Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions

Resuscitation ◽  
2006 ◽  
Vol 69 (3) ◽  
pp. 399-406 ◽  
Author(s):  
William P. Bozeman ◽  
Douglas M. Kleiner ◽  
Kevin L. Ferguson
Keyword(s):  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Short Term ◽  
Term Survival ◽  
Return Of Spontaneous Circulation ◽  
Short Term Survival

Abstract 4: Inducing Hypothermia During Resuscitation Improves Return Of Spontaneous Circulation In Prolonged Porcine Ventricular Fibrillation

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
James J Menegazzi ◽  
Jon C Rittenberger ◽  
Brian P Suffoletto ◽  
Eric S Logue ◽  
David D Salcido ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Porcine Model ◽  
Spontaneous Circulation ◽  
Right Atrial ◽  
Control Group ◽  
Short Term ◽  
Term Survival ◽  
Return Of Spontaneous Circulation ◽  
Short Term Survival ◽  
Total Fluid

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.

The effect of chest compression depth on short term survival during out of hospital cardiac arrest

Resuscitation ◽  
2010 ◽  
Vol 81 (2) ◽  
pp. S11
Author(s):  
Lukas R.-P. ◽  
Harding U. ◽  
Weber T.P. ◽  
Quan W. ◽  
Van Aken H. ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Short Term ◽  
Term Survival ◽  
Compression Depth ◽  
Hospital Cardiac Arrest ◽  
Short Term Survival

Abstract WP260: Pravastatin Improves Short-term Survival Rate Following Cardiac Arrest and Cardiopulumonary Resuscitation In Mice

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shin Nakayama ◽  
Noriko Taguchi ◽  
Makoto Tanaka
Keyword(s):  
Body Weight ◽  
Cardiac Arrest ◽  
Survival Rate ◽  
Neuronal Damage ◽  
Pleiotropic Effects ◽  
Histological Evaluation ◽  
Vehicle Group ◽  
Short Term ◽  
Term Survival ◽  
Short Term Survival

Statins (HMG-CoA reductase inhibitors) exert numerous pleiotropic effects and have been shown to attenuate ischemic injury in different rodent models of cerebral focal ischemia. Few studies have examined the effect of statins on post cardiac arrest syndrome. This study conducted cardiac arrest and cardiopulmonary resuscitation (CA/CPR) in mice and tested the hypothesis that intravenous statin after CPR improves survival rate and neurological outcomes. Methods: Adult male mice (20-26 g) were subjected to CA induced by intravenous (IV) KCL. After 8 min of CA, CPR was initiated with IV epinephrine, ventilation with 100% oxygen and chest compressions (rate 300/min). At 1 hr after return of spontaneous circulation, mice were treated with either IV injection of pravastatin (3mg/kg) or vehicle. Four days after CA/CPR, neurobehavioral assessments were performed and brains were removed for histological evaluation in hippocampus and caudateputamen. Results: No difference was found between two groups in body weight, duration of CPR and dose of epinephrine. Survival rate at 4 days after CPR was significantly higher in pravastatin group compared with vehicle group (66.7%; n=24 vs 48.4%; n=33). Neurobehavioral scores in pravastatin group were better than vehicle group at 2 to 4 days after CPR. Body weight loss in vehicle group at 4 days after CPR was higher than pravastatin group (-19.4±1.8% vs -13.4±2.0%), which indicates loss of feeding activity. Histological damages in hippocampus and caudateputamen were not statistically different between two groups (pravastatin: 23.8±7.0% vs vehicle: 35.2±9.2% in hippocampus) (pravastatin: 49.4±7.2% vs vehicle: 60.5±7.8% in caudateputamen). All values are presented as mean±SEM. Conclusions: Single IV injection of pravastatin after CA improved short-term survival and neurobehavioral score in the mouse experimental CA model. Neuronal damage in the brain region was comparable to vehicle group. These data suggest that pravastatin given after CA would be beneficial in the post resuscitation phase via systemic pleiotropic effects such as anti inflammatory response and improved vascular reactivity.

scholarly journals Effect of initial lactate level on short-term survival in patients with out-of-hospital cardiac arrest

2017 ◽  
Vol 17 (4) ◽  
pp. 123-127 ◽  
Author(s):  
Tuba Sarıaydın ◽  
Şeref Kerem Çorbacıoğlu ◽  
Yunsur Çevik ◽  
Emine Emektar
Keyword(s):  
Cardiac Arrest ◽  
Lactate Level ◽  
Short Term ◽  
Term Survival ◽  
Hospital Cardiac Arrest ◽  
Short Term Survival

Serum Copeptin Levels Predict the Return of Spontaneous Circulation and the Short-Term Prognosis of Patients with Out-of-Hospital Cardiac Arrest: A Randomized Control Study

2020 ◽  
Vol 35 (2) ◽  
pp. 120-127
Author(s):  
Sümeyye Cakmak ◽  
Ozgur Sogut ◽  
Levent Albayrak ◽  
Ayla Yildiz
Keyword(s):  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Accurate Prediction ◽  
Blood Gas ◽  
Short Term ◽  
Return Of Spontaneous Circulation ◽  
Copeptin Level ◽  
Prediction Of Survival ◽  
The Mean ◽  
Hospital Cardiac Arrest

AbstractIntroduction:Early and accurate prediction of survival to hospital discharge following resuscitation after cardiac arrest (CA) is a major challenge. Biomarkers can be used for early and accurate prediction of survival and prognosis following resuscitation after CA, but none of those identified so far are sufficient by themselves.Hypothesis/Problem:The goal of this study was to investigate the predictive power of the serum copeptin level for determining the return of spontaneous circulation (ROSC) and prognosis of patients with non-traumatic out-of-hospital cardiac arrest (OHCA) who underwent cardiopulmonary resuscitation (CPR).Methods:A total of 76 consecutive consenting adult patients who were diagnosed as non-traumatic OHCA and 63 age- and sex-matched healthy controls were enrolled. The patients were divided into two groups based on whether or not they had ROSC. The ROSC group was divided into two sub-groups according to whether death occurred within 24 hours or after 24 hours following ROSC. Serum copeptin, high-sensitivity cardiac troponin (hs-cTnI), creatine kinase-muscle/brain (CK-MB), glucose, and blood gas values were compared between the groups.Results:Serum copeptin levels were significantly higher in the patient group than control group (P <.001). Receiving operator characteristic analysis revealed a cut-off copeptin level of 27.29pmol/L, with 98.7% sensitivity and 100.0% specificity, for distinguishing patients from controls. Serum copeptin levels were significantly lower in the ROSC group than non-ROSC group (P = .018). Additionally, the mean serum hs-cTnI level was significantly higher in the ROSC group than non-ROSC group (P = .032). However, there were no significant differences in the mean serum glucose level and CK-MB levels or arterial blood gas levels between the ROSC and non-ROSC groups (all P >.05).Ten (38.5%) of the patients died within the first 24 hours after ROSC, whereas 16 (61.5%) survived longer than 24 hours. Serum copeptin levels were significantly lower in patients who survived longer than 24 hours compared with those who died within the first 24 hours. Moreover, the mean CPR duration was significantly lower in patients surviving more than 24 hours compared with less than 24 hours.Conclusion:The serum copeptin level may serve as a guide in diagnostic decision making to predict ROSC in patients undergoing CPR and determining the short-term prognosis of patients with ROSC.

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