Latest & greatest articles for cardiac arrest

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Top results for cardiac arrest

361. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. (Abstract)

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment. We studied whether mild systemic hypothermia increases the rate of neurologic recovery after resuscitation from cardiac arrest due to ventricular fibrillation.In this multicenter trial with blinded assessment of the outcome, patients who had been resuscitated after cardiac arrest due to ventricular fibrillation (...) were randomly assigned to undergo therapeutic hypothermia (target temperature, 32 degrees C to 34 degrees C, measured in the bladder) over a period of 24 hours or to receive standard treatment with normothermia. The primary end point was a favorable neurologic outcome within six months after cardiac arrest; secondary end points were mortality within six months and the rate of complications within seven days.Seventy-five of the 136 patients in the hypothermia group for whom data were available (55

2002 NEJM Controlled trial quality: predicted high

362. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. (Abstract)

Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. Cardiac arrest outside the hospital is common and has a poor outcome. Studies in laboratory animals suggest that hypothermia induced shortly after the restoration of spontaneous circulation may improve neurologic outcome, but there have been no conclusive studies in humans. In a randomized, controlled trial, we compared the effects of moderate hypothermia and normothermia in patients who remained (...) with hypothermia as compared with normothermia was 5.25 (95 percent confidence interval, 1.47 to 18.76; P=0.011). Hypothermia was associated with a lower cardiac index, higher systemic vascular resistance, and hyperglycemia. There was no difference in the frequency of adverse events.Our preliminary observations suggest that treatment with moderate hypothermia appears to improve outcomes in patients with coma after resuscitation from out-of-hospital cardiac arrest.

2002 NEJM Controlled trial quality: predicted high

363. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. (Abstract)

Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Although no randomised controlled trial has assessed the midterm effects of coronary-artery bypass surgery on the beating heart, this technique is being used in more and more patients. We did two randomised trials to compare the short-term morbidity associated with off-pump and on-pump myocardial (...) revascularisation. Our aim was to pool the results to assess midterm outcomes.From March, 1997, to November, 1999, we randomly allocated 200 patients to off-pump and 201 to on-pump coronary surgery. In Beating Heart Against Cardioplegic Arrest Study (BHACAS) 1, we excluded patients who had had myocardial infarction in the past month or who required grafting of the circumflex artery distal to the first obtuse marginal branch. In BHACAS 2, we included such patients. Primary outcomes were all-cause mortality

2002 Lancet Controlled trial quality: predicted high

364. Tissue plasminogen activator in cardiac arrest with pulseless electrical activity. (Abstract)

Tissue plasminogen activator in cardiac arrest with pulseless electrical activity. Coronary thrombosis and pulmonary thromboembolism are common causes of cardiac arrest. We assessed whether the administration of tissue plasminogen activator (t-PA) during cardiopulmonary resuscitation would benefit patients with cardiac arrest and pulseless electrical activity of unknown or presumed cardiovascular cause.Patients who were older than 16 years of age and who had more than one minute of pulseless (...) electrical activity that was unresponsive to initial therapy outside the hospital or in the emergency department were eligible. Patients were randomly assigned to receive 100 mg of t-PA or placebo intravenously over a 15-minute period in a double-blind fashion. Standard resuscitation was then continued for at least 15 minutes. The primary outcome was survival to hospital discharge.During the study period, 1583 patients with cardiac arrest were treated and 233 patients were enrolled (117 in the t-PA group

2002 NEJM Controlled trial quality: predicted high

365. Amiodarone and rural emergency medical services cardiac arrest patients: a cost analysis

Amiodarone and rural emergency medical services cardiac arrest patients: a cost analysis Amiodarone and rural emergency medical services cardiac arrest patients: a cost analysis Amiodarone and rural emergency medical services cardiac arrest patients: a cost analysis Pazdral T E, Burton J H, Strout T D, Bradshaw J R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods (...) , the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of amiodarone (150-mg vial) in a system-wide, rural prehospital treatment protocol for cardiac arrest patients was examined. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The study population comprised patients identified by EMS personnel as presenting with a diagnosis of cardiac arrest. Patients

2002 NHS Economic Evaluation Database.

366. Outcome and cost-effectiveness of cardiopulmonary resuscitation after in-hospital cardiac arrest in octogenarians

Outcome and cost-effectiveness of cardiopulmonary resuscitation after in-hospital cardiac arrest in octogenarians Outcome and cost-effectiveness of cardiopulmonary resuscitation after in-hospital cardiac arrest in octogenarians Outcome and cost-effectiveness of cardiopulmonary resuscitation after in-hospital cardiac arrest in octogenarians Paniagua D, Lopez-Jimenez F, Londono J C, Mangione C M, Fleischmann K, Lamas G A Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The study examined the use of cardiopulmonary resuscitation (CPR) in octogenarians after in-hospital cardiac arrest. Type of intervention Treatment. Economic study type Cost-utility analysis. Study population The study population comprised patients aged 80

