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Latest & greatest articles for cardiac arrest
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The use of antiarrhythmic drugs for adult cardiacarrest: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Association between arterial hyperoxia following resuscitation from cardiacarrest and in-hospital mortality PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
In patients with out-of-hospital cardiacarrest, does the provision of dispatch cardiopulmonary resuscitation instructions as opposed to no instructions improve outcome: a systematic review of the literature Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Early versus later rhythm analysis in patients with out-of-hospital cardiacarrest. In a departure from the previous strategy of immediate defibrillation, the 2005 resuscitation guidelines from the American Heart Association-International Liaison Committee on Resuscitation suggested that emergency medical service (EMS) personnel could provide 2 minutes of cardiopulmonary resuscitation (CPR) before the first analysis of cardiac rhythm. We compared the strategy of a brief period of CPR with early (...) of -0.2 percentage points (95% confidence interval, -1.1 to 0.7; P=0.59). Analyses of the data with adjustment for confounding factors, as well as subgroup analyses, also showed no survival benefit for either study group.Among patients who had an out-of-hospital cardiacarrest, we found no difference in the outcomes with a brief period, as compared with a longer period, of EMS-administered CPR before the first analysis of cardiac rhythm. (Funded by the National Heart, Lung, and Blood Institute
discharge.Use of the ITD did not significantly improve survival with satisfactory function among patients with out-of-hospital cardiacarrest receiving standard CPR. (Funded by the National Heart, Lung, and Blood Institute and others; ROC PRIMED ClinicalTrials.gov number, NCT00394706.). (...) A trial of an impedance threshold device in out-of-hospital cardiacarrest. The impedance threshold device (ITD) is designed to enhance venous return and cardiac output during cardiopulmonary resuscitation (CPR) by increasing the degree of negative intrathoracic pressure. Previous studies have suggested that the use of an ITD during CPR may improve survival rates after cardiac arrest.We compared the use of an active ITD with that of a sham ITD in patients with out-of-hospital cardiacarrest who
Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiacarrest: a randomised trial. Active compression-decompression cardiopulmonary resuscitation (CPR) with decreased intrathoracic pressure in the decompression phase can lead to improved haemodynamics compared with standard CPR. We aimed to assess effectiveness and safety of this intervention on survival (...) with favourable neurological function after out-of-hospital cardiac arrest.In our randomised trial of 46 emergency medical service agencies (serving 2·3 million people) in urban, suburban, and rural areas of the USA, we assessed outcomes for patients with out-of-hospital cardiacarrest according to Utstein guidelines. We provisionally enrolled patients to receive standard CPR or active compression-decompression CPR with augmented negative intrathoracic pressure (via an impedance-threshold device
2011LancetControlled trial quality: predicted high
Automated External Defibrillators and Survival After In-Hospital CardiacArrest. Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiacarrests, but data on their effectiveness in hospitalized patients are limited.To evaluate the association between AED use and survival for in-hospital cardiac arrest.Cohort study of 11,695 hospitalized patients with cardiacarrests between January 1, 2000, and August 26, 2008, at 204 US hospitals following the introduction (...) the entire study population, AED use was associated with a lower rate of survival after in-hospital cardiacarrest compared with no AED use (16.3% vs 19.3%; adjusted rate ratio [RR], 0.85; 95% confidence interval [CI], 0.78-0.92; P < .001). Among cardiacarrests due to nonshockable rhythms, AED use was associated with lower survival (10.4% vs 15.4%; adjusted RR, 0.74; 95% CI, 0.65-0.83; P < .001). In contrast, for cardiacarrests due to shockable rhythms, AED use was not associated with survival (38.4
Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiacarrest. Chest compression-only bystander cardiopulmonary resuscitation (CPR) may be as effective as conventional CPR with rescue breathing for out-of-hospital cardiac arrest.To investigate the survival of patients with out-of-hospital cardiacarrest using compression-only CPR (COCPR) compared with conventional CPR.A 5-year prospective observational cohort study of survival in patients at least 18 years old (...) with out-of-hospital cardiacarrest between January 1, 2005, and December 31, 2009, in Arizona. The relationship between layperson bystander CPR and survival to hospital discharge was evaluated using multivariable logistic regression.Survival to hospital discharge.Among 5272 adults with out-of-hospital cardiacarrest of cardiac etiology not observed by responding emergency medical personnel, 779 were excluded because bystander CPR was provided by a health care professional or the arrest occurred
