Outcomes from pediatric cardiac arrest and cardiopulmonary resuscitation (CPR) seem to be incrementally improving. The past 2 decades have brought advances in the understanding of the pathophysiology of cardiac arrest and ventricular fibrillation, better treatment strategies, and a more robust standard for CPR epidemiology and research reporting. The evolution of ...

Pediatric cardiac arrest is not a single problem. Although most episodes of pediatric cardiac arrest occur as complications and progressions of respiratory failure and shock, sudden cardiac arrest may result from sudden arrhythmias. With better understanding of the epidemiology of pediatric cardiac arrest, clinicians can better tailor therapy to optimize ...

A super-obese patient who suffered from severe sleep apnea (SSA) and other comorbidities underwent insertion of a BioEnterics intragastric balloon (BIB) before bariatric surgery. During the night, he was victim of cardiac arrest. After cardiopulmonary resuscitation and return of spontaneous circulation, he was transferred to intensive care unit. Two hours ...

BACKGROUND: Extracorporeal life support (ECLS) is associated with a high mortality rate in patients with preexisting multiple organ failure. To achieve better outcomes of ECLS in this high risk group, an understanding of the real impact of preexisting organ dysfunction on ECLS-associated mortality is necessary. METHODS: From January 2003 to ...

The baroreflex control of heart rate (HR) is reduced following chronic intermittent hypoxia (CIH). Since the nucleus ambiguus (NA) plays a key role in baroreflex control of HR, we examined whether CIH remodels vagal efferent projections to cardiac ganglia. C57BL/6J mice (3-4 months of age) were exposed to either room ...

The "late sodium current" (I(NaL)) is a sustained component of the fast Na+ current of cardiac myocytes and neurons. As recently appreciated, common neurological and cardiac conditions are associated with abnormal I(NaL) enhancement, which may contribute to the pathogenesis of both electrical and contractile dysfunction. For this reason, I(NaL) has ...

BACKGROUND: Benznidazole is effective for treating acute and chronic (recently acquired) Trypanosoma cruzi infection (Chagas' disease). Recent data indicate that parasite persistence plays a pivotal role in the pathogenesis of chronic Chagas' cardiomyopathy. However, the efficacy of trypanocidal therapy in preventing clinical complications in patients with preexisting cardiac disease is ...

BACKGROUND: Automated external defibrillators (AEDs) operated by lay persons are used in the UK in a National Defibrillator Programme promoting public access defibrillation (PAD). METHODS: Two strategies are used: (1) Static AEDs installed permanently in busy public places operated by those working nearby. (2) Mobile AEDs operated by community first ...

AIM: Patients' outcomes after prolonged cardiac arrest are often grim. The aim of this study was to find the longest period of normovolemic, normothermic, cardiac arrest no-flow after which good neurologic outcome can be achieved with conventional therapies. METHODS: Swine (28-37 kg) were subjected to ventricular fibrillation cardiac arrest, after ...

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether it is acceptable to delay cardiopulmonary resuscitation if a patient arrests after cardiac surgery in order to attempt defibrillation or pacing, prior to performing external cardiac massage. Altogether 550 papers were ...

OBJECTIVE: Comprehensive outcome assessment of children receiving cardiac extracorporeal life support. METHODS: From 2000 to 2004, 39 consecutive children (aged 1 day to 4.4 years) had cardiac extracorporeal life support. Neurodevelopmental follow-up of all survivors was performed more than 6 months after life support (aged 53 +/- 12 months). Developmental ...

The understanding of the incidence, epidemiology, etiology, and pathophysiology of pediatric cardiac arrest has evolved greatly in the past two decades. This includes recognition that cardiopulmonary resuscitation delays in cardiac arrest are especially injurious, ventricular arrhythmias are not as uncommon in children as previously believed, and four distinct phases of ...

PURPOSE OF REVIEW: The majority of cardiac arrest patients die after successful resuscitation. Despite disappointing survival rates, cardiac arrest research mainly focuses on new therapies applied during cardiac arrest in the out-of-hospital setting, but only little attention is given to therapies mitigating the so-called postresuscitation syndrome. Optimized postresuscitation hospital care ...

Introduction: Analysis of anesthesia related complications is important to identify the preventable causes and to make prevention strategies. Studies performed in various parts of the world (1-5) have examined perioperative cardiac arrests, with the main aim of improving quality. It is important to share such data, as insight into the ...

To operate on the abdominal aorta is difficult enough today, even with all the appurtenances of the modern operating theatre. Yet the first time this was performed, as an emergency by Astley Cooper of Guy's Hospital in 1817, it was carried out without any form of anaesthetic, in the patient's ...

PURPOSE OF REVIEW: No specific drug therapy has been shown to improve long-term survival after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This study reviews recent studies on drugs during cardiopulmonary resuscitation. RECENT FINDINGS: Epinephrine is the first-line vasopressor during cardiopulmonary resuscitation. Arginine vasopressin ...

