scholarly journals Subarachnoid Hemorrhage Associated with Ventricular Fibrillation and Out-of-Hospital Cardiac Arrest

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Hidetada Fukushima ◽  
Kenji Nishio ◽  
Kazuo Okuchi
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Vegetative State ◽  
Rare Event ◽  
Neurological Status ◽  
Neurological Deficits ◽  
Successful Resuscitation ◽  
Hospital Arrival ◽  
Coronary Syndrome ◽  
Hospital Cardiac Arrest

Aneurysmal subarachonoid hemorrhage (SAH) is a common cause of out-of-hospital cardiac arrest (OHCA). Even after successful resuscitation, most of these SAH patients suffer brain death or enter a vegetative state. To our knowledge, survival without neurological damage from SAH following OHCA is quite a rare event. We treated a case of SAH who presented with OHCA and survived without neurological sequelae. A 50-year-old woman presented with ventricular fibrillation (VF), and was successfully resuscitated before hospital arrival. Since there was no evidence of acute coronary syndrome, a head CT scan was performed and established the diagnosis of SAH. On arrival, she was comatose, however, 3 hours after admission, her neurological status recovered. She underwent treatment for the ruptured aneurysms and was discharged from hospital without any neurological deficits.

Abstract 323: Time to Specialized Prehospital Care and Neurologically Favorable Survival After Traumatic Out-Of-Hospital Cardiac Arrest: Results From a Japanese Registry-Based Study

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Tatsuma Fukuda ◽  
Naoko Ohashi-Fukuda ◽  
Yutaka Kondo ◽  
Hiroshi Sekiguchi ◽  
Ichiro Kukita
Keyword(s):  
Cardiac Arrest ◽  
Healthcare Professional ◽  
Prehospital Care ◽  
Neurological Status ◽  
Population Based ◽  
Continuous Variable ◽  
Prehospital Setting ◽  
Successful Resuscitation ◽  
Specialized Care ◽  
Hospital Cardiac Arrest

Introduction: Specialized care is essential for successful resuscitation after traumatic out-of-hospital cardiac arrest (OHCA). However, the effect of early specialized care by healthcare professional for traumatic OHCA in the prehospital setting is unknown. Hypothesis: We sought to determine whether time to specialized prehospital care by healthcare professional is associated with a neurological status after traumatic OHCA. Methods: This was a nationwide population-based study of traumatic OHCA based on data from the All-Japan Utstein Registry. We included patients who experienced traumatic OHCA in Japan from 2013 to 2016. The primary outcome was 1-month neurologically favorable survival. Results: A total of 8,470 patients were included. Among these patients, 50 (0.6%) survived with a favorable neurological status one month after OHCA. The median time to specialized prehospital care by healthcare professional was 9 minutes (IQR, 7-13; mean [SD], 10.7 [6.3] minutes). Longer time to specialized prehospital care was associated with a decreased chance of neurologically favorable survival: 2.6, 1.2, 0.9, 0.5, 0.2, and 0.0%, respectively, when time to specialized prehospital care was treated as a categorical variable categorized into ≤2, 3-5, 6-8, 9-11, 12-14, and ≥15 minutes (P for trend <0.0001), and multivariable-adjusted OR per minute delay 0.79 (95%CI 0.70-0.89, P<0.0001) when time to specialized prehospital care was treated as a linear and continuous variable. In subgroup analyses, longer time to specialized care was associated with a decreased chance of neurologically favorable survival when ALS was provided in the prehospital setting (adjusted OR 0.73, 95%CI 0.61-0.87, P=0.0007), especially when prehospital ALS was performed by physician (adjusted OR 0.72, 95%CI 0.56-0.93, P=0.0119), whereas there was no significant association between time to specialized care and neurologically favorable survival when only BLS was provided in the prehospital setting (adjusted OR 0.86, 95%CI 0.74-1.01, P=0.0734). Conclusion: In traumatic OHCA, delayed specialized prehospital care by healthcare professional was associated with a decreased chance of neurologically favorable survival, especially when a physician was involved in prehospital ALS.