Isotonic Solutions 0 Ringer's Lactate AIM IM N Engl J Med. 2011 Jan 13;364(2):185-6; author reply 187-8 21226601 N Engl J Med. 2011 Jan 13;364(2):186-7 21226599 N Engl J Med. 2011 Jan 13;364(2):186; author reply 187-8 21226600 N Engl J Med. 2011 Jan 13;364(2):187; author reply 187-8 21226598 Advanced Cardiac Life Support Body Temperature Coma etiology therapy HeartArrest complications therapy Humans Hypothermia, Induced adverse effects methods Isotonic Solutions therapeutic use Male Middle Aged (...) Targeted temperature management for comatose survivors of cardiacarrest. 20860507 2010 09 28 2018 12 01 1533-4406 363 13 2010 Sep 23 The New England journal of medicine N. Engl. J. Med. Targeted temperature management for comatose survivors of cardiacarrest. 1256-64 10.1056/NEJMct1002402 Holzer Michael M Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. email@example.com eng Journal Article Review United States N Engl J Med 0255562 0028-4793 0
Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation CardiacArrest. A Randomized Controlled Trial Therapeutic hypothermia is recommended for the treatment of neurological injury after resuscitation from out-of-hospital cardiacarrest. Laboratory studies have suggested that earlier cooling may be associated with improved neurological outcomes. We hypothesized that induction of therapeutic hypothermia by paramedics before hospital (...) arrival would improve outcome.In a prospective, randomized controlled trial, we assigned adults who had been resuscitated from out-of-hospital cardiacarrest with an initial cardiac rhythm of ventricular fibrillation to either prehospital cooling with a rapid infusion of 2 L of ice-cold lactated Ringer's solution or cooling after hospital admission. The primary outcome measure was functional status at hospital discharge, with a favorable outcome defined as discharge either to home
Laryngeal Masks (MeSH) OR LMA.mp] AND [cardiac arrest.mp or exp HeartArrest (MeSH) OR arrest.mp OR exp Cardiopulmonary Resuscitation (MeSH) OR CPR.mp], limited to humans (EMBASE and MEDLINE), adults and English language (CINAHL, EMBASE and MEDLINE). Google Scholar search: “laryngeal mask airway OR LMA” and “arrest” in the title of the article. Search Outcome Altogether 83 papers were found in MEDLINE, 65 in EMBASE, 12 in CINAHL, 34 in The Cochrane Central Register of Controlled Trials and 8 in Google (...) Laryngeal mask airway versus endotracheal intubation or bag-mask ventilation for cardiacarrest in adults BestBets: Laryngeal mask airway versus endotracheal intubation or bag-mask ventilation for cardiacarrest in adults Laryngeal mask airway versus endotracheal intubation or bag-mask ventilation for cardiacarrest in adults Report By: Mithun Biswas, Adam Zenkner and Sajid Aziz - Medical students Search checked by Adam Zenkner - Medical student Institution: University of Warwick Date Submitted
Association between arterial hyperoxia following resuscitation from cardiacarrest and in-hospital mortality. Laboratory investigations suggest that exposure to hyperoxia after resuscitation from cardiacarrest may worsen anoxic brain injury; however, clinical data are lacking.To test the hypothesis that postresuscitation hyperoxia is associated with increased mortality.Multicenter cohort study using the Project IMPACT critical care database of intensive care units (ICUs) at 120 US hospitals (...) between 2001 and 2005. Patient inclusion criteria were age older than 17 years, nontraumatic cardiacarrest, cardiopulmonary resuscitation within 24 hours prior to ICU arrival, and arterial blood gas analysis performed within 24 hours following ICU arrival. Patients were divided into 3 groups defined a priori based on PaO(2) on the first arterial blood gas values obtained in the ICU. Hyperoxia was defined as PaO(2) of 300 mm Hg or greater; hypoxia, PaO(2) of less than 60 mm Hg (or ratio of PaO(2
Small Area Variations in Out-of-Hospital CardiacArrest: Does the Neighborhood Matter? The incidence and outcomes of out-of-hospital cardiacarrest vary widely across cities. It is unknown whether similar differences exist at the neighborhood level.To determine the extent to which neighborhoods have persistently high rates of cardiacarrest but low rates of bystander cardiopulmonary resuscitation (CPR).Multilevel Poisson regression of 1108 cardiacarrests from 161 census tracts as captured (...) by the CardiacArrest Registry to Enhance Survival (CARES).Fulton County, Georgia, between 1 October 2005 to 30 November 2008.Incidence of cardiacarrest, by census tract and year and by rates of bystander CPR.Adjusted rates of cardiacarrest varied across neighborhoods (interquartile range [IQR], 0.57 to 0.73 per 1000 persons; mean, 0.64 per 1000 persons [SD, 0.11]) but were stable from year to year (intraclass correlation, 0.36 [95% CI, 0.26 to 0.50]; P < 0.001). Adjusted bystander CPR rates also varied