PURPOSE OF REVIEW: To review the evidence on urgent coronary angiography and percutaneous coronary intervention after resuscitated cardiac arrest and during ongoing cardiocerebral resuscitation. RECENT FINDINGS: In almost 450 patients with acute ST-elevation myocardial infarction after reestablishment of spontaneous circulation, success rate of primary percutaneous coronary intervention was 89%. Survival ...

BACKGROUND: According to the current guidelines for acute myocardial infarction, ventricular fibrillation during the acute phase of myocardial infarction is no indication for specific treatment like ICD implantation. Primary objective of our study was to evaluate the prognostic significance of cardiac arrest within the acute phase of myocardial infarction in ...

OBJECTIVE: To describe the development, design and consequent scientific implications of the Resuscitation Outcomes Consortium (ROC) population-based registry; ROC Epistry-Cardiac Arrest. METHODS: The ROC Epistry--Cardiac Arrest is designed as a prospective population-based registry of all Emergency Medical Services (EMSs)-attended 9-1-1 calls for patients with out-of-hospital cardiac arrest occurring in the ...

AIMS AND OBJECTIVES: This paper aims to undertake a review on the current evidence available on therapeutic hypothermia (TH) following cardiac arrest. BACKGROUND: The use of TH has been associated as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. Within the past ...

To investigate the relationship between the inflammatory responses and postresuscitation syndrome, we prospectively examined the serial changes of neutrophil elastase (NE), urinary trypsin inhibitor (UTI), and TNF-alpha) in successfully resuscitated patients after out-of-hospital cardiac arrest. This study included 36 patients with out-of-hospital cardiac arrests who were admitted to our intensive ...

The authors propose a new method for total arch replacement under normothermic beating heart surgery. The surgical procedure was performed with no time limit. The cardiopulmonary bypass was terminated without using inotropic agents. The patient regained consciousness in postoperative hour 8 without any neurologic deficit. This new strategy avoids the ...

The 2010 impact goal of the American Heart Association is to reduce death rates from heart disease and stroke by 25% and to lower the prevalence of the leading risk factors by the same proportion. Much of the burden of acute heart disease is initially experienced out of hospital and ...

Cardiac malposition is a rare but important finding when detected on fetal ultrasound. The purpose of this study was to evaluate the incidence of fetal cardiac malposition, associated abnormalities, and clinical outcome in a tertiary-care medical center. Records of fetuses (1993 to 2006) with dextroposition, dextrocardia, mesocardia, ectopia cordis, or ...

BACKGROUND: The most common location of out-of-hospital sudden cardiac arrest is the home, a situation in which emergency medical services are challenged to provide timely care. Consequently, home use of an automated external defibrillator (AED) might offer an opportunity to improve survival for patients at risk. METHODS: We randomly assigned ...

BACKGROUND: Transfusion-associated hyperkalemic cardiac arrest is a serious complication of rapid red blood cell (RBC) administration. We examined the clinical scenarios and outcomes of patients who developed hyperkalemia and cardiac arrest during rapid RBC transfusion. METHODS: We retrospectively reviewed the Mayo Clinic Anesthesia Database between November 1, 1988, and December ...

PURPOSE OF REVIEW: Current cardiopulmonary resuscitation guidelines emphasize that providing high-quality basic life support is the single most important contribution to successful resuscitation. Efficiency of advanced cardiac life support depends on sufficient cardiopulmonary resuscitation performance leading to continuous bloodflow and oxygenation. Existing data show that the quality of cardiopulmonary resuscitation ...

Hemodialysis patients have significant cardiac-related mortality. Sudden cardiac arrests in the dialysis unit are infrequent events but carry a poor prognosis. The predominant rhythm is ventricular tachycardia/fibrillation. Although the exact etiologies are not clear, several studies have confirmed an increased incidence on the first day after the weekend interval. Use ...

BACKGROUND: The effect of prearrest left ventricular ejection fraction (LVEF) on outcome after cardiac arrest is unknown. METHODS AND RESULTS: During a 26-month period, Utstein-style data were prospectively collected on 800 consecutive inpatient adult index cardiac arrests in an observational, single-center study at a tertiary cardiac care hospital. Prearrest echocardiograms ...

Increases in serum cytokines have been reported after successful resuscitation from prolonged ventricular fibrillation (VF). Pro-inflammatory cytokines can stimulate inducible nitric oxide synthase (iNOS) to produce excessive levels of nitric oxide (NO). High levels of both myocardial inflammatory cytokines and nitric oxide levels can depress myocardial contractile function. We hypothesized ...

OBJECTIVE: To test the feasibility of a neurocognitive test based on operant conditioning in a porcine model of cardiac arrest and cardiopulmonary resuscitation. Furthermore, to characterize the influence of different durations of cardiac arrest on cognitive performance and the accompanying neurohistopathological changes. DESIGN: Randomized controlled laboratory animal study. SETTING: Animal ...

During cardiac arrest emergencies, lay rescuers are required to manually check the patient's carotid pulse after the delivery of defibrillation shocks to assess the cardiac resuscitation progress of the patient. As a more automated way of monitoring the resuscitation progress, a new Doppler-ultrasound-based carotid pulse assessment approach is presented in ...

