Search Tag: cardiac arrest
2023 24 May
Hypoxic-ischaemic brain injury following cardiac arrest (CA) is associated with significant morbidity and mortality. Withdrawal of life-sustaining therapy (WLST) is a common cause of death in these cases. Prognostication plays a crucial role. Current guidelines, such as those from ESICM, propose a multimodal approach combining clinical examination,...Read more
2022 08 Dec
Current applications and limitations of critical care echocardiography in the critical care context and its use in guiding the care of the critically ill patient. Echocardiography in the ICU Echocardiography is currently considered an essential diagnostic tool at the disposal of the intensivist – a significant change from less than two decades...Read more
2022 08 Dec
This article aims to discuss the specific role of point of care ultrasound (POCUS) in the diagnosis and management of pathology in the critical care setting, as well as a specific tool to aid in invasive procedures. We discuss the ABCDE assessment of patients within critical care using POCUS. Introduction Since its introduction,...Read more
2022 08 Feb
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have released new guidelines on temperature control after cardiac arrest in adults. The term Targeted Temperature Management (TTM) is used to describe temperature control after cardiac arrest. However, recently the Advanced Life Support (ALS) Task...Read more
2021 23 Feb
A recent report evaluates the characteristics and outcomes among cardiac arrest cases with COVID-19 and the differences between out-of-hospital cardiac arrests (OHCA) and in-hospital cardiac arrest (IHCA) during the pre-pandemic and the pandemic period. Several reports demonstrate an increased risk of OHCA during the pandemic. A study from Paris...Read more
2020 24 Nov
Out-of-hospital cardiac arrests (OHCA) are associated with very high rates of mortality and poor cognitive outcome. This paper reviews long-term outcomes post OHCA and the pre-hospitalisation factors that predict them. Introduction Cardiac arrest is among the most common health emergencies worldwide, suffered by over a half million...Read more
2020 11 Jan
Post-anoxic brain damage after cardiac arrest is a complex condition that is managed through targeted temperature management (TTM) as it is currently the only neuroprotective intervention recommended after out-of-hospital cardiac arrest (OHCA). However, experts have raised concerns about the level of evidence supporting this intervention. Two early...Read more
2019 22 Aug
Delays in transferring patients from the Emergency Department (ED) to the ICU could delay treatment, leaving the patient at risk. A recent study explored the impact of this and found that increased ED to ICU wait times were associated with increased hospital mortality. Data was used from the Dutch quality registry National Intensive Care Evaluation,...Read more
2019 10 Apr
In patients who recover consciousness after cardiac arrest (CA), a subsequent death from non-neurological causes may confound the assessment of long-term neurological outcome. Researchers developed the so-called “Best CPC” (i.e., as for Cerebral Performance Category) project with the aim to assess the prevalence and causes of death after awakening...Read more
2019 06 Mar
Organ dysfunction is common after cardiac arrest and associated with worse short-term outcome. New research shows that extracerebral organ failure, measured as the 24 hour-EC-SOFA score, is also an important contributor to both long-term outcome and increased healthcare-associated costs in cardiac arrest patients. For this retrospective...Read more
2018 04 Dec
Cardiac arrest, a leading cause of admission to the intensive care unit (ICU), is associated with high mortality. Current illness severity scores perform poorly in predicting survival for this patient group. New research from Australia shows machine learning (ML) techniques can significantly increase the accuracy of estimating survival for ICU patients...Read more
2018 20 Nov
Perfusion-guided patient-specific resuscitation could be the next major step in improving cardiac arrest survival with good neurological outcomes, according to a letter published in Resuscitation . You might also like : Jerry Nolan - Cardiac arrest management Rohit Mohindra, Jewish General Hospital Department of Emergency Medicine and the...Read more
2018 27 Aug
Insights from the PARAMEDIC2 trial and future improvements Perkins et al. have advanced the long-awaited PARAMEDIC2 trial (Perkins et al. 2018). They deserve to be congratulated for such a well-interpreted and well-designed contribution. The study’s two main outcomes are as follows: the Epinephrine group had a significantly improved inpatient survival...Read more
