epinephrine and Vasopressin for Improving Survival Among Patients in Cardiac Arrest? How Effective Are Epinephrine and Vasopressin for Improving Survival Among Patients in Cardiac Arrest? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page To read this article in full, please review your options for gaining access at the bottom of the page. Article in Press How Effective Are Epinephrine and Vasopressin (...) for Improving Survival Among Patients in Cardiac Arrest? x Michael Gottlieb , MD (EBEM Commentator) , x Vishal P. Jani , DO (EBEM Commentator) , x Yanina A. Purim-Shem-Tov , MD, MS (EBEM Commentator) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: Publication History Published online: May 09, 2019 To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Epinephrine is associated with improved overall survival rates

2019 Annals of Emergency Medicine Systematic Review Snapshots

3. Sodium Bicarbonate Administration in Cardiac Arrest

Sodium Bicarbonate Administration in Cardiac Arrest Sodium Bicarbonate Administration in Cardiac Arrest | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette You’re working a busy shift in TCC one Sunday afternoon when you get a page that EMS is bringing in a patient in cardiac arrest. The patient is a 57-year-old male (...) a laryngeal airway device with a good waveform on capnography. You defibrillate the patient, which results in PEA. he has now been in cardiac arrest for twenty minutes, and you begin to wonder what other management options you have. you consider whether you should give sodium bicarbonate or calcium chloride given his prolonged cardiac arrest, but your attending tells you that neither treatment is beneficial (though , and you keep giving that). After a total of thirty minutes of downtime, the patient

2019 Washington University Emergency Medicine Journal Club

4. Community first responders for out-of-hospital cardiac arrest in adults and children. (PubMed)

Community first responders for out-of-hospital cardiac arrest in adults and children. Mobilization of community first responders (CFRs) to the scene of an out-of-hospital cardiac arrest (OHCA) event has been proposed as a means of shortening the interval from occurrence of cardiac arrest to performance of cardiopulmonary resuscitation (CPR) and defibrillation, thereby increasing patient survival.To assess the effect of mobilizing community first responders (CFRs) to out-of-hospital cardiac (...) arrest events in adults and children older than four weeks of age, in terms of survival and neurological function.We searched the following databases for relevant trials in January 2019: CENTRAL, MEDLINE (Ovid SP), Embase (Ovid SP), and Web of Science. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov, and we scanned the abstracts of conference proceedings of the American Heart Association and the European Resuscitation

2019 Cochrane

5. Time to delivery of an automated external defibrillator (AED) using a drone to improve out-of-hospital cardiac arrest (OHCA) mortality

Time to delivery of an automated external defibrillator (AED) using a drone to improve out-of-hospital cardiac arrest (OHCA) mortality "Time to delivery of an automated external defibrillator (AED) using a " by Vivian Nguyen > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: According to the American Heart Association (AHA), 2018 incidence of out-of-hospital cardiac (...) that control for many confounding factors in order to properly assess the efficacy of drone-delivered AEDs to OHCA mortality rate specifically. Keywords: Drones, AED(s), defibrillator(s) Recommended Citation Nguyen, Vivian, "Time to delivery of an automated external defibrillator (AED) using a drone to improve out-of-hospital cardiac arrest (OHCA) mortality" (2019). School of Physician Assistant Studies . 658. https://commons.pacificu.edu/pa/658 DOWNLOADS Since June 24, 2019 Share COinS Browse Search Enter

2019 Pacific University EBM Capstone Project

6. Prospective validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score for in-hospital cardiac arrest prognosis

Prospective validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score for in-hospital cardiac arrest prognosis We aimed to prospectively validate the Good Outcome Following Attempted Resuscitation (GO-FAR) score, which predicts the likelihood of survival to discharge neurologically intact or with minimal deficits (conscious, alert, and able to work) after in-hospital cardiac arrest (IHCA).Inpatients experiencing an index episode of IHCA between 2010 and 2016 in hospitals

2019 EvidenceUpdates

7. The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: Findings from the PACA and PARAMEDIC-2 randomised controlled trials (Full text)

The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: Findings from the PACA and PARAMEDIC-2 randomised controlled trials Previous research suggests there may be differences in the effects of adrenaline related to the initial cardiac arrest rhythm. The aim of this study was to assess the effect of adrenaline compared with placebo according to whether the initial cardiac arrest rhythm was shockable or non-shockable.Return of spontaneous circulation (...) (ROSC), survival and neurological outcomes according to the initial arrest rhythm were compared amongst patients enrolled in the PARAMEDIC-2 randomised, placebo controlled trial. The results of the PARAMEDIC-2 and PACA out of hospital cardiac arrest trials were combined and meta-analysed.The initial rhythm was known for 3929 (98.2%) in the placebo arm and 3919 (97.6%) in the adrenaline arm. The effect on the rate of ROSC of adrenaline relative to placebo was greater in patients with non-shockable

2019 EvidenceUpdates PubMed

8. Chiefs’ inquiry corner: monoclonal antibodies and clostridium difficile infection, outcomes after in-hospital cardiac arrest v out-of-hospital, dermatomyositis and malignancy, malignancy work up in unprovoked VTE.