Cardiac extra-corporeal life support is used more frequently in the current era of complex, high-risk neonatal heart surgery. Although outcome for neonates with complex heart disease has improved in the last decade, thanks to advances in surgery and intensive care, survival in the subset that require extra-corporeal support remains unchanged ...

OBJECTIVE: Both animal and human studies demonstrate activation of coagulation during cardiac arrest. Prearrest anticoagulation is used routinely in many experimental studies. We studied the hemodynamic effects of prearrest anticoagulation with a low-molecular-weight heparin suitable for clinical use during cardiopulmonary resuscitation in pigs. DESIGN: Randomized and blinded experimental animal study. ...

Despite the progresses made in the science of cardiopulmonary resuscitation, there is lack of published works on this area in the Malaysian context. This survey was done to look at the outcomes of all cardiopulmonary resuscitation performed in Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM). This is a one ...

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether adrenaline might be a useful addition to a protocol for the management of cardiac arrests for patients shortly after cardiac surgery. Altogether 889 papers were found using the reported search, of ...

AIMS: To study the cause of deaths after witnessed cardiac arrest followed by pulseless electrical activity and unsuccessful of out-of-hospital resuscitation; and to detect any differences between causes of death determined at autopsy and those inferred from clinical history. METHODS: In this prospective observational study, data were collected from 91 ...

Cardiopulmonary resuscitation by manual cardiac compression can restore cardiocirculatory function but can also injure patients. Commonly reported are skeletal fractures of the rips and sternum, while injuries to the large thoracic vessels will frequently be lethal. We report the case of a 57-year-old male patient with sudden cardiac arrest because ...

Cardiac arrest is the leading cause of death among dialysis patients in the United States. We measured the outcome of cardiac arrests attended by Emergency Medical Services (EMS) staff at hemodialysis facilities in a 14-year population-based retrospective study to identify cardiac arrest cases at a dialysis unit. Associated factors were ...

Multi-centred studies in patients who remain comatose after cardiac arrest and also in newborn babies with perinatal asphyxia have clearly demonstrated that mild hypothermia (32-34 degrees C) can improve neurological outcome after post-anoxic injury. This represents a highly promising development in the field of neurocritical care. This review discusses the ...

OBJECTIVE: To describe high level of awareness in a patient undergoing cardiopulmonary resuscitation for an asystolic cardiac arrest and review the literature regarding this phenomenon. METHODS: This is a case report of a patient admitted to the Intensive Care Unit who suffered an asystolic cardiac arrest. We reviewed MEDLINE using ...

In industrial countries it is estimated that the incidence of out-of-hospital sudden cardiac arrest lies between 36 and 128 per 100,000 inhabitants per year. Almost 80% of patients who initially survive a cardiac arrest present with coma lasting more than 1 h. Current therapy during cardiac arrest concentrates on the ...

Cardiac strain was evaluated in terms of working heart rate (WHR), relative cardiac cost (RCC), net cardiac cost (NCC) and other recovery indices among six younger (mean age 34.2 +/- 2.7 yr) and sixteen older (mean age 48.9 +/- 5.4 yr) drillers working in a manual underground coal mine over ...

Here we report two patients with hematological malignancies associated with complications of fatal cardiac zygomycosis. The first case, a 72-year-old man with myelodysplastic syndrome being treated with low-dose cytarabine, died of sudden cardiac arrest. An autopsy revealed disseminated zygomycosis accompanied with occlusion of the coronary artery by fungal thrombi. The ...

In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may ...

During ischemia, myocardial fatty acid metabolism ceases, rapidly depleting the other primary fuel, glucose. No technique has existed to continuously monitor myocardial glucose. Needle-tip enzymatic glucose biosensors have been developed for subcutaneous use in diabetic management. To study the utility of these sensors for real-time myocardial glucose monitoring in clinically ...

AIMS: The treatment recommendations from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science (hosted by the American Heart Association) advocate a goal-directed treatment strategy for hemodynamic optimization after return of spontaneous circulation (ROSC) in post-cardiac arrest care. We performed a systematic review to (1) examine ...

Therapeutic hypothermia (TH) represents an important method to attenuate post-resuscitation injury after cardiac arrest. Laboratory investigations have suggested that induction of hypothermia before return of spontaneous circulation (ROSC) may confer the greatest benefit. We hypothesized that a short delay in resuscitation to induce hypothermia before ROSC, even at the expense ...

BACKGROUND: Previous animal and clinical studies suggest that bystander-initiated cardiac-only resuscitation may be superior to conventional cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrests. Our hypothesis was that both cardiac-only bystander resuscitation and conventional bystander CPR would improve outcomes from out-of-hospital cardiac arrests of < or = 15 minutes' duration, whereas ...

A patient with alcohol induced end-stage liver disease developed cardiac arrest immediately after reperfusion during orthotopic liver transplantation. In our case, advanced age of the patient, alcohol-related severe liver disease with high ASA score, and myocardial dysfunction, combined with acute metabolic and hemodynamic changes throughout the surgery may have contributed ...