3752 Prevention of recurrences of life threatening arrhythmias: results of the Leiden out of hospital cardiac arrest trial (LOHCAT)

2003 ◽  
Vol 24 (5) ◽  
pp. 730
Author(s):  
M SCHALIJ
Keyword(s):  
Cardiac Arrest ◽  
Life Threatening ◽  
Hospital Cardiac Arrest

scholarly journals Profound Hypokalaemia Resulting in Maternal Cardiac Arrest: A Catastrophic Complication of Hyperemesis Gravidarum?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anna Walch ◽  
Madeline Duke ◽  
Travis Auty ◽  
Audris Wong
Keyword(s):  
Cardiac Arrest ◽  
Hyperemesis Gravidarum ◽  
Extracellular Fluid ◽  
Nutritional Deficiencies ◽  
Normal Limits ◽  
Life Threatening ◽  
Total Body ◽  
Anuric Renal Failure ◽  
Hospital Cardiac Arrest ◽  
In Pregnancy

We present a case of a 39-year-old G8P6 Pacific Islander woman who at 15+5 weeks’ gestation had an out-of-hospital cardiac arrest secondary to profound hypokalaemia which was associated with severe hyperemesis gravidarum (HG). Her clinical course after arrest was complicated by a second 5-minute cardiac arrest in the Intensive Care Unit (ICU) (pre-arrest potassium 1.8), anuric renal failure requiring dialysis, ischaemic hepatitis, and encephalopathy and unfortunately fetal demise and a spontaneous miscarriage on day 2 of admission. Despite these complications, she was discharged home 4 weeks later with a full recovery. Following a plethora of inpatient and outpatient investigations, the cause of her cardiac arrest was determined to be profound hypokalaemia. The hypokalaemia was presumed second to a perfect storm of HG with subsequent nutritional deficiencies causing electrolyte wasting, extracellular fluid (ECF) volume reduction, and activation of the renin-angiotensin-aldosterone axis (RAAS). This combined with the physiological changes that promote potassium wasting in pregnancy including volume expansion, increased renal blood flow, increased glomerular filtration rate, and increase in cortisol contributed to the patient having a profoundly low total body potassium level. This diagnosis is further strengthened by the fact that her pre- and post-pregnancy potassium levels were within normal limits in the absence of supplementary potassium. This case highlights the potentially life-threatening electrolyte imbalances that can occur with HG and the importance of recognising the disease, comprehensive electrolyte monitoring, and aggressive management in pregnancy.

scholarly journals Survival and long-term outcomes following in-hospital cardiac arrest in a Swiss university hospital: a prospective observational study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Alexander Fuchs ◽  
Dominic Käser ◽  
Lorenz Theiler ◽  
Robert Greif ◽  
Jürgen Knapp ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Return Of Spontaneous Circulation ◽  
Life Threatening ◽  
Team Interventions ◽  
Hospital Cardiac Arrest ◽  
Cardiac Arrest Team

Abstract Background Incidence of in-hospital cardiac arrest is reported to be 0.8 to 4.6 per 1,000 patient admissions. Patient survival to hospital discharge with favourable functional and neurological status is around 21–30%. The Bern University Hospital is a tertiary medical centre in Switzerland with a cardiac arrest team that is available 24 h per day, 7 days per week. Due to lack of central documentation of cardiac arrest team interventions, the incidence, outcomes and survival rates of cardiac arrests in the hospital are unknown. Our aim was to record all cardiac arrest team interventions over 1 year, and to analyse the outcome and survival rates of adult patients after in-hospital cardiac arrests. Methods We conducted a prospective single-centre observational study that recorded all adult in-hospital cardiac arrest team interventions over 1 year, using an Utstein-style case report form. The primary outcome was 30-day survival after in-hospital cardiac arrest. Secondary outcomes were return of spontaneous circulation, neurological status (after return of spontaneous circulation, after 24 h, after 30 days, after 1 and 5 years), according to the Glasgow Outcomes Scale, and functional status at 30 days and 1 year, according to the Short-form-12 Health Survey. Results The cardiac arrest team had 146 interventions over the study year, which included 60 non-life-threatening alarms (41.1%). The remaining 86 (58.9%) acute life-threatening situations included 68 (79.1%) as patients with cardiac arrest. The mean age of these cardiac arrest patients was 68 ± 13 years, with a male predominance (51/68; 75.0%). Return of spontaneous circulation was recorded in 49 patients (72.1%). Over one-third of the cardiac arrest patients (27/68) were alive after 30 days with favourable neurological outcome. The patients who survived the first year lived also to 5 years after the event with favourable neurological and functional status. Conclusions The in-hospital cardiac arrest incidence on a large tertiary Swiss university hospital was 1.56 per 1000 patient admissions. After a cardiac arrest, about a third of the patients survived to 5 years with favourable neurological and functional status. Alarms unrelated to life-threatening situations are common and need to be taken into count within a low-threshold alarming system. Trial Registration: The trial was registered in clinicaltrials.gov (NCT02746640).

