Resuscitative Endovascular Balloon Occlusion of the Aorta for Refractory Out-of-Hospital Non-Traumatic Cardiac Arrest – A Case Report

2019 ◽  
Vol 34 (05) ◽  
pp. 566-568 ◽  
Author(s):  
Carlo Coniglio ◽  
Lorenzo Gamberini ◽  
Cristian Lupi ◽  
Piergiorgio Cavallo ◽  
Marco Tartaglione ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Animal Studies ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Balloon Occlusion ◽  
Coronary Perfusion ◽  
Traumatic Cardiac Arrest ◽  
Endovascular Balloon Occlusion

AbstractResuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis of bleeding patients. Several animal studies demonstrated that its application in non-traumatic cardiac arrest could enhance cerebral and coronary perfusion during cardiopulmonary resuscitation (CPR); despite this, there are few reports of its application in humans. This is a case report of REBOA application during a refractory out-of-hospital cardiac arrest in a 50-year-old man where Advanced Cardiac Life Support (ACLS) alone was unable to maintain a stable return of spontaneous circulation (ROSC) and Extracorporeal Cardiac Life Support (ECLS) was not available.

scholarly journals Resuscitative endovascular balloon occlusion of the aorta vs epinephrine in the treatment of non-traumatic cardiac arrest in swine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alice Hutin ◽  
Yaël Levy ◽  
Fanny Lidouren ◽  
Matthias Kohlhauer ◽  
Pierre Carli ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Life Support ◽  
Statistical Significance ◽  
Spontaneous Circulation ◽  
Balloon Occlusion ◽  
Swine Model ◽  
Epinephrine Administration ◽  
Traumatic Cardiac Arrest ◽  
Endovascular Balloon Occlusion

Abstract Background The administration of epinephrine in the management of non-traumatic cardiac arrest remains recommended despite controversial effects on neurologic outcome. The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) could be an interesting alternative. The aim of this study was to compare the effects of these 2 strategies on return of spontaneous circulation (ROSC) and cerebral hemodynamics during cardiopulmonary resuscitation (CPR) in a swine model of non-traumatic cardiac arrest. Results Anesthetized pigs were instrumented and submitted to ventricular fibrillation. After 4 min of no-flow and 18 min of basic life support (BLS) using a mechanical CPR device, animals were randomly submitted to either REBOA or epinephrine administration before defibrillation attempts. Six animals were included in each experimental group (Epinephrine or REBOA). Hemodynamic parameters were similar in both groups during BLS, i.e., before randomization. After epinephrine administration or REBOA, mean arterial pressure, coronary and cerebral perfusion pressures similarly increased in both groups. However, carotid blood flow (CBF) and cerebral regional oxygenation saturation were significantly higher with REBOA as compared to epinephrine administration (+ 125% and + 40%, respectively). ROSC was obtained in 5 animals in both groups. After resuscitation, CBF remained lower in the epinephrine group as compared to REBOA, but it did not achieve statistical significance. Conclusions During CPR, REBOA is as efficient as epinephrine to facilitate ROSC. Unlike epinephrine, REBOA transitorily increases cerebral blood flow and could avoid its cerebral detrimental effects during CPR. These experimental findings suggest that the use of REBOA could be beneficial in the treatment of non-traumatic cardiac arrest.

scholarly journals Asystolic Cardiac Arrest Associated With Unstable Bradycardia During Augmentation Mammaplasty: A Case Report

2021 ◽  
Vol 4 ◽  
Author(s):  
Nicole R Vingan ◽  
Steven Teitelbaum ◽  
Rita Moorman ◽  
Jeffrey M Kenkel
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Cardiac Disease ◽  
Breast Augmentation ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Augmentation Mammaplasty ◽  
Timely Manner ◽  
Level Of Evidence

Abstract Cardiac arrest is a rare but reported complication during breast augmentation surgery. It is even more rare in a reportedly healthy patient without preexisting cardiac disease. The authors present the case of a healthy 34-year-old female who underwent elective bilateral augmentation mammaplasty and experienced unanticipated asystolic cardiac arrest intraoperatively following general anesthesia supplemented by a regional pectoral (pec I) nerve block. The performing plastic surgeon provided cardiopulmonary resuscitation while the anesthesiologist initiated a rescue protocol per Advanced Cardiac Life Support (ACLS) guidelines. Fortunately, the patient was resuscitated in a timely manner and had a successful return of spontaneous circulation within 1 minute. This case report serves to briefly review the literature and recommendations on proper resuscitation of cardiac arrest per ACLS protocols as well as discuss unstable bradycardia in otherwise healthy patients undergoing breast augmentation surgery. Plastic surgeons and anesthesiologists who perform this procedure should be aware of the possible, rare but serious progression to asystole as well as the proper resuscitative measures to take should they be required. Level of Evidence: 5

Resuscitative Endovascular Balloon Occlusion of the Aorta To Augment Afterload in Non-Traumatic Cardiac Arrest

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Felix Boecker ◽  
Kalyan Gorantla
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Balloon Occlusion ◽  
Cardiac Arrest Patient ◽  
Traumatic Cardiac Arrest ◽  
First Case ◽  
Endovascular Balloon Occlusion ◽  
Cardiac Afterload

We describe the first case report of using a REBOA catheter to augment cardiac afterload in a non-traumatic cardiac arrest patient.

Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation

2020 ◽  
pp. 088506662090680
Author(s):  
Natalie Achamallah ◽  
Jeffrey Fried ◽  
Rebecca Love ◽  
Yuri Matusov ◽  
Rohit Sharma
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Pupillary Light Reflex ◽  
Return Of Spontaneous Circulation ◽  
Neurologic Recovery ◽  
Light Reflex ◽  
Pupillary Light ◽  
Hospital Cardiac Arrest

Introduction: Absence of pupillary light reflex (PLR) is a well-studied indicator of poor neurologic recovery after cardiac arrest. Interpretation of absent PLR is difficult in patients with hypothermia or hypotension, or who have electrolyte or acid-base disturbances. Additionally, many studies exclude patients who receive epinephrine or atropine from their analysis on the basis that these drugs are thought to abolish the PLR. This observational cohort study assessed for presence or absence of PLR in in-hospital cardiac arrest patients who received epinephrine with or without atropine during advanced cardiac life support and achieved return of spontaneous circulation (ROSC). Methods: Pupil size and reactivity were assessed in adult patients who had an in-hospital cardiac arrest, received epinephrine with or without atropine, and achieved ROSC. Measurements were taken using a NeurOptics NPi-200 infrared pupillometer. Results: Forty patients had pupillometry performed within 1 hour (median: 6 minutes) after ROSC. Of these only 1 (2.5%) patient had nonreactive pupils at first measurement after ROSC. The remaining 39 (97.5%) had reactive pupils. Of the 19 patients who had pupils checked within 3 minutes of ROSC, 100% had reactive pupils. Degree of pupil responsiveness was not correlated with cumulative dose of epinephrine. Ten patients received atropine in addition to epinephrine, including the sole patient with nonreactive pupils. The remaining 9 (90%) had reactive pupils. Conclusion: Epinephrine and atropine do not abolish the PLR in patients who achieve ROSC after in-hospital cardiac arrest. Lack of pupillary response in the post-arrest patient should not be attributed to these drugs.

Resuscitative endovascular balloon occlusion of the aorta during non-ST elevation myocardial infarction: A case report

Trauma ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 147-151
Author(s):  
Eleanor E Curtis ◽  
Rachel M Russo ◽  
Eric Nordsieck ◽  
Michael Austin Johnson ◽  
Timothy K Williams ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Animal Studies ◽  
Case Reports ◽  
Balloon Occlusion ◽  
St Elevation Myocardial Infarction ◽  
Control Technique ◽  
Coronary Perfusion ◽  
Previous Trauma ◽  
St Elevation ◽  
Endovascular Balloon Occlusion

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a hemorrhage control technique that is increasingly being adopted for the management of noncompressible bleeding. In addition to limiting hemorrhage, REBOA increases blood flow to the heart, lungs, and brain. A small number of case reports and animal studies describe the use of REBOA to increase coronary perfusion during cardiopulmonary resuscitation. We report a case in which REBOA may have reversed ST-segment abnormalities during a Type II non-ST elevation myocardial infarction (NSTEMI) in a patient with previous trauma. We describe the presentation, course, and decision making that contributed to the use of REBOA in this case. Additionally, we will present a review of the literature on the effects of REBOA on coronary perfusion.

scholarly journals Out-of-Hospital Cardiac Arrest Response to a Pregnant Woman by the 119 Emergency Medical Service System: A Case Study

2020 ◽  
Vol 34 (1) ◽  
pp. 127-134
Author(s):  
Jae-Min Lee ◽  
Soo-Mi Hong ◽  
Guk-Ki An ◽  
Hyeong-Wan Yun
Keyword(s):  
Cardiac Arrest ◽  
Pregnant Woman ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Pregnant Patient ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Emergency Medical Service System ◽  
Rescue Workers ◽  
System A

When a pregnant woman experiences cardiac arrest, resuscitation is of the utmost importance. Cardiac arrest in pregnant women differs from cardiac arrest in the general population since both mother and fetus need to be taken into consideration. In the event of cardiac arrest, determining whether to deliver the baby is significant. Cardiopulmonary resuscitation is not always successful, and the survival rate depends on the speed and precision of the procedure. In this study, we focus on the case of a 30-year-old pregnant woman who experienced cardiac arrest and whose family was quick to perceive her condition and call the hospital. A witness performed initial cardiopulmonary resuscitation, while rescue workers performed the advanced procedure. In this case, the patient and baby received proper treatment and left the hospital after six days. It is extremely rare for a pregnant patient to achieve return of spontaneous circulation (ROSC) or receive advanced cardiac life support before reaching the hospital. However, the woman in question in this study achieved ROSC and received both cardiopulmonary resuscitation before reaching the hospital and advanced cardiac life support at the hospital. The specifics of the case are reported in the context of a literature review.

scholarly journals The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review

2020 ◽  
Vol 1 (5) ◽  
pp. 737-743
Author(s):  
Craig D. Nowadly ◽  
M. Austin Johnson ◽  
Guillaume L. Hoareau ◽  
James E Manning ◽  
James I. Daley
Keyword(s):  
Cardiac Arrest ◽  
Balloon Occlusion ◽  
Traumatic Cardiac Arrest ◽  
Endovascular Balloon Occlusion
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