Amiodarone or nifekalant upon hospital arrival for refractory ventricular fibrillation after out-of-hospital cardiac arrest

Resuscitation ◽  
2016 ◽  
Vol 109 ◽  
pp. 127-132 ◽  
Author(s):  
Takashi Tagami ◽  
Hiroki Matsui ◽  
Saori Ishinokami ◽  
Masao Oyanagi ◽  
Akiko Kitahashi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Arrival ◽  
Hospital Cardiac Arrest

Abstract 75: Ventricular Fibrillation in Cardiac Arrest with Nonshockable Initial Rhythm

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Fernando Rosell-Ortiz ◽  
Francisco J Mellado-Vergel ◽  
Patricia Fernández-Valle ◽  
Auxiliadora Caballero-García ◽  
Ismael González-Lobato ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Neurological Status ◽  
Good Prognosis ◽  
Spontaneous Circulation ◽  
Emergency Team ◽  
Shockable Rhythm ◽  
Initial Rhythm ◽  
Prognostic Group ◽  
Hospital Cardiac Arrest

The initial shockable rhythm in cardiac arrest is a well known factor of good prognosis. Little is known about the influence of the onset of ventricular fibrillation during resuscitation at cardiac arrest whose initial rhythm was non-shockable. Methods: Retrospective analysis of a continuous registry of out-of-hospital cardiac arrest (OHCA) Inclusion criteria, all consecutive patients suffering OHCA attended by emergency teams in Andalusia, Spain. Period January 2008 - December 2012. Results: 5067 patients were included. According to the initial cardiac arrest rhythm 1038 (20.5%) cases presented initial shockable rhythm (SR) and 4029 (79.5%) with non-shockable initial rhythm (NSR). Of these patients 150 (3%) reported one or more episodes of ventricular fibrillation during resuscitation (NSRVF). The main clinical characteristics of these three groups are shown in Table 1. Variables associated with good neurological status at hospital discharge are shown in Table 2. Conclusions: NSRVF patients present higher survival with good neurological status than NSR patients. These patients may represent a third prognostic group in cardiac arrest with a survival rate between shockable and non-shockable initial rhythms. Table 1. Clinical data of patients regarding rhythm of cardiac arrest Table 2. Variables associated with good neurological status at discharge (CPC 1-2 ) SD: Standard deviation. IQR: Interquartile range. OR: Odds Ratio. CI: Confidence Interval. ET: Emergency Team. VF: Ventricular Fibrillation. CPR: Cardiopulmonary resuscitation. CPC: Cerebral Perfomance Category. ROSC: Return of spontaneous circulation

Abstract 33: Impact of Delayed Time to Defibrillation on Neurological and Functional Status Among Survivors of In-Hospital Cardiac Arrest

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Paul S Chan ◽  
Harlan M Krumholz ◽  
Graham Nichol ◽  
Brahmajee K Nallamothu
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Vegetative State ◽  
Neurological Status ◽  
National Registry ◽  
Hospital Size ◽  
Risk Patients ◽  
The Impact ◽  
Delayed Time ◽  
Hospital Cardiac Arrest

Background: Expert guidelines advocate defibrillation within 2 minutes of an in-hospital cardiac arrest due to ventricular arrhythmias. However, the impact of delayed defibrillation on neurological and functional status at discharge among survivors is unknown. Methods: We identified 6,744 patients with cardiac arrests due to ventricular fibrillation or pulseless ventricular tachycardia at 369 hospitals within the National Registry of Cardiopulmonary Resuscitation. Using multivariable logistic regression that adjusted for demographics, clinical variables, hospital site, hospital-level variables (hospital size, monitored bed or intensive care status), and admitting diagnoses, we examined the association between delayed defibrillation (>2 minutes) and neurological and functional status at discharge using the previously developed Cerebral and Overall Performance Categories. Performance categories were dichotomized as no major disability vs. major disability and/or vegetative state. Results: The median time to defibrillation was 1 minute (interquartile range:< 1 to 3 minutes), with delayed defibrillation found in 2,000 (29.7%) patients. Overall, 2,311 (34.3%) patients survived to hospital discharge [n=1,863 (39.3%) for prompt defibrillation; n=448 (n=22.4%) for delayed defibrillation]. Among those surviving to discharge, delayed defibrillation was associated with a lower likelihood of no major disability in neurological status (adjusted OR of 0.73; 95% CI: 0.57 to 0.94; p=0.01) and functional status (adjusted OR of 0.73; 95% CI: 0.55 to 0.96; p=0.02). Conclusion : Delayed defibrillation is associated with worse neurological and functional status among survivors of in-hospital cardiac arrests. Minimizing time to defibrillation represents a major opportunity to improve neurological and functional status in these high-risk patients.

Outcomes and In-hospital Treatment of Out-of-Hospital Cardiac Arrest Patients Resuscitated From Ventricular Fibrillation by Early Defibrillation

2004 ◽  
Vol 79 (5) ◽  
pp. 613-619 ◽  
Author(s):  
T. Jared Bunch ◽  
Roger D. White ◽  
Bernard J. Gersh ◽  
Win-Kuang Shen ◽  
Stephen C. Hammill ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Treatment ◽  
Early Defibrillation ◽  
Hospital Cardiac Arrest
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