Chiefs’ inquiry corner: monoclonal antibodies and clostridium difficile infection, outcomes after in-hospital cardiac arrest v out-of-hospital, dermatomyositis and malignancy, malignancy work up in unprovoked VTE. Chiefs’ Inquiry Corner – Clinical Correlations Search Chiefs’ Inquiry Corner June 10, 2019 3 min read Clostridium difficile (C diff) is the most common pathogen implicated in infectious diarrhea among hospitalized patients. Several antimicrobials, chief among them an oral formulation (...) was discontinued after interim analysis). Patients receiving bezlotoxumab-containing regimens demonstrated significantly reduced rates of recurrence within 12 weeks compared to placebo, suggesting a possible role for this monoclonal antibody in the prevention of recurrence when added to standard antimicrobial therapy. References: The epidemiology, etiology, and outcomes of in-hospital cardiac arrest (IHCA) are quite different from those of out-of-hospital cardiac arrest (OHCA). In contrast to OHCA, survival

2019 Clinical Correlations

9. Accuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arrest

Accuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arrest A new pre-triage screening tool, Nature of Call (NoC), has been introduced into the telephone triage system of UK ambulance services which employ National Health Service Pathways (NHSP). Its function is to provide rapid recognition of patients who may need immediate ambulance dispatch for out-of-hospital cardiac arrest (OHCA) and withholding dispatch for other calls while

2019 EvidenceUpdates

10. Defibrillation energy dose during pediatric cardiac arrest: Systematic review of human and animal model studies

Defibrillation energy dose during pediatric cardiac arrest: Systematic review of human and animal model studies To determine the initial defibrillation energy dose that is associated with sustained return of spontaneous circulation (ROSC) during paediatric cardiac arrest with ventricular fibrillation or pulseless ventricular tachycardia.A systematic review was performed using four databases (PROSPERO: CRD42016036734). Human studies and animal model studies of pediatric cardiac arrest involving

2019 EvidenceUpdates

11. Vasopressors during adult cardiac arrest: A systematic review and meta-analysis

Vasopressors during adult cardiac arrest: A systematic review and meta-analysis To systematically review the literature on the use of vasopressors during adult cardiac arrest to inform an update of international guidelines.PRISMA guidelines were followed. We searched Medline, Embase, Web of Science, CINAHL, and the Cochrane Library for controlled trials and observational studies. The population included adults with cardiac arrest in any setting. Pairs of investigators reviewed studies (...) for relevance, extracted data, and assessed the risk of bias for individual studies. Certainty of evidence was evaluated using GRADE for controlled trials and meta-analyses were performed when at least two studies could be pooled.We included 15 controlled trials and 67 observational studies. The majority of studies included out-of-hospital cardiac arrest only. Meta-analyses were performed for two controlled trials comparing epinephrine to placebo, three comparing vasopressin to epinephrine, and three

2019 EvidenceUpdates

12. Advanced airway management during adult cardiac arrest: A systematic review

Advanced airway management during adult cardiac arrest: A systematic review To systematically review the literature on advanced airway management during adult cardiac arrest in order to inform the International Liaison Committee of Resuscitation (ILCOR) consensus on science and treatment recommendations.The review was performed according to PRISMA guidelines and registered on PROSPERO (CRD42018115556). We searched Medline, Embase, and Evidence-Based Medicine Reviews for controlled trials (...) and observational studies published before October 30, 2018. The population included adult patients with cardiac arrest. Two investigators reviewed studies for relevance, extracted data, and assessed the risk of bias of individual studies.We included 78 observational studies and 11 controlled trials. Most of the observational studies and all of the controlled trials only included patients with out-of-hospital cardiac arrest. The risk of bias for individual observational studies was overall assessed as critical

2019 EvidenceUpdates

13. Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: An external validation of the HOPE score

Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: An external validation of the HOPE score The HOPE score, based on covariates available at hospital admission, predicts the probability of in-hospital survival after extracorporeal life support (ECLS) rewarming of a given hypothermic cardiac arrest patient with accidental hypothermia. Our goal was to externally validate the HOPE score.We included consecutive hypothermic arrested patients who (...) was excellent (97%).This study provides the first external validation of the HOPE score reaching good calibration and excellent discrimination. Clinically, the prediction of the HOPE score remains accurate in the validation sample. The HOPE score may replace serum potassium in the future as the triage tool when considering ECLS rewarming of a hypothermic cardiac arrest victim.Copyright © 2019. Published by Elsevier B.V.

