Gavin D Perkins, Claire Kenna, Chen Ji, Charles D Deakin, Jerry P Nolan, Tom Quinn, Charlotte Scomparin, Rachael Fothergill, Imogen Gunson, Helen Pocock, Nigel Rees, Lyndsey O'Shea, Judith Finn, Simon Gates, Ranjit Lall
PURPOSE: To examine the time to drug administration in patients with a witnessed cardiac arrest enrolled in the Pre-Hospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest (PARAMEDIC2) randomised controlled trial. METHODS: The PARAMEDIC2 trial was undertaken across 5 NHS ambulance services in England and Wales with randomisation between December 2014 and October 2017. Patients with an out-of-hospital cardiac arrest who were unresponsive to initial resuscitation attempts were randomly assigned to 1 mg intravenous adrenaline or matching placebo according to treatment packs that were identical apart from treatment number...
March 2020: Intensive Care Medicine
Hilde Karlsen, Harald Arne Bergan, Per Steinar Halvorsen, Kjetil Sunde, Eirik Qvigstad, Geir Øystein Andersen, Jan Frederik Bugge, Theresa Mariero Olasveengen
BACKGROUND: The effectiveness of adrenaline during resuscitation continues to be debated despite being recommended in international guidelines. There is evidence that the β-adrenergic receptor (AR) effects of adrenaline are harmful due to increased myocardial oxygen consumption, post-defibrillation ventricular arrhythmias and increased severity of post-arrest myocardial dysfunction. Esmolol may counteract these unfavourable β-AR effects and thus preserve post-arrest myocardial function...
December 4, 2019: Intensive Care Medicine Experimental
Johanna Lazarus, Rajeshwari Iyer, Rachael T Fothergill
OBJECTIVES: The aim of this study was to gather the views and experiences of paramedics who participated in a large-scale randomised controlled drug trial and to identify barriers to recruitment. DESIGN: We surveyed paramedics using a questionnaire consisting of a mix of closed and open ended questions. SETTING: The study was conducted within the London Ambulance Service, London, UK. PARTICIPANTS: 150 paramedics who were trained to enrol patients into the PARAMEDIC-2 randomised controlled trial of adrenaline versus placebo in out-of-hospital cardiac arrest and who returned the questionnaire...
December 1, 2019: BMJ Open
S Seewald, J Wnent, R Lefering, M Fischer, A Bohn, T Jantzen, S Brenner, S Masterson, B Bein, J Scholz, J T Gräsner
AIM: The aim of this study was to develop a score to predict the outcome for patients brought to hospital following out-of-hospital cardiac arrest (OHCA). METHODS: All patients recorded in the German Resuscitation Registry (GRR) who suffered OHCA 2010-2017, who had ROSC or ongoing CPR at hospital admission were included. The study population was divided into development (2010-2016: 7985) and validation dataset (2017: 1806). Binary logistic regression analysis was used to derive the score...
January 1, 2020: Resuscitation
Johann P Hreinsson, Asgeir P Thorvaldsson, Vidar Magnusson, Brynjar T Fridriksson, Berglind G Libungan, Sigurbergur Karason
BACKGROUND: The Basic life support (BLS) and Advanced life support (ALS) are known prediction rules for termination of resuscitation (TOR) in out-of-hospital cardiac arrest (OHCA). Recently, a new rule was developed by Jabre et al. We aimed to independently validate and compare the predictive accuracy of these rules. METHODS: OHCA cases in Iceland from 2008-2017 from a population-based, prospectively registered database. Primary outcome was survival to discharge among patients that met all conditions of abovementioned rules: BLS (not witnessed by EMS personnel, no defibrillation nor ROSC before transport), ALS (BLS criteria plus not witnessed nor CPR by bystander) and Jabre (not witnessed by EMS personnel, initial rhythm non-shockable, no sustainable ROSC before third dose of adrenaline)...
November 8, 2019: Resuscitation
Lu Huan, Fei Qin, Yin Wu
AIM: Our objective is to assess the effects of epinephrine for out of hospital cardiac arrest. BACKGROUND: Cardiac arrest was the most serious medical incidents with an estimated incidence in the United States of 95.7 per 100,000 person years. Though epinephrine improved coronary and cerebral perfusion, improving a return of spontaneous circulation, potentially harmful effects on the heart lead to greater myocardial oxygen demand. Concerns about the effect of epinephrine for out-of-hospital cardiac arrest were controversial and called for a higher argument to determine whether the effects of epinephrine is safe and effective for shor and long terms outcomes...
