keyword
https://read.qxmd.com/read/38149972/prediction-of-the-neurological-outcomes-post-cardiac-arrest-a-prospective-validation-of-the-cast-and-rcast
#21
MULTICENTER STUDY
Kazuya Kikutani, Mitsuaki Nishikimi, Kota Matsui, Atsushi Sakurai, Kei Hayashida, Nobuya Kitamura, Takashi Tagami, Taka-Aki Nakada, Shigeyuki Matsui, Shinichiro Ohshimo, Nobuaki Shime
INTRODUCTION: The neurologic prognosis of out-of-hospital cardiac arrest (OHCA) patients in whom return of spontaneous circulation (ROSC) is achieved remains poor. The aim of this study was to externally and prospectively validate two scoring systems developed by us: the CAST score, a scoring system to predict the neurological prognosis of OHCA patients undergoing targeted temperature management (TTM), and a simplified version of the same score developed for improved ease of use in clinical settings, the revised CAST (rCAST) score...
January 2024: American Journal of Emergency Medicine
https://read.qxmd.com/read/38140038/neuroprotective-neurorestorative-effects-induced-by-progesterone-on-global-cerebral-ischemia-a-narrative-review
#22
REVIEW
Pedro Montes, Emma Ortíz-Islas, Citlali Ekaterina Rodríguez-Pérez, Elizabeth Ruiz-Sánchez, Daniela Silva-Adaya, Pavel Pichardo-Rojas, Victoria Campos-Peña
Progesterone (P4) is a neuroactive hormone having pleiotropic effects, supporting its pharmacological potential to treat global (cardiac-arrest-related) cerebral ischemia, a condition associated with an elevated risk of dementia. This review examines the current biochemical, morphological, and functional evidence showing the neuroprotective/neurorestorative effects of P4 against global cerebral ischemia (GCI). Experimental findings show that P4 may counteract pathophysiological mechanisms and/or regulate endogenous mechanisms of plasticity induced by GCI...
November 29, 2023: Pharmaceutics
https://read.qxmd.com/read/38139279/neurological-improvement-via-lysophosphatidic-acid-administration-in-a-rodent-model-of-cardiac-arrest-induced-brain-injury
#23
JOURNAL ARTICLE
Mitsuaki Nishikimi, Rishabh C Choudhary, Muhammad Shoaib, Tsukasa Yagi, Lance B Becker, Junhwan Kim
Lysophosphatidic acid (LPA) serves as a fundamental constituent of phospholipids. While prior studies have shown detrimental effects of LPA in a range of pathological conditions, including brain ischemia, no studies have explored the impact of LPA in the context of cardiac arrest (CA). The aim of this study is to evaluate the effects of the intravenous administration of an LPA species containing oleic acid, LPA (18:1) on the neurological function of rats (male, Sprague Dawley) following 8 min of asphyxial CA...
December 14, 2023: International Journal of Molecular Sciences
https://read.qxmd.com/read/38115364/neurological-outcomes-and-quality-of-life-in-post-cardiac-arrest-patients-with-return-of-spontaneous-circulation-supported-by-ecmo-a-retrospective-case-series
#24
JOURNAL ARTICLE
Claudia Poveda-Henao, Natalia Valenzuela-Faccini, Michel Pérez-Garzón, Karen Mantilla-Viviescas, Omar Chavarro-Alfonso, Henry Robayo-Amortegui
Post-cardiac arrest brain injury constitutes a significant contributor to morbidity and mortality, leading to cognitive impairment and subsequent disability. Individuals within this patient cohort grapple with uncertainty regarding the potential advantages of extracorporeal life support (ECMO) cannulation. This study elucidates the neurological outcomes and quality of life of post-cardiac arrest patients who attained spontaneous circulation and underwent ECMO cannulation. This is a retrospective case study within a local context, the research involved 32 patients who received ECMO support following an intrahospital cardiac arrest with return of spontaneous circulation (ROSC)...
December 15, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/38098060/modulation-of-mitochondrial-function-with-near-infrared-light-reduces-brain-injury-in-a-translational-model-of-cardiac-arrest
#25
JOURNAL ARTICLE
Joseph M Wider, Erin Gruley, Paul T Morse, Junmei Wan, Icksoo Lee, Anthony R Anzell, Garrett M Fogo, Jennifer Mathieu, Gerald Hish, Brian O'Neil, Robert W Neumar, Karin Przyklenk, Maik Hüttemann, Thomas H Sanderson
BACKGROUND: Brain injury is a leading cause of morbidity and mortality in patients resuscitated from cardiac arrest. Mitochondrial dysfunction contributes to brain injury following cardiac arrest; therefore, therapies that limit mitochondrial dysfunction have the potential to improve neurological outcomes. Generation of reactive oxygen species (ROS) during ischemia-reperfusion injury in the brain is a critical component of mitochondrial injury and is dependent on hyperactivation of mitochondria following resuscitation...