2002 NHS Economic Evaluation Database.

367. Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia

Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2002 PedsCCM Evidence-Based Journal Club

368. Mild Therapeutic Hypothermia to Improve the Neurologic Outcome After Cardiac Arrest

Mild Therapeutic Hypothermia to Improve the Neurologic Outcome After Cardiac Arrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2002 PedsCCM Evidence-Based Journal Club

369. Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. (Abstract)

Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. Some people report a near-death experience (NDE) after a life-threatening crisis. We aimed to establish the cause of this experience and assess factors that affected its frequency, depth, and content.In a prospective study, we included 344 consecutive cardiac patients who were successfully resuscitated after cardiac arrest in ten Dutch hospitals. We compared demographic, medical, pharmacological (...) , and psychological data between patients who reported NDE and patients who did not (controls) after resuscitation. In a longitudinal study of life changes after NDE, we compared the groups 2 and 8 years later.62 patients (18%) reported NDE, of whom 41 (12%) described a core experience. Occurrence of the experience was not associated with duration of cardiac arrest or unconsciousness, medication, or fear of death before cardiac arrest. Frequency of NDE was affected by how we defined NDE, the prospective nature

2001 Lancet

370. Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. (Abstract)

19-38] vs 35 [20-40]; p50.75) and median cerebral performance category scores (1 vs 1).We failed to detect any survival advantage for vasopressin over epinephrine. We cannot recommend the routine use of vasopressin for inhospital cardiac arrest patients, and disagree with American Heart Association guidelines, which recommend vasopressin as alternative therapy for cardiac arrest. (...) Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. Survival rates for cardiac arrest patients, both in and out of hospital, are poor. Results of a previous study suggest better outcomes for patients treated with vasopressin than for those given epinephrine, in the out-of-hospital setting. Our aim was to compare the effectiveness and safety of these drugs for the treatment of in-patient cardiac arrest.We did a triple-blind randomised trial

2001 Lancet Controlled trial quality: predicted high

371. Allopurinol Neurocardiac Protection Trial in Infants Undergoing Heart Surgery Using Deep Hypothermic Circulatory Arrest

Allopurinol Neurocardiac Protection Trial in Infants Undergoing Heart Surgery Using Deep Hypothermic Circulatory Arrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2001 PedsCCM Evidence-Based Journal Club

372. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. (Abstract)

Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. Whether antiarrhythmic drugs improve the rate of successful resuscitation after out-of-hospital cardiac arrest has not been determined in randomized clinical trials.We conducted a randomized, double-blind, placebo-controlled study of intravenous amiodarone in patients with out-of-hospital cardiac arrest. Patients who had cardiac arrest with ventricular fibrillation (or pulseless ventricular (...) subgroups and at all times of drug administration. The adjusted odds ratio for survival to admission to the hospital in the amiodarone group as compared with the placebo group was 1.6 (95 percent confidence interval, 1.1 to 2.4; P=0.02). The trial did not have sufficient statistical power to detect differences in survival to hospital discharge, which differed only slightly between the two groups.In patients with out-of-hospital cardiac arrest due to refractory ventricular arrhythmias, treatment

1999 NEJM Controlled trial quality: predicted high

373. Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II

Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II Stiell I G, Wells G A, Field B J, Spaite D W, De Maio V J (...) of receiving the emergency call) in a large multi-centre emergency medical services (EMS) system with existing basic life support and defibrillation (BLS-D) level of care for improving cardiac arrest survival. Some of the rapid defibrillation strategies employed were: ambulance base paging, mobile deployment of ambulances, implementation of new provincial dispatch guidelines, tiered response agreements with fire departments, continuous quality improvement for response intervals and introduction

1999 NHS Economic Evaluation Database.

374. A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest

G A Authors' objectives To determine the relative effectiveness of differences in the defibrillation response time interval, proportion of bystander cardiopulmonary resuscitation (CPR), and type of emergency medical services (EMS) system on survival after out-of-hospital cardiac arrest. Searching MEDLINE (1966-Aug 1997) was searched using the following keywords: 'heart arrest' (with subheading 'therapy') and 'resuscitation' or 'cardiopulmonary resuscitation' combined with 'prognosis (...) and the findings were only based on case series. In view of these issues the authors' conclusions should be treated with caution, as they themselves highlight. Implications of the review for practice and research Practice: The authors state that 'this analysis supports the need for strong links in the chain of survival to improve survival after cardiac arrest, as endorsed by the American Heart Association: early access, early bystander CPR, early defibrillation, and early ALS consisting of intubation

1999 DARE.

375. A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European Epinephrine Study Group. (Abstract)

A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European Epinephrine Study Group. Clinical trials have not shown a benefit of high doses of epinephrine in the management of cardiac arrest. We conducted a prospective, multicenter, randomized study comparing repeated high doses of epinephrine with repeated standard doses in cases of out-of-hospital cardiac arrest.Adult patients who had cardiac arrest outside the hospital were (...) -dose epinephrine improved the rate of successful resuscitation in patients with asystole, but not in those with ventricular fibrillation.In our study, long-term survival after cardiac arrest outside the hospital was no better with repeated high doses of epinephrine than with repeated standard doses.