scholarly journals 1053-209 Amiodarone in survivors of life-threatening ventricular arrhythmias: Does it improve outcome? Results of the leiden out of hospital cardiac arrest trial (LOHCAT)

2004 ◽  
Vol 43 (5) ◽  
pp. A116
Author(s):  
ppine Kiès ◽  
Jeroen J Bax ◽  
Alida E Borger van der Burg ◽  
Eric Boersma ◽  
Marrian tsma ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Arrhythmias ◽  
Improve Outcome ◽  
Life Threatening ◽  
Hospital Cardiac Arrest

scholarly journals Exploring the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to apparent life threatening events

Resuscitation ◽  
2016 ◽  
Vol 109 ◽  
pp. 40-48 ◽  
Author(s):  
Kathleen Meert ◽  
Russell Telford ◽  
Richard Holubkov ◽  
Beth S. Slomine ◽  
James R. Christensen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Safety And Efficacy ◽  
Life Threatening ◽  
Hospital Cardiac Arrest

Prediction of Countershock Success in Patients Using the Autoregressive Spectral Estimation

2012 ◽  
Vol 51 (01) ◽  
pp. 13-20 ◽  
Author(s):  
A. Neurauter ◽  
L. Wieser ◽  
V. Wenzel ◽  
B. Abella ◽  
H. Myklebust ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Spectral Estimation ◽  
Amplitude Spectrum ◽  
Diagnostic Odds Ratio ◽  
Dominant Frequency ◽  
Fast Fourier Transformation ◽  
Optimal Timing ◽  
Spectrum Area ◽  
Life Threatening ◽  
Hospital Cardiac Arrest

SummaryObjectives: Ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia and within of minutes of its occurrence, optimal timing of countershock therapy is highly warranted to improve the chance of survival. This study was designed to investigate whether the autoregressive (AR) estimation technique was capable to reliably predict countershock success in VF cardiac arrest patients.Methods: ECG data of 1077 countershocks applied to 197 cardiac arrest patients with out-of-hospital and in-hospital cardiac arrest between March 2002 and July 2004 were retrospectively analyzed. The ECG from the 2.5 s interval of the precountershock VF ECG was used for computing the AR based features Spectral Pole Power (SPP) and Spectral Pole Power with Dominant Frequency weighing (SPPDF) and Centroid Frequency (CF) and Amplitude Spectrum Area (AMSA) based on Fast Fourier Transformation (FFT).Results: With ROC AUC values up to 84.1 % and diagnostic odds ratio up to 19.12 AR based features SPP and SPPDF have better prediction power than the FFT based features CF (80.5 %; 6.56) and AMSA (82.1 %; 8.79).Conclusions: AR estimation based features are promising alternatives to FFT based features for countershock outcome when analyzing human data.

Standardized screening and treatment of patients with life-threatening arrhythmias: The leiden out-of-hospital cardiac arrest evaluation study

Heart Rhythm ◽  
2004 ◽  
Vol 1 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Alida E Borger van der Burg ◽  
Jeroen J Bax ◽  
Eric Boersma ◽  
Lieselot van Erven ◽  
Marianne Bootsma ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Evaluation Study ◽  
Life Threatening ◽  
Standardized Screening ◽  
Hospital Cardiac Arrest

Non-occlusive mesenteric ischaemia in out of hospital cardiac arrest survivors

2017 ◽  
Vol 7 (5) ◽  
pp. 450-458 ◽  
Author(s):  
Raphael Wurm ◽  
Anna Cho ◽  
Henrike Arfsten ◽  
Raphael van Tulder ◽  
Christian Wallmüller ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Spontaneous Circulation ◽  
Base Deficit ◽  
Mesenteric Ischaemia ◽  
Immediate Recovery ◽  
Life Saving ◽  
Patients At Risk ◽  
Life Threatening ◽  
Hospital Cardiac Arrest

Background and aim of the study: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function. Since after successful cardiopulmonary resuscitation patients are often ventilated and sedated, NOMI might be underdiagnosed and potentially life-saving treatment delayed. Material and methods: A prospectively maintained multi-purpose cohort of out of hospital cardiac arrest survivors, who had successful restoration of spontaneous circulation, was used for this retrospective database analysis. Patients’ charts were screened for clinical, radiological or pathological evidence of NOMI and clinical data were collected. Results: Between 2000 and 2014, 1780 patients who were successfully resuscitated after out of hospital cardiac arrest were screened for NOMI. Twelve patients (0.68 %) suffered from NOMI and six of those died (50 %). Patients suffering from NOMI tended to have a longer duration until restoration of spontaneous circulation (27 vs. 20 min, p=0.128) and had significantly higher lactate (14 mmol/l vs. 8 mmol/l, p=0.002) and base deficit levels at admission (−17 vs. −10, p=0.012). Median leukocyte counts in NOMI patients peaked at the day of diagnosis. Conclusion: NOMI is a rare but life-threatening and potentially curable complication following successful cardiopulmonary resuscitation. Lactate and base deficit at admission could help to identify patients at risk for developing NOMI who might benefit from increased clinical attention.

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