December 14, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38030115/cardiac-power-output-is-associated-with-cardiovascular-related-mortality-in-the-icu-in-post-cardiac-arrest-patients
#26
JOURNAL ARTICLE
Federica Magni, Rossana Soloperto, Anita Farinella, Elisa Bogossian, Katarina Halenarova, Zoe Pletschette, Mariangela Gozza, Vincent Labbé, Walter Ageno, Fabio Silvio Taccone, Filippo Annoni
AIM: Although brain injury is the main determinant of poor outcome following cardiac arrest (CA), cardiovascular failure is the leading cause of death within the first days after CA. However, it remains unclear which hemodynamic parameter is most suitable for its early recognition. We investigated the association of cardiac power output (CPO) with early mortality in intensive care unit (ICU) after CA and with mortality related to post-CA cardiovascular failure. METHODS: Retrospective analysis of adult comatose survivors of CA admitted to the ICU of a University Hospital...
January 2024: Resuscitation
https://read.qxmd.com/read/38011882/-managing-post-cardiac-arrest-syndrome
#27
JOURNAL ARTICLE
Atsushi Sakurai
Four conditions occur after cardiac arrest resuscitation and are referred to as the post-cardiac arrest syndrome. Moreover, post-cardiac arrest brain injury has the greatest impact on outcomes. Brain injury can be primary as a result of global cerebral ischemia during cardiac arrest. It may be secondary(reperfusion injury)after initiation of cardiopulmonary resuscitation. After cardiac arrest resuscitation, the patient must be managed in the intensive care unit, and it is recommended to avoid hypotension(MAP<65 mmHg), hypoxemia, and hyperoxemia...
November 2023: No Shinkei Geka. Neurological Surgery
https://read.qxmd.com/read/37977348/simple-approach-to-quantify-hypoxic-ischemic-brain-injury-severity-from-computed-tomography-imaging-files-after-cardiac-arrest
#28
JOURNAL ARTICLE
Nicholas P Case, Clifton W Callaway, Jonathan Elmer, Patrick J Coppler
BACKGROUND: Grey-white ratio (GWR) can estimate severity of cytotoxic cerebral edema secondary to hypoxic-ischemic brain injury after cardiac arrest and predict progression to death by neurologic criteria (DNC). Current approaches to calculating GWR are not standardized and have variable interrater reliability. We tested if measures of variance of brain density on early computed tomographic (CT) imaging after cardiac arrest could predict DNC. METHODS: We performed a retrospective cohort study, identifying post-arrest patients treated between 2011 and 2020 at our single center...
November 15, 2023: Resuscitation
https://read.qxmd.com/read/37943300/prehospital-high-dose-methylprednisolone-in-resuscitated-out-of-hospital-cardiac-arrest-patients-sterohca-a-randomized-clinical-trial
#29
JOURNAL ARTICLE
Laust E R Obling, Rasmus P Beske, Martin A S Meyer, Johannes Grand, Sebastian Wiberg, Benjamin Nyholm, Jakob Josiassen, Frederik T Søndergaard, Thomas Mohr, Anders Damm-Hejmdal, Mette Bjerre, Ruth Frikke-Schmidt, Fredrik Folke, Jacob E Møller, Jesper Kjaergaard, Christian Hassager
PURPOSE: Patients who are successfully resuscitated following out-of-hospital cardiac arrest (OHCA) are still at a high risk of neurological damage and death. Inflammation and brain injury are components of the post-cardiac arrest syndrome, and can be assessed by systemic interleukin 6 (IL-6) and neuron-specific enolase (NSE). Anti-inflammatory treatment with methylprednisolone may dampen inflammation, thereby improving outcome. This study aimed to determine if prehospital high-dose methylprednisolone could reduce IL-6 and NSE in comatose OHCA patients...
November 9, 2023: Intensive Care Medicine
https://read.qxmd.com/read/37899341/-survey-on-the-application-of-external-cardiopulmonary-resuscitation-in-chinese-children-with-sudden-cardiac-arrest
#30
JOURNAL ARTICLE
X Yang, Y Cheng, X Y Hong, Y X Guo, X Wang, Y Y Yang, J P Chu, Y P Jin, Y B Cheng, Y C Zhang, G P Lu
Objectives: To investigate the current application status and implementation difficulties of extracorporeal cardiopulmonary resuscitation (ECPR) in children with sudden cardiac arrest. Methods: This cross-sectional survey was conducted in 35 hospitals. A Children's ECPR Information Questionnaire on the implementation status of ECPR technology (abbreviated as the questionnaire) was designed, to collect the data of 385 children treated with ECPR in the 35 hospitals. The survey extracted the information about development of ECPR, the maintenance of extracorporeal membrane oxygenation (ECMO) machine, the indication of ECPR, and the difficulties of implementation in China...
