Feasibility of correlating the pulse check with focused point-of-care echocardiography during pediatric cardiac arrest: A case series

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care. Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers. Results: We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids. Conclusion: Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.

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The impact of extracorporeal membrane oxygenation on cerebral oxygen delivery during cardiac arrest: a case series

Resuscitation Plus ◽

10.1016/j.resplu.2020.100068 ◽

2021 ◽

Vol 5 ◽

pp. 100068

Author(s):

Emma Roellke ◽

Sam Parnia ◽

Jignesh Patel ◽

Steven Friedman ◽

Amanda Mengotto

Keyword(s):

Cardiac Arrest ◽

Extracorporeal Membrane Oxygenation ◽

Oxygen Delivery ◽

Case Series ◽

Cerebral Oxygen ◽

Membrane Oxygenation ◽

The Impact

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Retrospective Study of the Utility of Point-of-care Blood Testing During Cardiac Arrest

CHEST Journal ◽

10.1378/chest.1923997 ◽

2014 ◽

Vol 145 (3) ◽

pp. 207C

Author(s):

Sumedh Hoskote ◽

Elizabeth Hassebroek ◽

Shihab Sugeir ◽

Sumanjit Kaur ◽

Aysen Erdogan ◽

...

Keyword(s):

Cardiac Arrest ◽

Retrospective Study ◽

Point Of Care ◽

Blood Testing

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International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): An international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest – CORRIGENDUM

CJEM ◽

10.1017/cem.2017.31 ◽

2017 ◽

Vol 19 (04) ◽

pp. 327 ◽

Cited By ~ 2

Author(s):

P. Atkinson ◽

J. Bowra ◽

J. Milne ◽

D. Lewis ◽

M. Lambert ◽

...

Keyword(s):

Emergency Medicine ◽

Cardiac Arrest ◽

Consensus Statement ◽

Point Of Care ◽

International Federation ◽

Point Of Care Ultrasound ◽

International Consensus

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Abstract 17116: Incidence and Outcomes of Out-of-hospital Maternal Cardiac Arrest and Compliance With Resuscitation Guidelines

Circulation ◽

10.1161/circ.132.suppl_3.17116 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Alan A Lipowicz ◽

Sheldon Cheskes ◽

Sarah H Gray ◽

Farida Jeejeebhoy ◽

Janice Lee ◽

...

Keyword(s):

Cardiac Arrest ◽

Performance Metrics ◽

Point Of Care ◽

Survival Rates ◽

Rare Event ◽

Population Based ◽

Childbearing Age ◽

Child Bearing ◽

Resuscitation Guidelines ◽

Regional Health Authorities

Background: Published survival rates after out-of-hospital cardiac arrests (OHCA) are lower than in-hospital cardiac arrest (IHCA). Current estimates for the incidence and rate of survival for maternal cardiac arrest are published only for IHCA. There are no studies that report the incidence and outcomes of maternal OHCA. Current cardiopulmonary resuscitation guidelines contain specific maternal recommendations, although compliance with recommended benchmarks has not been reported. The objective of this study was to report maternal OHCA incidence, outcomes, and compliance with resuscitation and maternal specific guidelines. Methods: This was a population-based cohort study of consecutive maternal OHCA between May 2010 and April 2014. The denominator was estimated from the total regional population of all women of childbearing age obtained from census and age-specific pregnancy rates provided by regional health authorities. Resuscitation performance was measured against the 2010 AHA Guidelines. Results: A total of 6 maternal OHCA occurred amongst 1,085 OHCA occurring in females of child bearing age (15-49) over 4yrs; Incidence-1.85:100,000 (95% CI 1.76 to 1.95) vs. 19.4 per 100,000 (95% CI, 19.37 to 19.43). Maternal and neonatal survival to discharge was 16.7% and 33.3%, respectively. Compliance with CPR quality metrics averaged 83% with a range from 75% to 100%. Compliance with maternal-specific resuscitation guidelines averaged 46.9%, with a range from 0% to 100%. The only performance metrics with 100% compliance was intravenous line insertion above the diaphragm and prehospital activation of the maternal cardiac arrest team. Uterine displacement compliance was low at 0%. Conclusion: The incidence of maternal OHCA was 1.85:100,000, which is lower than the published estimate for maternal IHCA. Survival after OHCA for mother and for child was higher than OHCA occurring in non-pregnant adult females of child bearing age; however, the number of survivors was small (<5). Compliance rates with recommended resuscitation guidelines were high, yet compliance with maternal-specific guidelines were low suggesting targeted training and implementation optimization at the point of care is required to prepare for this rare event involving two lives.

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Abstract 12933: Myocardial Dysfunction After In-Hospital Cardiac Arrest in COVID-19 Patients

Circulation ◽

10.1161/circ.144.suppl_2.12933 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Abhishek Bhardwaj ◽

Mahmoud Alwakeel ◽

Siddharth Dugar ◽

sudhir krishnan ◽

Xiaofeng Wang ◽

...