for out-of-hospital cardiacarrest, we did not detect an improvement in outcome, in comparison with placebo. (ClinicalTrials.gov number, NCT00157261.) Intravascular thrombosis plays a fundamental role in the pathophysiology of cardiacarrest. Autopsy results from cases of unsuccessful resuscitation and coronary angiography in survivors of out-of-hospital cardiacarrest suggest that 50-70% of deaths can be attributed to thrombosis in the form of myocardial infarction or pulmonary embolism (...) in unsuccessful prehospital resuscitation. J Intern Med 1991, 229: 331-335. 10.1111/j.1365-2796.1991.tb00355.x Spaulding CM, Joly LM, Rosenberg A, Monchi M, Weber SN, Dhainaut JF, Carli P: Immediate coronary angiography in survivors of out-of-hospital cardiacarrest. N Engl J Med 1997, 336: 1629-1633. 10.1056/NEJM199706053362302 Böttiger BW, Motsch J, Böhrer H, Böker T, Aulmann M, Nawroth PP, Martin E: Activation of blood coagulation after cardiacarrest is not balanced adequately by activation of endogenous
Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiacarrests: a prospective, nationwide, population-based cohort study. The American Heart Association recommends cardiopulmonary resuscitation (CPR) by bystanders with chest compression only for adults who have cardiacarrests, but not for children. We assessed the effect of CPR (conventional with rescue breathing or chest compression only) by bystanders on outcomes (...) after out-of-hospital cardiacarrests in children.In a nationwide, prospective, population-based, observational study, we enrolled 5170 children aged 17 years and younger who had an out-of-hospital cardiacarrest from Jan 1, 2005, to Dec 31, 2007. Data collected included age, cause, and presence and type of CPR by bystander. The primary endpoint was favourable neurological outcome 1 month after an out-of-hospital cardiacarrest, defined as Glasgow-Pittsburgh cerebral performance category 1 or 2.3675
arrest (SCA) each year in the United States and abroad. Advanced Cardiac Life Support (ACLS) is an algorithm-based set of recommendations and instructions assembled by the American Heart Association for the management of this condition. While rapid defibrillation appears highly effective for SCA, the role of intravenous agents is unproven. This review examined the utility of the ACLS algorithms in the only two high quality trials to test them. The first used historical controls during the ‘phase (...) ACLS Medications for CardiacArrest ACLS Medications for CardiacArrest – TheNNTTheNNT Advanced Cardiac Life Support Medications for CardiacArrest No benefit found In Summary, for those who received the cardiac medications: Benefits in NNT 100% saw no benefit None were helped Harms in NNT 0% were identifiably harmed* None were identifiably harmed* View As: NNT % Source: Efficacy Endpoints: Mortality Harm Endpoints: Mortality Narrative: Hundreds of thousands of individuals suffer sudden cardiac
Defibrillation for CardiacArrest Defibrillation for CardiacArrest – TheNNTTheNNT Rapid Defibrillation for CardiacArrest 2.5 for mortality In Summary, for those who received the defibrillation: Benefits in NNT 62% saw no benefit 38% were saved from death 1 in 2.5 were helped (prevented death) Harms in NNT 0% were harmed None were identifiably harmed* *Side effects from cardioversion/electricity View As: NNT % Source: Efficacy Endpoints: Mortality Harm Endpoints: Mortality Narrative: Hundreds (...) of thousands of individuals suffer sudden cardiacarrest (SCA) each year in the United States and abroad. Rapid defibrillation has been thought highly effective for SCA, but data have been sparse. This review examined the utility of rapid defibrillation under the best of possible circumstances: in a public location, with otherwise relatively healthy patients who suffer witnessed, sudden cardiacarrest, and in whom defibrillation is typically available within 3-4 minutes. Under these unusual circumstances
Delayed versus immediate defibrillation for out-of-hospital cardiacarrest due to ventricular fibrillation: a systematic review and meta-analysis of randomised controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
. Vasopressin and epinephrine versus epinephrine in management of patients with cardiacarrest: a meta-analysis. Signa Vitae 2010; 5(1): 20-26 Original Paper URL Indexing Status Subject indexing assigned by CRD MeSH Drug Therapy, Combination; Epinephrine; HeartArrest; Humans; Vasopressins AccessionNumber 12010003760 Date bibliographic record published 20/10/2010 Date abstract record published 12/01/2011 Record Status This is a critical abstract of a systematic review that meets the criteria for inclusion (...) Vasopressin and epinephrine versus epinephrine in management of patients with cardiacarrest: a meta-analysis Vasopressin and epinephrine versus epinephrine in management of patients with cardiacarrest: a meta-analysis Vasopressin and epinephrine versus epinephrine in management of patients with cardiacarrest: a meta-analysis Jing XL, Wang DP, Li X, Li H, Liao XX, Xiong Y, Wang XF CRD summary This review concluded that there was no evidence that vasopressin and epinephrine was more effective