November 2, 2023: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://read.qxmd.com/read/37891731/behavioral-effects-of-repetitive-transcranial-magnetic-stimulation-in-disorders-of-consciousness-a-systematic-review-and-meta-analysis
#31
REVIEW
Zihan Yang, Tian Yue, Volker R Zschorlich, Dai Li, Duanwei Wang, Fengxue Qi
Traumatic brain injury, cardiac arrest, intracerebral hemorrhage, and ischemic stroke may cause disorders of consciousness (DoC). Repetitive transcranial magnetic stimulation (rTMS) has been used to promote the recovery of disorders of consciousness (DoC) patients. In this meta-analysis, we examined whether rTMS can relieve DoC patient symptoms. We searched through journal articles indexed in PubMed, the Web of Science, Embase, Scopus, and the Cochrane Library until 20 April 2023. We assessed whether studies used rTMS as an intervention and reported the pre- and post-rTMS coma recovery scale-revised (CRS-R) scores...
September 23, 2023: Brain Sciences
https://read.qxmd.com/read/37876138/outcome-prediction-in-comatose-cardiac-arrest-patients-with-initial-shockable-and-non-shockable-rhythms
#32
JOURNAL ARTICLE
Henning Wimmer, Stine Håheim Stensønes, Jūratė Šaltytė Benth, Christofer Lundqvist, Geir Ø Andersen, Tomas Draegni, Kjetil Sunde, Espen Rostrup Nakstad
BACKGROUND: Prognosis after out-of-hospital cardiac arrest (OHCA) is presumed poorer in patients with non-shockable than shockable rhythms, frequently leading to treatment withdrawal. Multimodal outcome prediction is recommended 72 h post-arrest in still comatose patients, not considering initial rhythms. We investigated accuracy of outcome predictors in all comatose OHCA survivors, with a particular focus on shockable vs. non-shockable rhythms. METHODS: In this observational NORCAST sub-study, patients still comatose 72 h post-arrest were stratified by shockable vs...
October 24, 2023: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/37867037/the-effect-of-early-severe-hyperoxia-in-adults-intubated-in-the-prehosptial-setting-or-emergency-department-a-scoping-review
#33
REVIEW
George Yusin, Charlotte Farley, Charles Scott Dorris, Sofiya Yusina, Saad Zaatari, Munish Goyal
BACKGROUND: The detrimental effects of hyperoxia exposure have been well-described in patients admitted to intensive care units. However, data evaluating the effects of short-term, early hyperoxia exposure in patients intubated in the prehospital setting or emergency department (ED) have not been systematically reviewed. OBJECTIVE: Our aim was to quantify and describe the existing literature examining the clinical outcomes in ED patients exposed to hyperoxia within the first 24 h of mechanical ventilation...
December 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/37859655/transcranial-doppler-during-the-first-week-after-cardiac-arrest-and-association-with-6-month-outcomes
#34
JOURNAL ARTICLE
Antje Reichenbach, Lars Alteheld, Julia Henriksen, Espen Rostrup Nakstad, Geir Øystein Andersen, Kjetil Sunde, Jūratė Šaltytė Benth, Christofer Lundqvist
BACKGROUND: Early prediction of outcomes in comatose patients after out-of-hospital cardiac arrest is challenging. Prognostication tools include clinical examination, biomarkers, and neuroradiological and neurophysiological tests. We studied the association between transcranial Doppler (TCD) and the outcome. METHODS: This was a pre-defined sub-study of the prospective observational Norwegian Cardiorespiratory Arrest Study. Patients underwent standardized post-resuscitation care, including target temperature management (TTM) to 33°C for 24 h...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37845464/insufficient-oxygen-supplementation-during-cardiopulmonary-resuscitation-leads-to-unfavorable-biological-response-while-hyperoxygenation-contributes-to-metabolic-compensation
#35
JOURNAL ARTICLE
Tomoaki Aoki, Vanessa Wong, Kei Hayashida, Lance B Becker, Koichiro Shinozaki
Sudden cardiac arrest (CA) is the third leading cause of death. Immediate reoxygenation with high concentrations of supplemental oxygen (O2 ) during cardiopulmonary resuscitation (CPR) is recommended according to the current guidelines for adult CA. However, a point in controversy exists because of the known harm of prolonged exposure to 100% O2 . Therefore, there have been much debate on an optimal use of supplemental O2 , yet little is known about the duration and dosage of O2 administration. To test whether supplying a high concentration of O2 during CPR and post resuscitation is beneficial or harmful, rats subjected to 10-minute asphyxia CA were administered either 100% O2 (n = 8) or 30% O2 (n = 8) for 2 hours after CPR...