November 2019: Medicine (Baltimore)
Jun Shitara, Kei Jitsuiki, Yiuichi Yanagawa
A 54-year-old man suffered a leg cramp while diving in the ocean at a depth of 20 meters. He began to surface, with his ascent based on a decompression table. He lost consciousness at the surface and was rescued by a nearby boat. The boat staff judged him to be in cardiac arrest, so they performed chest compressions. When the boat reached port where an ambulance was waiting, emergency medical technicians confirmed that the patient was in cardiac arrest; his initial rhythm was asystole. Treated with basic life support, the patient was then transported to a rendezvous point, where a physician-staffed helicopter waited...
September 2019: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
W D D Priyankara, E M Manoj, A Gunapala, A G R M A Ranaweera, K S Vithanage, M Sivasubramanium, E Snajeeva
Kounis syndrome is associated with mast cell activation resulting in acute coronary syndrome secondary to an allergic insult. Various drugs such as antibiotics, analgesics, and environmental exposures such as bee, wasp sting, and poison ivy are known to induce Kounis syndrome. A 68-year-old man admitted with a cobra bite on both hands to emergency care unit and sustained cardiorespiratory arrest. Electrocardiogram, taken 6 hours after the cardiac arrest, showed ST elevations in leads V2 to V5 suggestive of anterior ST elevation myocardial Infarction (STEMI)...
2019: Case Reports in Critical Care
(no author information available yet)
BACKGROUND: Australian in-hospital cardiac arrest (IHCA) literature is limited, and mostly published before rapid response teams (RRTs). Contemporary data may inform strategies to improve IHCA outcomes. STUDY DESIGN: Prospective observational study of ward adult IHCAs in seven Australian hospitals. PARTICIPANTS AND OUTCOMES: IHCA was defined as unresponsiveness, no respiratory effort, and commencement of external cardiac compressions. Data included IHCA frequency, patient demographics, resuscitation management, intensive care unit (ICU) management, and hospital discharge status...
September 2019: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Davide Margonato, Raffaele Abete, Gabriella Di Giovine, Pietro Delfino, Massimiliano Grillo, Simone Mazzetti, Daniele Poggio, Jessica Rossi, Toufic Khouri, Andrea Mortara
A 60-year-old female developed cardiac arrest after experiencing an anaphylactic shock during administration of plasma-expanders. An electrocardiogram registered after restoration of sinus rhythm showed mild ST-elevation in the anterior precordial leads and T waves changes followed by appearance of echocardiographic alterations of left ventricular apex kinesis. Coronary angiography revealed normal coronary arteries, and cardiovascular magnetic resonance confirmed apical ballooning with late gadolinium enhancement in the segments with abnormal contractility...
August 2019: Journal of Cardiology Cases
Caitlin E O'Brien, Polan T Santos, Michael Reyes, Shawn Adams, C Danielle Hopkins, Ewa Kulikowicz, Jennifer L Hamrick, Justin T Hamrick, Jennifer K Lee, Sapna R Kudchadkar, Elizabeth A Hunt, Raymond C Koehler, Donald H Shaffner
AIM: To examine the relationship between survival and diastolic blood pressure (DBP) throughout resuscitation from paediatric asphyxial cardiac arrest. METHODS: Retrospective, secondary analysis of 200 swine resuscitations. Swine underwent asphyxial cardiac arrest and were resuscitated with predefined periods of basic and advanced life support (BLS and ALS, respectively). DBP was recorded every 30 s. Survival was defined as 20-min sustained return of spontaneous circulation (ROSC)...
October 2019: Resuscitation
Shouming Chen, Lan Wu, Yaqin Xiong
No abstract text is available yet for this article.
July 22, 2019: Minerva Anestesiologica
Tomas Barry, Maeve C Doheny, Siobhán Masterson, Niall Conroy, Jan Klimas, Ricardo Segurado, Mary Codd, Gerard Bury
BACKGROUND: Mobilization of community first responders (CFRs) to the scene of an out-of-hospital cardiac arrest (OHCA) event has been proposed as a means of shortening the interval from occurrence of cardiac arrest to performance of cardiopulmonary resuscitation (CPR) and defibrillation, thereby increasing patient survival. OBJECTIVES: To assess the effect of mobilizing community first responders (CFRs) to out-of-hospital cardiac arrest events in adults and children older than four weeks of age, in terms of survival and neurological function...
