Document Detail


Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: a prospective computed tomography study.
MedLine Citation:
PMID:  19581033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Aneurysmal subarachnoid haemorrhage (SAH) is a relatively common cause of out-of-hospital cardiac arrest (OHCA). Early identification of SAH-induced OHCA with the use of brain computed tomography (CT) scan obtained immediately after resuscitation may help emergency physicians make therapeutic decision as quickly as they can. METHODS: During the 4-year observation period, brain CT scan was obtained prospectively in 142 witnessed non-traumatic OHCA survivors who remained haemodynamically stable after resuscitation. Demographics and clinical characteristics of SAH-induced OHCA survivors were compared with those with "negative" CT finding. RESULTS: Brain CT scan was feasible with an average door-to-CT time of 40.0 min. SAH was found in 16.2% of the 142 OHCA survivors. Compared with 116 survivors who were negative for SAH, SAH-induced OHCA survivors were significantly more likely to be female, to have experienced a sudden headache, and trended to have achieved return of spontaneous circulation (ROSC) prior to arrival in the emergency department less frequently. Ventricular fibrillation (VF) was significantly less likely to be seen in SAH-induced than SAH-negative OHCA (OR, 0.06; 95% CI, 0.01-0.46). Similarly, Cardiac Trop-T assay was significantly less likely to be positive in SAH-induced OHCA (OR, 0.08; 95% CI, 0.01-0.61). CONCLUSION: Aneurysmal SAH causes OHCA more frequently than had been believed. Immediate brain CT scan may particularly be useful in excluding SAH-induced OHCA from thrombolytic trial enrollment, for whom the use of thrombolytics is contraindicated. The low VF incidence suggests that VF by itself may not be a common cause of SAH-induced OHCA.
Authors:
Joji Inamasu; Satoru Miyatake; Hideto Tomioka; Masaru Suzuki; Masashi Nakatsukasa; Naoki Maeda; Takeshi Ito; Kunihiko Arai; Masahiro Komura; Kenichi Kase; Kenji Kobayashi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-07-05
Journal Detail:
Title:  Resuscitation     Volume:  80     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  977-80     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. ginamasu@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / adverse effects*
Diagnosis, Differential
Female
Follow-Up Studies
Heart Arrest / complications*
Humans
Intracranial Aneurysm / complications*,  radiography
Male
Middle Aged
Outpatients*
Prognosis
Prospective Studies
Reproducibility of Results
Risk Factors
Subarachnoid Hemorrhage / etiology*,  radiography
Time Factors
Tomography, X-Ray Computed / methods*
Ventricular Fibrillation / complications
Comments/Corrections
Comment In:
Resuscitation. 2009 Sep;80(9):969-70   [PMID:  19640627 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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