2019 EvidenceUpdates

14. Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial. (PubMed)

Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial. Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest).To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves (...) survival with good neurologic outcome compared with cooling initiated after hospital arrival.The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled.Patients were randomly assigned

2019 JAMA

15. Paediatric targeted temperature management post cardiac arrest: A systematic review and meta-analysis

Paediatric targeted temperature management post cardiac arrest: A systematic review and meta-analysis The International Liaison Committee on Resuscitation prioritized the need to update the review on the use of targeted temperature management (TTM) in paediatric post cardiac arrest care. In this meta-analysis, the effectiveness of TTM at 32-36 °C was compared with no target or a different target for comatose children who achieve a return of sustained circulation after cardiac arrest.Electronic (...) at 32-34 °C compared with a target at 36-37.5 °C did not statistically improve long-term good neurobehavioural survival (risk ratio: 1.15; 95% CI: 0.69-1.93), long-term survival (RR: 1.14; 95% CI: 0.93-1.39), or short-term survival (risk ratio: 1.14; 95% CI: 0.96-1.36). TTM at 32-34 °C did not show statistically increased risks of infection, recurrent cardiac arrest, serious bleeding, or arrhythmias. A novel analysis suggests that another small RCT might provide enough evidence to show benefit

2019 EvidenceUpdates

16. Advanced airway interventions for paediatric cardiac arrest: A systematic review and meta-analysis

Advanced airway interventions for paediatric cardiac arrest: A systematic review and meta-analysis To assess the use of advanced airway interventions (tracheal intubation (TI) or supraglottic airway (SGA) placement), compared with bag mask ventilation (BMV) alone, for resuscitation of children in cardiac arrest.We searched Medline, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) for human trials and observational studies published before September 24, 2018 for clinical trials (...) studies suitable for meta-analysis. The overall certainty of evidence was low to very low. For the critically important outcomes of survival to hospital discharge with good neurologic outcome and survival to hospital discharge results suggested better outcomes achieved with BMV than either TI or SGA; limited data favored SGA over TI. The majority of studies involved out-of-hospital cardiac arrest, with few studies of in-hospital cardiac arrest.TI or SGA are not superior to BMV for resuscitation

2019 EvidenceUpdates

17. Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial

Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial During the first 6-12 h of intensive care unit (ICU) stay, post-cardiac arrest (CA) patients treated with a mean arterial pressure (MAP) 65 mmHg target experience a drop of the cerebral oxygenation that may cause additional cerebral damage. Therefore, we investigated whether an early goal directed haemodynamic optimization strategy (EGDHO

2019 EvidenceUpdates

18. Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? - A systematic review

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? - A systematic review To perform a systematic review to answer 'In adults with attempted resuscitation after non-traumatic cardiac arrest does care at a specialised cardiac arrest centre (CAC) compared to care in a healthcare facility not designated as a specialised cardiac arrest centre improve patient outcomes?'The PRISMA guidelines were followed. We searched bibliographic databases (Embase, MEDLINE (...) neurological outcomes. Secondary outcomes were survival to 30 days, survival to hospital discharge and return of spontaneous circulation (ROSC) post-hospital arrival for patients with ongoing resuscitation. This systematic review was registered in PROSPERO (CRD 42018093369) RESULTS: We included data from 17 observational studies on out-of-hospital cardiac arrest (OHCA) patients in meta-analyses. Overall, the certainty of evidence was very low. Pooling data from only adjusted analyses, care at CAC

2019 EvidenceUpdates

19. In-Hospital Cardiac Arrest: A Review. (Full text)

In-Hospital Cardiac Arrest: A Review. In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke, myocardial infarction, and out-of-hospital cardiac arrest.In-hospital cardiac arrest occurs in over 290 000 adults each year in the United States. Cohort data from the United States indicate that the mean age of patients with in-hospital (...) cardiac arrest is 66 years, 58% are men, and the presenting rhythm is most often (81%) nonshockable (ie, asystole or pulseless electrical activity). The cause of the cardiac arrest is most often cardiac (50%-60%), followed by respiratory insufficiency (15%-40%). Efforts to prevent in-hospital cardiac arrest require both a system for identifying deteriorating patients and an appropriate interventional response (eg, rapid response teams). The key elements of treatment during cardiac arrest include chest

2019 JAMA PubMed

20. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. (PubMed)

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain.To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF.The Catheter Ablation vs (...) at the discretion of site investigators. The drug therapy group (n = 1096) received standard rhythm and/or rate control drugs guided by contemporaneous guidelines.The primary end point was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. Among 13 prespecified secondary end points, 3 are included in this report: all-cause mortality; total mortality or cardiovascular hospitalization; and AF recurrence.Of the 2204 patients randomized (median age, 68 years; 37.2% female; 42.9% had

2019 JAMA