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Cardiac Arrest - Europe PMC

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Last Updated: 10 January 2023

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The epidemiology of in-hospital cardiac arrest patients admitted to the Intensive Care Unit in Australia - A retrospective observational study.

Background In hospital cardiac arrest In Australia, approximately 3000 patients are annually affected by this condition. The introduction of the National Standard for Deteriorating Patients in 2011 was associated with reduced IHCA-related ICU admissions and reduced in-hospital mortality among such patients. Aims To determine whether the reduction in IHCA-related ICU admissions from hospital wards following the introduction of the National Standard was retained over the follow-up period in Australia. Following IHCA, the most notable result was the proportion of patients admitted to ICU from the ward following IHCA. Results The number of cardiac arrest-related admissions from the ward's follow-up period was lower in this comparison to baseline. The likelihood of being admitted to ICU following cardiac arrest on the ward increased after adjustment for severity of illness [OR 1. 13 p=0. 001].

Source link: https://europepmc.org/article/MED/36620904


Canagliflozin Pretreatment Attenuates Myocardial Dysfunction and Improves Postcardiac Arrest Outcomes After Cardiac Arrest and Cardiopulmonary Resuscitation in Mice.

Objectivity Canagliflozin, a SGLT2 inhibitor, not only reduces glycemia in type 2 diabetic patients but also has cardioprotective properties in diabetics. In vivo, the aim of this research was to investigate the protective effect of canagliflozin pretreatment on postresuscitation-induced cardiac dysfunction. Methods Male C57/BL6 mice were randomly assigned to vehicle or canagliflozin therapy groups in a computerized trial. After resuscitation, canagliflozin-pretreated mice had a higher survival rate, a shorter return of spontaneous circulation time, and a higher metabolic score than control mice. Canagliflozin was able to reduce cardiac arrest and resuscitation-associated cardiac dysfunction, as shown by an elevated left ventricular ejection percentage and fractional shortening. Canagliflozin promoted the phosphorylation of cardiac STAT-3 postresuscitation, according to a narrator. In addition, pharmacological inhibition of STAT-3 by Ag490 dulled STAT-3 phosphorylation and banished canagliflozin's cardioprotective activity. Canagliflozin had a significant cardioprotective role against cardiac arrest and resuscitation-induced cardiac dysfunction, according to the authors.

Source link: https://europepmc.org/article/MED/36609949


Coagulation measures after cardiac arrest (CMACA).

The aim of this research was to describe the time course of coagulation abnormalities after out-of-hospital CA and to determine the relationship with clinical findings in patients undergoing targeted temperature control after OHCA. Methods This prospective, multicenter, observational cohort study was conducted in eight emergency departments in Korea between September 2018 and September 2019. Patients with poor medical results at admission and 24 hours after ROSC, lactic acid, prothrombin time, and D-dimer levels were elevated in patients with poor neurological outcomes at admission and 24 hours after ROSC. At hospital discharge, neurological problems were reported in admission and D-dimer levels 24 h after ROSC were linked with neurological problems. The duration of time from collapse to ROSC was moderately correlated with coordination-related factors. Among coagulation-related factors, PT at admission, and D-dimer levels 24 hours after ROSC were attributed to poor medical outcomes in patients treated with TTM at hospital discharge.

Source link: https://europepmc.org/article/MED/36608053


Ventilation during continuous compressions or at 30:2 compression-to-ventilation ratio results in similar arterial oxygen and carbon dioxide levels in an experimental model of prolonged cardiac arrest.

During prolonged experimental cardiopulmonary resuscitation, We hypothesized that a compression/ventilation ratio of 30:2 would provide more ventilation and gas exchange relative to a synchronous CCC. Methods We trialed 30 anaesthetized domestic swine with electrically induced fibrillation to the CCC or 30:2 group and bag-valve ventilation with a fraction of inspired oxygen of 100%. Chest compressions were carried out using a Stryker Medical LUCASu00ae 2 mechanical chest compression unit. During the CPR, arterial blood gas samples were collected every 5 minutes, measured ventilation delivery during the CPR by electrical impedance tomography, and examined post-mortem computed tomography scans for differences in lung aeration status. Conclusions The CCC group had a 90 mmHg relative pressure of oxygen at 30 minutes, and the 30:2 group had a 70 mmHg. Carbon dioxide at 30 minutes was 70 mmHg for the 30:2 group and 68 mmHg for the CCC group, respectively.

Source link: https://europepmc.org/article/MED/36607514


Transesophageal Echocardiography in Cardiac Arrest: the Heart and Beyond.