2023: Advances in Experimental Medicine and Biology
https://read.qxmd.com/read/37845441/brainstem-damage-underlies-changes-in-hypoxic-ventilatory-response-following-cardiac-arrest-and-resuscitation-in-rats
#36
JOURNAL ARTICLE
Kui Xu, Alireza Abdollahifar, Xiaoyen Sun, Joseph LaManna
People resuscitated after sudden cardiac arrest remain at high risk for mortality, with treatment for survivors varying from monitoring to life support. With respect to assessing survivability post cardiac arrest and resuscitation (CAR), we previously demonstrated the potential of the hypoxic ventilatory response (HVR) as a reliable indicator for discerning between survivors and non-survivors in the early stages of recovery following CAR in rats. Since HVR describes the increase in ventilation in response to hypoxia, we hypothesize that damage to cardiorespiratory regulatory centers in the brainstem underlie the loss of HVR observed post resuscitation in nonsurvivors...
2023: Advances in Experimental Medicine and Biology
https://read.qxmd.com/read/37841299/the-use-of-neurone-specific-enolase-to-prognosticate-neurological-recovery-and-long-term-neurological-outcomes-in-oohca-patients
#37
JOURNAL ARTICLE
Caitlyn Maher, Matthew Cadd, Maya Nunn, Jennifer Worthy, Rebecca Gray, Owen Boyd
INTRODUCTION: Hypoxic-ischaemic brain injury (HIBI), is a common sequalae following out-of-hospital cardiac arrest (OOHCA), it is reported as the cause of death in 68% of patients who survive to ICU admission, while other patients can be left with permanent neurological disability. Prediction of neurological outcome follows a multimodal approach, including use of the biomarker, neurone specific enolase (NSE). There is however no definitive cut-off value for poor neurological outcome, and little research has analysed NSE and long-term outcomes in survivors...
November 2023: Journal of the Intensive Care Society
https://read.qxmd.com/read/37822592/lance-adams-syndrome-case-series-and-literature-review
#38
Judy Zheng, Zachary Storad, Mustafa Al-Chalabi, Khaled Gharaibeh, Sidra Saleem, Ajaz Sheikh, Naeem Mahfooz
BACKGROUND: Lance-Adams Syndrome (LAS) is a rare complication of successful cardiopulmonary resuscitation (CPR). It is a form of posthypoxic myoclonus characterized by action or intention myoclonus developing days to months after an hypoxic insult to the brain. LAS, especially early in a patient's clinical course, can be challenging to diagnose. Electroencephalogram (EEG) pattern of midline spike-wave discharge associated with favorable prognosis. There is no consensus in treatment of LAS but use of various anti-epileptic medications has been documented in literature...
2023: Clinical Neurophysiology Practice
https://read.qxmd.com/read/37807303/a-154-neuropsychological-profile-of-a-patient-post-anoxic-brain-injury-with-balint-syndrome-a-case-study-five-years-post-injury
#39
JOURNAL ARTICLE
Jacqueline A Moncivais, Justyna Piszczor, Jessica Yang, Joseph W Fink
OBJECTIVE: Cerebral anoxia is the absence or near absence of oxygen in the brain's arterial blood supply. One cause of cerebral anoxia is acute cardiorespiratory failure, which, if left untreated, can lead to brain tissue necrosis, causing an anoxic brain injury (AnBI). AnBI causes a range of motor and cognitive deficits, though long-term (> 2.0 years) neuropsychological sequelae of AnBI are not well understood. METHOD: A 66-year-old female presented for a neuropsychological evaluation 5...
October 8, 2023: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://read.qxmd.com/read/37806620/extracorporeal-cardiopulmonary-resuscitation-based-approach-to-refractory-out-of-hospital-cardiac-arrest-a-focus-on-organ-donation-a-secondary-analysis-of-a-prague-ohca-randomized-study
#40
JOURNAL ARTICLE
Smalcova Jana, Havranek Stepan, Pokorna Eva, Franek Ondrej, Huptych Michal, Kavalkova Petra, Pudil Jan, Rob Daniel, Dusik Milan, Belohlavek Jan
BACKGROUND: Refractory out-of-hospital cardiac arrest (OHCA) has a poor outcome. In patients, who cannot be rescued despite using advanced techniques like extracorporeal cardiopulmonary resuscitation (ECPR), organ donation may be considered. This study aims to evaluate, in refractory OHCA, how ECPR versus a standard-based approach allows organ donorship. METHODS: The Prague OHCA trial randomized adults with a witnessed refractory OHCA of presumed cardiac origin to either an ECPR-based or standard approach...
October 6, 2023: Resuscitation
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