Keyword(s):

Cardiac Arrest ◽

Median Time ◽

Systolic Function ◽

Myocardial Dysfunction ◽

Systolic Dysfunction ◽

Cleveland Clinic ◽

Case Series ◽

Apache Ii Score ◽

Lv Function ◽

Hospital Cardiac Arrest

Introduction: Post resuscitation myocardial dysfunction (PRMD) is common after out-of-hospital cardiac arrest. While PRMD is a known cause of post-resuscitation circulatory failure, few studies have reported associations between PRMD and neurologic outcome or survival. Further, little is known about PRMD after in-hospital cardiac arrest (IHCA) nor on the incidence and prognosis of PRMD in COVID-19 IHCA. We sought to evaluate the incidence of PRMD in a multicenter cohort of resuscitated COVID-19 IHCA patients. Study Population and Methods: We included adult patients (≥18 y) admitted to multiple hospitals of Cleveland Clinic Health System. Patients who attained ROSC with an initial echocardiogram (EC) in the 72 hours post-arrest were included. Data were extracted from a data registry and electronic medical records. Results: From 03/2020-10/2020, 58 patients with COVID-19 had IHCA. ROSC was noted in 35 patients (60.3%), 27 (46.6%) were alive at 24 h and 13 patients (22.4%) survived to hospital discharge. Of the 35 patients who had ROSC, 14 patients (40%) had an EC within 72 h. The median age of this cohort was 67 y (IQR 47 - 73); 71% were male, and median BMI of 28 (IQR 27 - 34), and admission APACHE II score was 13 (IQR 11 - 19). One third of the patients (36%) were mechanically ventilated before arrest and 43% were on vasopressors. Initial arrest rhythms were: PEA/Asystole, 79%; and VF/VT, 21%. Most patients (93%) received manual chest compression with median CPR duration of 5 min (IQR 2 - 10). The median time of obtaining first EC post-ROSC in these 14 patients was 22 hours (IQR 6 - 62). 7/14 (50%) of the patient had systolic dysfunction on initial EC (6 had global dysfunction, 1 with regional wall motion abnormality, and 4/7 had combined LV and RV systolic dysfunction). 5/14 patients had a follow up EC with a median time of 43 days. 2/5 had normal initial EC and 3 out of these 5 patients who initially had PMRD showed complete recovery in their LV and RV systolic function. Conclusion: We report a case series of PRMD in COVID-19 patients who experienced IHCA. We found that PMRD is seen in half of the patients. Most patients with PMRD recovered to normal RV and LV function, consistent with prior studies of non-COVID-19 arrest EC.

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Abstract P85: Out-of-hospital Cardiac Arrests With Extracorporeal Cardiopulmonary Resuscitation In Japan: Systematic Literature Review

Circulation ◽

10.1161/circ.118.suppl_18.s_1463-c ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tetsuya Sakamoto ◽

Yasufumi Asai ◽

Ken Nagao ◽

Yoshio Tahara ◽

Takahiro Atsumi ◽

...

Keyword(s):

Cardiac Arrest ◽

Survival Rate ◽

Cardiopulmonary Resuscitation ◽

Literature Review ◽

Case Series ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Funnel Plot ◽

Case Series Study ◽

Series Study ◽

Hospital Cardiac Arrest

Background: In Japan, extracorporeal cardiopulmonary resuscitation (ECPR) became popular for cardiac arrest patients who resist conventional advanced life supports. Regardless of many clinical experiences, there has been no previous systematic literature review. Methods: Case series, reports and proceedings of scientific meeting about ECPR for out-of-hospital cardiac arrest written in Japanese between January 1, 1983 and July 31, 2007 were collected with Japana Centra Revuo Medicina (medical publication database in Japan) and review by experts. The outcome and characteristics of the patients were investigated, and the influence of publication bias of the case series study was also examined by the Funnel Plot method. Results: There were 951 out-of-hospital cardiac arrest patients who received ECPR in 92 reports (including 59 case series and 33 case reports) during the period. The average of age was 38.1 (4 – 88) years old and 76.1% was male. Three hundreds and eighty-one cases (40.1%) were arrests of cardiac etiology, and 212 were non-cardiac (22.3%). The cause of arrest was not described in other 37.6%. Excluding reports for only one case, weighted survival rate at discharge of 792 cases those were clearly described the outcome was 39.5±10.0%. When the relationship between the number of cases and the survival rate at discharge in each 59 case series study was shown in figure by the Funnel Plot method, the plotted data presented the reverse-funnel type that centered on the average of survival rate of all. Conclusions: The influence of publication bias of previous reports in Japan was relatively low. ECPR can greatly contribute to improve the outcome of out-of hospital cardiac arrests.

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Interstitial syndrome-lung ultrasound B lines: a potential marker for pulmonary metastases? A case series

Italian Journal of Medicine ◽

10.4081/itjm.2018.1009 ◽

2018 ◽

Vol 12 (3) ◽

pp. 223-226 ◽

Cited By ~ 1

Author(s):

Maria Viviana Carlino ◽

Costantino Mancusi ◽

Giovanni De Simone ◽

Filomena Liccardi ◽

Mario Guarino ◽

...

Keyword(s):

Lung Ultrasound ◽

Pulmonary Metastases ◽

Lung Metastases ◽

Point Of Care ◽

Case Series ◽

Point Of Care Ultrasound ◽

Interstitial Syndrome ◽

Potential Marker ◽

Bilateral Lung ◽

Enhanced Computed Tomography

Four patients presented to the Emergency Department with dyspnea and they underwent point-of-care ultrasound. Lung ultrasound showed a diffuse bilateral B-profile pattern-interstitial syndrome, they underwent contrast-enhanced computed tomography scan of thorax that showed multiple bilateral lung metastases. The detection, in a dyspneic patient, of a diffuse Bprofile pattern not attributable to traditional interstitial syndrome conditions (pulmonary fibrosis, acute respiratory distress syndrome, acute pulmonary edema, interstitial pneumonia) could be indicative of multiple pulmonary metastases.

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