POCUS' use in cardiac arrest has mainly been described using transthoracic echocardiography as both a diagnostic and prognostic device. In this narrative review, we explore TEE's role in four specific contexts: Chest compression quality feedback; rhythm characterization; Diagnosis of reversible causes; and Procedural guidance. Given its own limitations, we propose an algorithm for the inclusion of TEE in cardiac arrest focusing on these four applications and expanding its reach to extra-cardiac applications.

Source link: https://europepmc.org/article/MED/36621564


Effect of video laryngoscopy for non-trauma out-of-hospital cardiac arrest on clinical outcome: A registry-based analysis.

We investigated the effects of non-traumatic out-of-hospital cardiac arrest patients treated with VL versus direct laryngoscopy for airway management using data from the German Resuscitation Registry. To determine the effect of the outcome of known influence variables and of VL vs. DL, we used multivariate binary logistic regression to determine the effects on the outcome of reported outcome variables and of VL vs. DL. Patients with ROSC were treated with improved neurological outcomes when using endotracheal intubation at OHCA, according to Conclusion VL. Hence, the use of VL for OHCA in OHCA is a promising prospect. Trial registration DRKS00028137, prospectively registered on 23 February 2022, prospectively registered on 23 February 2022 before data processing, according to trial results.

Source link: https://europepmc.org/article/MED/36621529


The effect of blood pressure on mortality following out-of-hospital cardiac arrest: a retrospective cohort study of the United Kingdom Intensive Care National Audit and Research Centre database.

Hypotension after out-of-hospital cardiac arrest may cause secondary brain injury and an elevated mortality risk, according to the author. Methods We conducted a retrospective review of OHCA patients participating in the Intensive Care National Audit and Research Centre Case Mix Programme from 1 January 2010 to 31 December 2019. In the first 24 hours of ICU care and hospital mortality, we present an adjusted odds ratio for associations between the lowest and highest mean arterial pressure and systolic blood pressure. The lowest reported mortality was among patients with a highest mapped MAP in the range 95-104 mmHg. In the first 24 hours in ICU and mortality following OHCA, we discovered a connection between hypotension and hypertension. Following OHCA, survivors' inability to distinguish between survivors' and non-survivors' median blood pressure indicates the need for study into individualised blood pressure targets for survivors.

Source link: https://europepmc.org/article/MED/36604745


Out-of-Hospital Cardiac Arrest Prospective Epidemiology Monitoring during the First Five Years of EuReCa Program Implementation in Serbia.

Introduction Poor results are still a significant issue for patients with out-of-hospital cardiac arrest around the world, and there are significant differences between European countries regarding not only incidence rates, but also survival rates. Study aim The aim of this research is to analyze the results of the first five-year study after the establishment of EuReCa study protocol elements integration in Serbia's OHCA epidemiological data collection. Conclusion The OHCA incidence in Serbia is comparable to those in the majority of European countries, and survival rates are now significantly higher in Utstein events compared to Serbia's previous findings. Enrolment of witnessing bystanders in initiating CPR steps remains a point of worry, as it seeks to learn about CPR's importance and education of the general population in administering CPR policies.

Source link: https://europepmc.org/article/MED/36600667


Targeted Temperature Management Following Out-of-Hospital Cardiac Arrest: Integrating Evidence into Real World Practice.

A point of controversy in the hopes of improving post-arrest outcomes has been a targeted temperature control post-out of hospital cardiac arrest. The role of TTM post-cardiac arrest has been discussed in recent studies, suggesting that treating normothermia should be the standard of care for first-comatose survivors of cardiac arrest. We wanted to identify the populations represented in international OHCA registry registries and to provide a pathway to bring clinical trial results into use in this research. Patients with a non-shockable rhythm are also suffering from poor hypothermia as a result of targeted normothermia.

Source link: https://europepmc.org/article/MED/36610519


Updating the Model for Risk-Standardizing Survival for In-Hospital Cardiac Arrest to Facilitate Hospital Comparisons.

Background: For hospital benchmarking and research, risk-standardized survival rates for in-hospital cardiac arrest have been widely used. Because of the fact that COVID-19 infection is associated with markedly reduced survival, the novel coronavirus 2019 pandemic has resulted in a drastic decrease in IHCA survival. We developed and validated updated survival rate model for hospital discharge and compared the results of this new RSSR model to the previous model using hierarchical logistic regression. The updated parsimonious model included 13 variables-all 9 predictors in the initial model as well as four additional predictors, including COVID-19 infection status. The latest model produced RSSRs that were similar to the initial model for IHCAs in the pre-pandemic period, and can be used to aid continuing efforts to benchmark hospitals and facilitate research that uses data from either before or after the introduction of COVID-19.

Source link: https://europepmc.org/article/MED/36610502

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions