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Latest & greatest articles for cardiac arrest
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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
Association Between Therapeutic Hypothermia and Survival After In-Hospital CardiacArrest. Therapeutic hypothermia is used for patients following both out-of-hospital and in-hospital cardiacarrest. However, randomized trials on its efficacy for the in-hospital setting do not exist, and comparative effectiveness data are limited.To evaluate the association between therapeutic hypothermia and survival after in-hospital cardiac arrest.In this cohort study, within the national Get (...) With the Guidelines-Resuscitation registry, 26 183 patients successfully resuscitated from an in-hospital cardiacarrest between March 1, 2002, and December 31, 2014, and either treated or not treated with hypothermia at 355 US hospitals were identified. Follow-up ended February 4, 2015.Induction of therapeutic hypothermia.The primary outcome was survival to hospital discharge. The secondary outcome was favorable neurological survival, defined as a Cerebral Performance Category score of 1 or 2 (ie, without severe
Early Bispectral Index and Sedation Requirements During Therapeutic Hypothermia Predict Neurologic Recovery Following CardiacArrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiacarrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Induction of Therapeutic Hypothermia During Out-of-Hospital CardiacArrest Using a Rapid Infusion of Cold Saline: The RINSE Trial (Rapid Infusion of Cold Normal Saline) Patients successfully resuscitated by paramedics from out-of-hospital cardiacarrest often have severe neurologic injury. Laboratory and observational clinical reports have suggested that induction of therapeutic hypothermia during cardiopulmonary resuscitation (CPR) may improve neurologic outcomes. One technique for induction (...) of mild therapeutic hypothermia during CPR is a rapid infusion of large-volume cold crystalloid fluid.In this multicenter, randomized, controlled trial we assigned adults with out-of-hospital cardiacarrest undergoing CPR to either a rapid intravenous infusion of up to 2 L of cold saline or standard care. The primary outcome measure was survival at hospital discharge; secondary end points included return of a spontaneous circulation. The trial was closed early (at 48% recruitment target) due
Early Identification of Patients With Out-of-Hospital CardiacArrest With No Chance of Survival and Consideration for Organ Donation. In patients with out-of-hospital cardiacarrest (OHCA), care requirements can conflict with the need to promptly focus efforts on organ donation in patients who are pronounced dead.To evaluate objective criteria for identifying patients with OHCA with no chance of survival during the first minutes of cardiopulmonary resuscitation to enable prompt orientation (...) not witnessed by emergency medical services personnel, nonshockable initial cardiac rhythm, and no return of spontaneous circulation before receipt of a third 1-mg dose of epinephrine), survival rate at hospital discharge among patients meeting these criteria, performance of the criteria, and number of patients eligible for organ donation.In the Paris SDEC 1-year cohort, the survival rate among the 772 patients with OHCA who met the objective criteria was 0% (95% CI, 0.0% to 0.5%), with a specificity of 100
Outcomes Following Single and Recurrent In-Hospital CardiacArrests in Children With Heart Disease: A Report From American Heart Association's Get With the Guidelines Registry-Resuscitation PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
The Extent of Myocardial Injury during Prolonged Targeted Temperature Management after Out-of-Hospital CardiacArrest The aim of this study is to evaluate the extent of myocardial injury by cardiac biomarkers during prolonged targeted temperature management of 24 hours vs 48 hours after out-of-hospital cardiac arrest.This randomized Scandinavian multicenter study compares the extent of myocardial injury quantified by area under the curve (AUC) of cardiac biomarkers during prolonged targeted (...) temperature management at 33°C ± 1°C of 24 hours and 48 hours, respectively. Through a period of 2.5 years, 161 comatose out-of-hospital cardiacarrest patients were randomized to targeted temperature management for 24 hours (n = 77) or 48 hours (n = 84). The AUC was calculated using both high-sensitivity cardiac troponin T (hs-cTnTAUC) and creatine kinase-myocardial band (CK-MBAUC) that were based upon measurements of these biomarkers every 6 hours upon admission until 96 hours after reaching target
Effect of Cyclosporine in Nonshockable Out-of-Hospital CardiacArrest: The CYRUS Randomized Clinical Trial. Experimental evidence suggests that cyclosporine prevents postcardiac arrest syndrome by attenuating the systemic ischemia reperfusion response.To determine whether early administration of cyclosporine at the time of resuscitation in patients with out-of-hospital cardiacarrest (OHCA) would prevent multiple organ failure.A multicenter, single-blind, randomized clinical trial was conducted (...) from June 22, 2010, to March 13, 2013 (Cyclosporine A in Out-of-Hospital CardiacArrest Resuscitation [CYRUS]). Sixteen intensive care units in 7 university-affiliated hospitals and 9 general hospitals in France participated. A total of 6758 patients who experienced nonshockable OHCA (ie, asystole or pulseless electrical activity) were assessed for eligibility. Analyses were performed according to the intention-to-treat analysis.Patients received an intravenous bolus injection of cyclosporine, 2.5
Association of Circulating MicroRNA-124-3p Levels With Outcomes After Out-of-Hospital CardiacArrest: A Substudy of a Randomized Clinical Trial. The value of microRNAs (miRNAs) as biomarkers has been investigated in various clinical contexts. Initial small-scale studies suggested that miRNAs might be useful indicators of outcome after cardiac arrest.To address the prognostic value of circulating miRNAs in a large cohort of comatose patients with out-of-hospital cardiac arrest.This substudy (...) of the Target Temperature Management After CardiacArrest (TTM) trial, a multicenter randomized, parallel-group, assessor-blinded clinical trial, compared the 6-month neurologic outcomes and survival of patients with cardiacarrest after targeted temperature management at 33°C or 36°C. Five hundred seventy-nine patients who survived the first 24 hours after the return of spontaneous circulation and who had blood samples available for miRNA assessment were enrolled from 29 intensive care units in 9 countries
Usefulness of the Myocardial Infarction and CardiacArrest Calculator as a Discriminator of Adverse Cardiac Events After Elective Hip and Knee Surgery The 2014 American College of Cardiology and American Heart Association guidelines on perioperative evaluation recommend differentiating patients at low risk (<1%) versus elevated risk (≥1%) for cardiac complications to guide appropriate preoperative testing. Among the tools recommended for estimating perioperative risk is the National Surgical (...) Quality Improvement Program (NSQIP) Myocardial Infarction and CardiacArrest (MICA) risk calculator. We investigated whether the NSQIP MICA risk calculator would accurately discriminate adverse cardiac events in a cohort of adult patients undergoing elective orthopedic surgery. We retrospectively reviewed 1,098 consecutive, elective orthopedic surgeries performed at Hershey Medical Center from January 1, 2013, to December 31, 2014. Adverse cardiac events were defined as myocardial infarction
Prognostic values of blood pH and lactate levels in patients resuscitated from outâ€ofâ€hospital cardiacarrest Early prediction of prognosis after out-of-hospital cardiacarrest (OHCA) remains difficult. High blood lactate or low pH levels may be associated with poor prognosis in OHCA patients, but these associations remain controversial. We compared blood lactate and pH levels in OHCA patients transferred to our hospital to measure their prognostic performance.We investigated