The natural biochemical changes during ventricular fibrillation with cardiopulmonary resuscitation and the onset of postdefibrillation pulseless electrical activity

2006 ◽  
Vol 24 (5) ◽  
pp. 577-581 ◽  
Author(s):  
Leslie A. Geddes ◽  
Rebecca A. Roeder ◽  
Ann E. Rundell ◽  
Michael P. Otlewski ◽  
Andre E. Kemeny ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Electrical Activity ◽  
Pulseless Electrical Activity ◽  
Biochemical Changes

Abstract 052: Improved Hospital Outcomes With Hypokalemia on Admission in Cardiac Arrest Survivors Treated With Therapeutic Hypothermia

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Angelo de la Rosa ◽  
Manuel Tapia ◽  
Yong Ji ◽  
Basil Saour ◽  
Mikhail Torosoff
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Mortality ◽  
Electrical Activity ◽  
Therapeutic Hypothermia ◽  
Multivariate Logistic Regression Analysis ◽  
Pulseless Electrical Activity ◽  
Older Age ◽  
Chi Square

Purpose: We hypothesized that advanced circulatory compromise, as manifested by acidosis and hyperkalemia should be associated with worsened clinical outcomes in cardiac arrest patients treated with therapeutic hypothermia. Methods: Results of initial admission laboratory studies, medical history, and echocardiogram in 203 consecutive cardiac arrest patients (59 females, 59+/- 15 years old) undergoing therapeutic hypothermia were reviewed. Mortality was ascertained through hospital records. ANOVA, chi-square, Kaplan-Meier, and logistic regression analyses were used. The study was approved by the institutional IRB. Results: Increased mortality was noted with older age, decreased admission pH, elevated admission lactate, lower admission hemoglobin, and pulseless electrical activity or asystole as presenting rhythms (Table). Admission hypokalemia and ventricular fibrillation/tachycardia were associated with improved hospital mortality (Table). Potassium was significantly lower in patients admitted with ventricular fibrillation/tachycardia (3.897+/-0.92) as compared to patients with asystole (4.674+/-1.377) or pulseless electrical activity (4.491+/-1.055 mEq/dL, p<0.0001). In multivariate logistic regression analysis, independent predictors of increased hospital mortality included increased admission potassium (OR 2.0, 95%CI 1.291-3.170, p=0.002)), older age (OR 1.04, 95%CI 1.007-1.071, p=0.017), admission PEA (OR 3.7, 95%CI 1.358-10.282, p=0.011 when compared to ventricular fibrillation/tachycardia) or asystole (OR 17.2, 95%CI 4.423-66.810, p<0.001 when compared to ventricular fibrillation/tachycardia); while decreased mortality was associated with higher hemoglobin (OR 0.8, 95%CI 0.665-0.997, p=0.047). Conclusions: Hyperkalemia, pulseless electrical activity, and asystole are predictive of increased hospital mortality in survivors of cardiac arrest. An association between low or low-normal potassium, observed VT-VF, and better outcomes is unexpected and may be used for prognostic purposes. More prospective investigations of mortality predictors in these critically ill patients are needed.

scholarly journals Refractory Ventricle Arrhythmias Alternating with Pulseless Electrical Activity in a Young Woman Rescued by Extracorporeal Cardiopulmonary Resuscitation

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ilona Lálová ◽  
Lucie Filipovská ◽  
Hana Skalická ◽  
Ondřej Šmíd ◽  
Aleš Linhart ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Electrical Activity ◽  
Pulseless Electrical Activity ◽  
Myocardial Biopsy ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Case Presentation ◽  
Cardioverter Defibrillator ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Hospital Cardiac Arrest ◽  
Caucasian Female

Introduction. Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation. The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator. Conclusion. Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.