2018 24 Jul
In addition to early initiation of cardiopulmonary resuscitation (CPR), treatment strategies for out-of-hospital cardiac arrest have included the use of various drugs, but there is limited evidence that such medications are effective. Results of the clinical trial (Pre-hospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug...Read more
2018 01 Jun
When paramedics used a new, more flexible laryngeal breathing tube to give oxygen to patients who had had an out-of-hospital cardiac arrest, these patients survived longer than patients who received oxygen via the traditional endotracheal tube, according to the results of a large randomised controlled trial conducted in the USA. The results...Read more
2018 16 Mar
Hypothermia (HT) is a cornerstone of neuroprotective strategies and has been used in critical care for acutely brain injured adult patients for many years. This review aims to discuss the clinical evidence supporting the use of HT in neurocritical care patients beyond care after cardiac arrest (CA), such as traumatic brain injury (TBI), acute ischaemic...Read more
2017 05 Dec
Return of spontaneous circulation after cardiac arrest results in a systemic inflammatory state called the post-cardiac arrest syndrome (PCAS), characterised by oxidative stress, coagulopathy, neuronal injury, and organ dysfunction. Further, patients who suffer cardiac arrest are at high risk for pulmonary infection. Meticulous attention to mechanical...Read more
2017 25 Aug
NICE has developed a medtech innovation briefing (MIB) on the Arctic Sun® 5000 Temperature management System. The Arctic Sun® 5000 Temperature management system is a non-invasive system for controlling and monitoring body temperature within the range of 32°C to 38.5°C. It is intended for use in adults who are comatose after sudden cardiac...Read more
2017 11 Jul
Researchers in South Korea previously reported that diffusion-weighted magnetic resonance imaging (DW-MRI) could be used to predict neurologic outcomes before targeted temperature management (TTM) after return of spontaneous circulation (ROSC) from cardiac arrest. In a new study, the same team of researchers compared the efficacy of brain computed...Read more
2017 28 May
The “chain of survival” metaphor for improving outcomes from sudden cardiac arrest (CA) was first coined in the 1980s. Since adopted by the American Heart Association and the International Liaison Committee on Resuscitation amongst others, it is a useful tool to concentrate efforts on how to optimise every link in the chain to improve survival and...Read more
2017 28 May
A registry study from Denmark has investigated the 1-year risk of anoxic brain damage or nursing home admission and of mortality among patients who survived to day 30 after an out-of-hospital cardiac arrest. The risks were analysed according to whether bystander CPR or defibrillation was performed. The study is published in the New England Journal...Read more
2017 28 May
Bystander cardiopulmonary resuscitation (CPR) is crucial to successful resuscitation following out-of-hospital cardiac arrest (OHCA). New research shows that bystander CPR was positively associated with long-term survival and appears cost-effective, with an incremental costeffectiveness ratio of USD48,044 per quality-adjusted life year (QALY).The findings...Read more
2017 28 May
The treatment of cardiac arrest has made significant progress over the last 10–15 years. This period marks a significant turning point, because the treatment of out-of-hospital cardiac arrest (OHCA) had often been considered an exercise in futility, with no improvement in outcome for the previous 30 years (Berdowski et al. 2010). In recent years, several investigators...Read more
2017 28 May
More patient lives have been saved after OHCA in recent years, but the numbers can improve further. Increased awareness, more education of laypersons and more first responders, in combination with reduced response times for the EMS and early defibrillation will save many lives The chances of surviving an out-of-hospital cardiac arrest (OHCA)...Read more
2017 28 May
Cardiac arrest (CA) causes ischaemic brain injury and persistent cerebral hypoperfusion and cerebral hypoxia during the early post-resuscitation period. PaCO2 is the major physiological regulator of cerebral blood flow, is a modifiable component of care and mild hypercapnia may lead to improved neurological outcomes for resuscitated CA survivors....Read more