Outcomes Associated With Cardiac Arrest in Patients in the Cardiac Intensive Care Unit With Cardiogenic Shock

Author(s):  
Abdelrahman M. Ahmed ◽  
Meir Tabi ◽  
Brandon M. Wiley ◽  
Saraschandra Vallabhajosyula ◽  
Gregory W. Barsness ◽  
...  
2020 ◽  
Vol 49 (1) ◽  
pp. 169-169
Author(s):  
Abdelrahman Ahmed ◽  
Meir Tabi ◽  
Gregory Barsness ◽  
Kianoush Kashani ◽  
Jacob Jentzer

2007 ◽  
Vol 17 (S4) ◽  
pp. 116-126 ◽  
Author(s):  
Stacie B. Peddy ◽  
Mary Fran Hazinski ◽  
Peter C. Laussen ◽  
Ravi R. Thiagarajan ◽  
George M. Hoffman ◽  
...  

AbstractPulseless cardiac arrest, defined as the cessation of cardiac mechanical activity, determined by unresponsiveness, apneoa, and the absence of a palpable central pulse, accounts for around one-twentieth of admissions to paediatric intensive care units, be they medical or exclusively cardiac. Such cardiac arrest is higher in children admitted to a cardiac as opposed to a paediatric intensive care unit, but the outcome of these patients is better, with just over two-fifths surviving when treated in the cardiac intensive care unit, versus between one-sixth and one-quarter of those admitted to paediatric intensive care units. Children who receive chest compressions for bradycardia with pulses have a significantly higher rate of survival to discharge, at 60%, than do those presenting with pulseless cardiac arrest, with only 27% surviving to discharge. This suggests that early resuscitation before the patient becomes pulseless, along with early recognition and intervention, are likely to improve outcomes. Recently published reports of in-hospital cardiac arrests in children can be derived from the multi-centric National Registry of Cardiopulmonary Resuscitation provided by the American Heart Association. The population is heterogeneous, but most arrests occurred in children with progressive respiratory insufficiency, and/or progressive circulatory shock. During the past 4 years at the Children’s Hospital of Philadelphia, 3.1% of the average 1000 annual admissions to the cardiac intensive care unit have received cardiopulmonary resuscitation. Overall survival of those receiving cardiopulmonary resuscitation was 46%. Survival was better for those receiving cardiopulmonary resuscitation after cardiac surgery, at 53%, compared with survival of 33% for pre-operative or non-surgical patients undergoing resuscitation. Clearly there is room for improvement in outcomes from cardiac resuscitation in children with cardiac disease. In this review, therefore, we summarize the newest developments in paediatric resuscitation, with an expanded focus upon the unique challenges and importance of anticipatory care in infants and children with cardiac disease.


2020 ◽  
Vol 96 (7) ◽  
pp. 1350-1359 ◽  
Author(s):  
Jacob C. Jentzer ◽  
Timothy D. Henry ◽  
Gregory W. Barsness ◽  
Venu Menon ◽  
David A. Baran ◽  
...  

2019 ◽  
Vol 9 (7) ◽  
pp. 779-787 ◽  
Author(s):  
Laust Obling ◽  
Christian Hassager ◽  
Charlotte Illum ◽  
Johannes Grand ◽  
Sebastian Wiberg ◽  
...  

Background: Patients admitted to a cardiac intensive care unit are often unconscious with uncertain prognosis. Automated infrared pupillometry for neurological assessment in the intensive care unit may provide early prognostic information. This study aimed to determine the prognostic value of automated pupillometry in different subgroups of patients in a cardiac intensive care unit with 30-day mortality as the primary endpoint and neurological outcome as the secondary endpoint. Methods: A total of 221 comatose patients were divided into three groups: out-of-hospital cardiac arrest, in-hospital cardiac arrest and others (i.e. patients with cardiac diagnoses other than cardiac arrest). Automated pupillometry was serially performed until discharge or death and pupil measurements were analysed using the neurological pupil index algorithm. We applied receiver operating characteristic curves in univariable and multivariable logistic regression models and a calculated Youden index identified neurological pupil index cut-off values at different specificities. Results: In out-of-hospital cardiac arrest patients higher neurological pupil index values were independently associated with lower 30-day mortality. The univariable model for 30-day mortality had an area under the curve of 0.87 and the multivariable model achieved an area under the curve of 0.94. The Youden index identified a neurological pupil index cut-off in out-of-hospital cardiac arrest patients of 2.40 for a specificity of 100%. For patients with in-hospital cardiac arrest and other cardiac diagnoses, we found no association between neurological pupil index values and 30-day mortality, and the univariable models showed poor predictive values. Conclusion: Automated infrared pupillometry has promising predictive value after out-of-hospital cardiac arrest, but poor predictive value in patients with in-hospital cardiac arrest or cardiac diagnoses unrelated to cardiac arrest. Our data suggest a possible neurological pupil index cut-off of 2.40 for poor outcome in out-of-hospital cardiac arrest patients.


2012 ◽  
Vol 13 (5) ◽  
pp. 583-588 ◽  
Author(s):  
Michael G. Gaies ◽  
Nicholas S. Clarke ◽  
Janet E. Donohue ◽  
James G. Gurney ◽  
John R. Charpie ◽  
...  

2019 ◽  
Vol 74 (17) ◽  
pp. 2117-2128 ◽  
Author(s):  
Jacob C. Jentzer ◽  
Sean van Diepen ◽  
Gregory W. Barsness ◽  
Timothy D. Henry ◽  
Venu Menon ◽  
...  

2018 ◽  
Vol 34 (2) ◽  
pp. 156-167 ◽  
Author(s):  
Varinder K. Randhawa ◽  
Brian E. Grunau ◽  
Derek B. Debicki ◽  
Jian Zhou ◽  
Ahmed F. Hegazy ◽  
...  

Shock ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Barry Burstein ◽  
Saraschandra Vallabhajosyula ◽  
Bradley Ternus ◽  
Gregory W. Barsness ◽  
Kianoush Kashani ◽  
...  

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