July 19, 2019: Cochrane Database of Systematic Reviews
Fumitaka Kato, Kazunori Fujino, Naoto Shiomi, Yutaka Eguchi
Aim: Out-of-hospital cardiac arrests (OHCA) are a significant public health problem; to improve patients' prognoses, various interventions, such as providing physician-staffed ambulances, have been implemented. We aimed to examine whether physician-staffed ambulances were associated with patients' prognoses after OHCA with respect to first-monitored rhythms. Methods: This retrospective observational study was undertaken between 1 September 2011 and 31 December 2015, using data based on Utstein-style guidelines...
July 2019: Acute Medicine & Surgery
E Ter Avest, H Lameijer
The PARAMEDIC-2 trial demonstrated that the use of adrenaline compared with placebo in out-of-hospital cardiac arrest (OHCA) resulted in a small increase in 30-day survival, but was associated with a higher number of survivors with severe neurological impairment. These findings received a lot of attention, and generated a widespread discussion about the role of adrenaline in cardiac arrest. In this point of view, we aim to place the PARAMEDIC-2 results in the right perspective by comparing the relative effect of adrenaline to other determinants of cerebral blood flow...
July 2019: Netherlands Heart Journal
Andreas Lundin, Christian Rylander, Thomas Karlsson, Johan Herlitz, Peter Lundgren
OBJECTIVE: To describe how administration of adrenaline is associated with return of spontaneous circulation (ROSC) and 30-day survival in patients with in-hospital cardiac arrest (IHCA). DESIGN: Retrospective observational study. SETTING: Analysis of data extracted from a national cardiac arrest registry. STUDY POPULATION: Patients >18 years old with IHCA from January 2015 up to June 2017. OUTCOME MEASURES: Primary outcomes were ROSC and 30-day survival...
July 2019: Resuscitation
Mohamad Hakam Tiba, Brendan M McCracken, Brandon C Cummings, Carmen I Colmenero, Chandler J Rygalski, Cindy H Hsu, Thomas H Sanderson, Brahmajee K Nallamothu, Robert W Neumar, Kevin R Ward
AIM: We examined the use of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) catheter during cardiopulmonary resuscitation (CPR) after cardiac arrest (CA) to assess its effect on haemodynamics such as coronary perfusion pressure (CPP), common carotid artery blood flow (CCA-flow) and end-tidal CO2 (PetCO2 ) which are associated with increased return of spontaneous circulation (ROSC). METHODS: Six male swine were instrumented to measure CPP, CCA-Flow, and PetCO2 ...
May 20, 2019: Resuscitation
Gavin D Perkins, Claire Kenna, Chen Ji, Charles D Deakin, Jerry P Nolan, Tom Quinn, Rachael Fothergill, Imogen Gunson, Helen Pocock, Nigel Rees, Karl Charlton, Judith Finn, Simon Gates, Ranjit Lall
INTRODUCTION: Previous research suggests there may be differences in the effects of adrenaline related to the initial cardiac arrest rhythm. The aim of this study was to assess the effect of adrenaline compared with placebo according to whether the initial cardiac arrest rhythm was shockable or non-shockable. METHODS: Return of spontaneous circulation (ROSC), survival and neurological outcomes according to the initial arrest rhythm were compared amongst patients enrolled in the PARAMEDIC-2 randomised, placebo controlled trial...
July 2019: Resuscitation
Benton R Hunter
No abstract text is available yet for this article.
May 21, 2019: Annals of Internal Medicine
Satoshi Gando, Takeshi Wada
The aims of this review are to demonstrate that the changes in coagulation and fibrinolysis observed in cardiac arrest and resuscitation can be recognized as disseminated intravascular coagulation (DIC), and to discuss the probability of DIC being a therapeutic target. The appearance of triggers of DIC, such as damage-associated molecular patterns, inflammatory cytokines, and adrenaline, is associated with platelet activation, marked thrombin generation and fibrin formation, insufficient anticoagulation pathways, and increased fibrinolysis by tissue-type plasminogen activator, followed by the suppression of fibrinolysis by plasminogen activator inhibitor-1, in patients with cardiac arrest and resuscitation...
August 2019: Journal of Thrombosis and Haemostasis: JTH
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