The duration of ventricular fibrillation required to produce pulseless electrical activity

2005 ◽  
Vol 23 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Leslie A. Geddes ◽  
Rebecca A. Roeder ◽  
André Kemeny ◽  
Michael Otlewski
Keyword(s):  
Ventricular Fibrillation ◽  
Electrical Activity ◽  
Pulseless Electrical Activity

Survival from pulseless electrical activity after cardiopulmonary resuscitation in-hospitalazed patients

Resuscitation ◽  
2006 ◽  
Vol 70 (2) ◽  
pp. 318
Author(s):  
Montse Tió ◽  
J. Fontanals ◽  
E. Carrero ◽  
G. Sánchez-Etayo ◽  
F.J. Tercero ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Electrical Activity ◽  
Pulseless Electrical Activity

scholarly journals Cardiac arrest with pulseless electrical activity rhythm in newborn infants: a case series

2019 ◽  
Vol 104 (6) ◽  
pp. F572-F574 ◽  
Author(s):  
Deandra Luong ◽  
Po-Yin Cheung ◽  
Keith J Barrington ◽  
Peter G Davis ◽  
Jennifer Unrau ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiopulmonary Resuscitation ◽  
Electrical Activity ◽  
Activity Rhythm ◽  
Healthcare Providers ◽  
Newborn Infants ◽  
Case Series ◽  
Neonatal Resuscitation ◽  
Pulseless Electrical Activity ◽  
Resuscitation Guidelines

The 2015 neonatal resuscitation guidelines added ECG to assess an infant’s heart rate when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. We report four cases of pulseless electrical activity during neonatal cardiopulmonary resuscitation in levels II–III neonatal intensive care units in Canada (Edmonton [n=3] and Winnipeg [n=1]).Healthcare providers should be aware that pulseless electrical activity can occur in newborn infants during cardiopulmonary resuscitation. We propose an adapted neonatal resuscitation algorithm to include pulseless electrical activity. Furthermore, in compromised newborns, heart rate should be assessed using a combination of methods/techniques to ensure accurate heart rate assessment. When ECG displays a heart rate but the infant is unresponsive, pulseless electrical activity should be suspected and chest compression should be started.

scholarly journals Cohort study on the factors associated with survival post-cardiac arrest

2015 ◽  
Vol 133 (6) ◽  
pp. 495-501 ◽  
Author(s):  
Cássia Regina Vancini-Campanharo ◽  
Rodrigo Luiz Vancini ◽  
Claudio Andre Barbosa de Lira ◽  
Marília dos Santos Andrade ◽  
Aécio Flávio Teixeira de Góis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Cohort Study ◽  
Survival Rate ◽  
Ventricular Fibrillation ◽  
Electrical Activity ◽  
Pulseless Electrical Activity ◽  
Factors Associated ◽  
One Year

CONTEXT AND OBJECTIVE: Cardiac arrest is a common occurrence, and even with efficient emergency treatment, it is associated with a poor prognosis. Identification of predictors of survival after cardiopulmonary resuscitation may provide important information for the healthcare team and family. The aim of this study was to identify factors associated with the survival of patients treated for cardiac arrest, after a one-year follow-up period. DESIGN AND SETTING: Prospective cohort study conducted in the emergency department of a Brazilian university hospital. METHODS: The inclusion criterion was that the patients presented cardiac arrest that was treated in the emergency department (n = 285). Data were collected using the In-hospital Utstein Style template. Cox regression was used to determine which variables were associated with the survival rate (with 95% significance level). RESULTS: After one year, the survival rate was low. Among the patients treated, 39.6% experienced a return of spontaneous circulation; 18.6% survived for 24 hours and of these, 5.6% were discharged and 4.5% were alive after one year of follow-up. Patients with pulseless electrical activity were half as likely to survive as patients with ventricular fibrillation. For patients with asystole, the survival rate was 3.5 times lower than that of patients with pulseless electrical activity. CONCLUSIONS: The initial cardiac rhythm was the best predictor of patient survival. Compared with ventricular fibrillation, pulseless electrical activity was associated with shorter survival times. In turn, compared with pulseless electrical activity, asystole was associated with an even lower survival rate.

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