A Pilot Study on Early Versus Delayed Hypertonic Saline Dextran Resuscitation in a Porcine Model of Near-Lethal Liver Injury: Early Hemodynamic Response and Short-Term Survival

Introduction: Induced hypothermia has been shown to improve survival and neurologic outcomes for ventricular fibrillation (VF) cardiac arrest. Clinical studies have not begun inducing hypothermia until after return of spontaneous circulation (ROSC). The effects of cooling during the resuscitation are not well-studied. Hypothesis: We hypothesized that inducing hypothermia at the start of resuscitation would increase the rates of ROSC and short-term survival (20 minutes) in an established porcine model of prolonged VF. We compared intra-resuscitation hypothermia (IRH) with a normothermic control group (CTL). Methods: We anesthetized and instrumented 28 domestic swine (mean mass 26.5 ±2.4 kgs) with ECG, esophageal temperature, and micromanometer-tipped aortic and right atrial catheters. We then randomly assigned them to IRH and CTL groups (n= 14 each). VF was electrically induced and untreated for 8 minutes. Then resuscitation was begun with mechanical chest compression and ventilation. Hypothermia was induced by rapid IV infusion of ice-cold normal saline (30 mL/kg) at the beginning of resuscitation in the IRH group. The CTL group got 30 mL/kg of body-temperature saline at the start of resuscitation. After 8 minutes of VF, two minutes of CPR was followed by delivery of drugs (epinephrine 0.1 mg/kg, vasopressin 40 U, and propranolol 1.0 mg) and 3 more minutes of CPR (first rescue shock at 13 minutes of VF). ROSC (systolic BP above 80 mmHg for one minute continuously) and survival were recorded, as was total fluid given and hematocrits. Temperatures are reported in degrees C. Rates were compared with 2-tailed Fisher’s exact test, with alpha=0.05. Results: Baseline temperatures at 8 minutes VF did not differ (IRH=37.9° and CTL=37.7°). Post-infusion temperatures at 13 minutes of VF were IRH=34.9° and CTL=37.9°. ROSC occurred in 12/14 (86%) IRH animals and in 6/14 (43%) CTL, with p=0.046. Survival occurred in 8/14 (57%) IRH animals and 4/14 (36%) CTL, with p=0.15. Total fluid volumes given and hematocrits did not differ between groups. Conclusions: IRH doubled the rate of ROSC compared to CTL. There was a non-significant 58% relative improvement in short-term survival. In this porcine model, rapid infusion of ice-cold saline quickly cooled during resuscitation.

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Transapical cardioscopic mitral annuloplasty: a short-term survival study in a porcine model

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivx282 ◽

2017 ◽

Vol 26 (1) ◽

pp. 131-138 ◽

Cited By ~ 2

Author(s):

Thang Duc Vu ◽

Min Zin Oo ◽

Duc-Viet Nguyen ◽

Ervin Marquez Ocampo ◽

Yilin Ong ◽

...

Keyword(s):

Porcine Model ◽

Short Term ◽

Term Survival ◽

Mitral Annuloplasty ◽

Survival Study ◽

Short Term Survival

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Relationship between the time of day lung transplantation is performed during 24-hours shifts and short-term survival

10.26226/morressier.57108e2fd462b80290b4a68c ◽

2016 ◽

Author(s):

Johannes Menger

Keyword(s):

Lung Transplantation ◽

Time Of Day ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Influence of age and shock severity on short-term survival in patients with cardiogenic shock

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuaa035 ◽

2021 ◽

Author(s):

Jacob C Jentzer ◽

Benedikt Schrage ◽

David R Holmes ◽

Salim Dabboura ◽

Nandan S Anavekar ◽

...

