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Latest & greatest articles for cardiac arrest
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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
A good outcome after absence of bilateral N20 SSEPs post-cardiacarrest A 51-year-old man suffered a cardiacarrest after an attempted hanging. Post-arrest assessment revealed the bilateral absence of negative 20 somatosensory evoked potentials (N20 SSEPs) which is suggestive of a poor neurological outcome. Current evidence recommends its use in prognostication. Our patient made a good recovery which brings into question the value of negative 20 somatosensory evoked potentials
Management of cardiacarrest survivors in UK intensive care units: a survey of practice Cardiacarrest is a common presentation to intensive care units. There is evidence that management protocols between hospitals differ and that this variation is mirrored in patient outcomes between institutions, with standardised treatment protocols improving outcomes within individual units. It has been postulated that regionalisation of services may improve outcomes as has been shown in trauma, burns (...) and stroke patients, however a national protocol has not been a focus for research. The objective of our study was to ascertain current management strategies for comatose post cardiacarrest survivors in intensive care in the United Kingdom.A telephone survey was carried out to establish the management of comatose post cardiacarrest survivors in UK intensive care units. All 235 UK intensive care units were contacted and 208 responses (89%) were received.A treatment protocol is used in 172 units (82.7
Alignment of Do-Not-Resuscitate Status With Patients' Likelihood of Favorable Neurological Survival After In-Hospital CardiacArrest. After patients survive an in-hospital cardiacarrest, discussions should occur about prognosis and preferences for future resuscitative efforts.To assess whether patients' decisions for do-not-resuscitate (DNR) orders after a successful resuscitation from in-hospital cardiacarrest are aligned with their expected prognosis.Within Get With The Guidelines (...) -Resuscitation, we identified 26,327 patients with return of spontaneous circulation (ROSC) after in-hospital cardiacarrest between April 2006 and September 2012 at 406 US hospitals. Using a previously validated prognostic tool, each patient's likelihood of favorable neurological survival (ie, without severe neurological disability) was calculated. The proportion of patients with DNR orders within each prognosis score decile and the association between DNR status and actual favorable neurological survival
Association of presence and timing of invasive airway placement with outcomes after pediatric in-hospital cardiacarrest PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Association of Bystander Interventions With Neurologically Intact Survival Among Patients With Bystander-Witnessed Out-of-Hospital CardiacArrest in Japan. Neurologically intact survival after out-of-hospital cardiacarrest (OHCA) has been increasing in Japan. However, associations between increased prehospital care, including bystander interventions and increases in survival, have not been well estimated.To estimate the associations between bystander interventions and changes in neurologically (...) intact survival among patients with OHCA in Japan.Retrospective descriptive study using data from Japan's nationwide OHCA registry, which started in January 2005. The registry includes all patients with OHCA transported to the hospital by emergency medical services (EMS) and recorded patients' characteristics, prehospital interventions, and outcomes. Participants were 167,912 patients with bystander-witnessed OHCA of presumed cardiac origin in the registry between January 2005 and December 2012
Association of Bystander and First-Responder Intervention With Survival After Out-of-Hospital CardiacArrest in North Carolina, 2010-2013. Out-of-hospital cardiacarrest is associated with low survival, but early cardiopulmonary resuscitation (CPR) and defibrillation can improve outcomes if more widely adopted.To examine temporal changes in bystander and first-responder resuscitation efforts before arrival of the emergency medical services (EMS) following statewide initiatives to improve (...) bystander and first-responder efforts in North Carolina from 2010-2013 and to examine the association between bystander and first-responder resuscitation efforts and survival and neurological outcome.We studied 4961 patients with out-of-hospital cardiacarrest for whom resuscitation was attempted and who were identified through the CardiacArrest Registry to Enhance Survival (2010-2013). First responders were dispatched police officers, firefighters, rescue squad, or life-saving crew trained to perform
) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001).A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiacarrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.). (...) Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiacarrest. Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiacarrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital
Early cardiopulmonary resuscitation in out-of-hospital cardiacarrest. Three million people in Sweden are trained in cardiopulmonary resuscitation (CPR). Whether this training increases the frequency of bystander CPR or the survival rate among persons who have out-of-hospital cardiacarrests has been questioned.We analyzed a total of 30,381 out-of-hospital cardiacarrests witnessed in Sweden from January 1, 1990, through December 31, 2011, to determine whether CPR was performed before (...) the arrival of emergency medical services (EMS) and whether early CPR was correlated with survival.CPR was performed before the arrival of EMS in 15,512 cases (51.1%) and was not performed before the arrival of EMS in 14,869 cases (48.9%). The 30-day survival rate was 10.5% when CPR was performed before EMS arrival versus 4.0% when CPR was not performed before EMS arrival (P<0.001). When adjustment was made for a propensity score (which included the variables of age, sex, location of cardiacarrest, cause