1998 NEJM Controlled trial quality: uncertain

376. Randomised trial of magnesium in in-hospital cardiac arrest. Duke Internal Medicine Housestaff. (Abstract)

Randomised trial of magnesium in in-hospital cardiac arrest. Duke Internal Medicine Housestaff. The apparent benefit of magnesium in acute myocardial infarction, and the persistently poor outcome after cardiac arrest, have led to use of magnesium in cardiopulmonary resuscitation. Because few data on its use in cardiac arrest were available, we undertook a randomised placebo-controlled trial (MAGIC trial).Patients treated for cardiac arrest by the Duke Hospital code team were randomly assigned (...) intravenous magnesium (2 g [8 mmoles] bolus, followed by 8 g [32 mmoles] over 24 h; 76 patients) or placebo (80 patients). Only patients in intensive care or general wards were eligible; those whose cardiac arrest occurred in emergency, operating, or recovery rooms were excluded. The primary endpoint was return of spontaneous circulation, defined as attainment of any measurable blood pressure or palpable pulse for at least 1 h after cardiac arrest. The secondary endpoints were survival to 24 h, survival

1997 Lancet Controlled trial quality: predicted high

377. Effect of community CPR education programmes on mortality from out-of-hospital cardiac arrest: a systematic review of the research evidence

Effect of community CPR education programmes on mortality from out-of-hospital cardiac arrest: a systematic review of the research evidence Effect of community CPR education programmes on mortality from out-of-hospital cardiac arrest: a systematic review of the research evidence Effect of community CPR education programmes on mortality from out-of-hospital cardiac arrest: a systematic review of the research evidence Young J Authors' objectives To conduct a systematic review on the effectiveness (...) of community cardiopulmonary resuscitation (CPR) education programmes to increase survival following out-of-hospital cardiac arrest. Searching MEDLINE, CINAHL and EMBASE were searched from 1966 to 1996. A preliminary broad search strategy was mentioned, but not described. The only search strategy provided was one designed to identify randomised controlled trials (RCTs). Nine journals were handsearched (details provided in the report), bibliographies were checked, experts and study authors were contacted

1997 DARE.

378. The Ontario trial of active compression-decompression cardiopulmonary resuscitation for in-hospital and prehospital cardiac arrest. (Abstract)

The Ontario trial of active compression-decompression cardiopulmonary resuscitation for in-hospital and prehospital cardiac arrest. To compare the impact of active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) and standard CPR on the outcomes of in-hospital and prehospital victims of cardiac arrest.Randomized controlled trial with blinding of allocation using a sealed container.(1) Emergency departments, wards, and intensive care units of 5 university hospitals and (2) all (...) in both groups). Exploration of clinically important subgroups failed to identify any patients who appeared to benefit from ACD CPR.ACD CPR did not improve survival or neurologic outcomes in any group of patients with cardiac arrest.

1996 JAMA Controlled trial quality: predicted high

379. Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: a metaanalysis

to emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med 1996;27:711-20. Indexing Status Subject indexing assigned by NLM MeSH Cardiopulmonary Resuscitation; Emergency Medical Services /organization & Heart Arrest /mortality /therapy; Humans; Life Support Care; Reaction Time; Survival Analysis; administration /standards AccessionNumber 11996001047 Date bibliographic record published 30/04/1997 Date abstract record published 30/04/1997 Record Status This is a critical (...) Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: a metaanalysis Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: a metaanalysis Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: a metaanalysis Nichol G, Detsky A S, Stiell I G, O' Rourke K, Wells G, Laupacis A Authors' objectives To determine the effect of differences in response time, proportion of bystander CPR

1996 DARE.

380. Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest

improvements to emergency medical services for victims of out-of-hospital cardiac arrest. Annals of Emergency Medicine 1996; 27(6): 711-720 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Cardiopulmonary Resuscitation /education; Cost-Benefit Analysis; Decision Trees; Electric Countershock /economics; Emergency Medical Services /economics; Heart Arrest /mortality /therapy; Humans; Life Support Care /economics; Ontario; Reaction Time AccessionNumber 21996000689 Date bibliographic record (...) Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest Nichol G, Laupacis A, Stiell I G, O'Rourke K, Anis A, Bolley H, Detsky A S Record Status This is a critical

1996 NHS Economic Evaluation Database.