Keyword(s):

Cardiogenic Shock ◽

Mayo Clinic ◽

Older Patients ◽

Cox Proportional Hazards ◽

Circulatory Support ◽

Short Term ◽

Term Survival ◽

Risk Of Death ◽

Coronary Syndrome ◽

Short Term Survival

Abstract Aims Cardiogenic shock (CS) is associated with poor outcomes in older patients, but it remains unclear if this is due to higher shock severity. We sought to determine the associations between age and shock severity on mortality among patients with CS. Methods and results Patients with a diagnosis of CS from Mayo Clinic (2007–15) and University Clinic Hamburg (2009–17) were subdivided by age. Shock severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Predictors of 30-day survival were determined using Cox proportional-hazards analysis. We included 1749 patients (934 from Mayo Clinic and 815 from University Clinic Hamburg), with a mean age of 67.6 ± 14.6 years, including 33.6% females. Acute coronary syndrome was the cause of CS in 54.0%. The distribution of SCAI shock stages was 24.1%; C, 28.0%; D, 33.2%; and E, 14.8%. Older patients had similar overall shock severity, more co-morbidities, worse kidney function, and decreased use of mechanical circulatory support compared to younger patients. Overall 30-day survival was 53.3% and progressively decreased as age or SCAI shock stage increased, with a clear gradient towards lower 30-day survival as a function of increasing age and SCAI shock stage. Progressively older age groups had incrementally lower adjusted 30-day survival than patients aged <50 years. Conclusion Older patients with CS have lower short-term survival, despite similar shock severity, with a high risk of death in older patients with more severe shock. Further research is needed to determine the optimal treatment strategies for older CS patients.

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Parenteral Nutrition and Oxidant Load in Neonates

Nutrients ◽

10.3390/nu13082631 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2631

Author(s):

Kandeepan Karthigesu ◽

Robert F. Bertolo ◽

Robert J. Brown

Keyword(s):

Parenteral Nutrition ◽

Storage Temperature ◽

Oral Feeding ◽

Published Data ◽

Short Term ◽

Antioxidant Defences ◽

Term Survival ◽

Nutrient Sources ◽

Short Term Survival

Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.

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LACK OF ASSOCIATION BETWEEN 99MTC-PYP HEART TO CONTRALATERAL RATIO AND SHORT-TERM SURVIVAL IN PATIENTS REFERRED FOR TRANSTHYRETIN CARDIAC AMYLOIDOSIS EVALUATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02762-5 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1404

Author(s):

Trejeeve Martyn ◽

Joshua Saef ◽

Muzna Hussain ◽

Ossama Abou Hassan ◽

Eoin Donnellan ◽

...

Keyword(s):

Cardiac Amyloidosis ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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A registry study on radial head arthroplasties in the Netherlands: Indications, types and short-term survival

Shoulder & Elbow ◽

10.1177/1758573220987843 ◽

2021 ◽

pp. 175857322098784

Author(s):

Arno A Macken ◽

Ante Prkić ◽

Koen LM Koenraadt ◽

Iris van Oost ◽

Anneke Spekenbrink-Spooren ◽

...

Keyword(s):

Radial Head ◽

Register Data ◽

Implant Survival ◽

Short Term ◽

Term Survival ◽

Arthroplasty Register ◽

Common Indication ◽

Radial Head Arthroplasty ◽

Kaplan Meier ◽

Short Term Survival

Background This study aims to use the Dutch Arthroplasty Register data to report an overview of the contemporary indications and implant designs, and report the short-term survival of radial head arthroplasty. Methods From the Dutch Arthroplasty Register, data on patient demographics, surgery and revision were extracted for radial head arthroplasties performed from January 2014 to December 2019. Implant survival was calculated using the Kaplan–Meier method. Results Two hundred fifty-eight arthroplasties were included with a median follow-up of 2.2 years. The most common indication was a fracture of the radial head (178, 69%). One hundred thirty-nine (68%) of the prostheses were of bipolar design, and the most commonly used implant type was the Radial Head System (Tornier; 134, 51%). Of the 258 included radial head arthroplasties, 16 were revised at a median of six months after surgery. Reason for revision was predominantly aseptic loosening (9). The overall implant survival was 95.8% after one year, 90.5% after three years and 89.5% after five years. Discussion For radial head arthroplasties, acute trauma is the most common indication and Radial Head System the most commonly used implant. The implant survival is 89.5% after five years.

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