scholarly journals Cardiac Arrest after Connecting Negative Pressure to the Subgaleal Drain during Craniotomy Closure

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Monu Yadav ◽  
Sapna A. Nikhar ◽  
Dilip Kumar Kulkarni ◽  
R. Gopinath
Keyword(s):  
Cardiac Arrest ◽  
Negative Pressure ◽  
Surgical Procedure ◽  
Vacuum System ◽  
Suction Drain ◽  
Pressure Application ◽  
Neurosurgical Patients ◽  
One Year ◽  
Pressure Suction ◽  
Subgaleal Space

A one-year-old child operated on for arachnoid cyst in right frontoparietotemporal region had sudden bradycardia followed by cardiac arrest leading to death after connecting negative pressure to the subgaleal drain during craniotomy closure. The surgical procedure was uneventful. It is a common practice to place epidural or subgaleal drains connected to a vacuum system towards the end of craniotomy to prevent accumulation of intracranial and extracranial blood. The phenomenon of bradycardia with hypotension is known to occur following negative pressure application to the epidural, epicranial, or subgaleal space after craniotomy closure. However cardiac arrest as a complication of negative pressure suction drain in neurosurgical patients is not described in the literature.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

scholarly journals Contacts to the healthcare system prior to out-of-hospital cardiac arrests

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Zylyftari ◽  
S.G Moller ◽  
M Wissenberg ◽  
F Folke ◽  
C.A Barcella ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
General Population ◽  
Healthcare System ◽  
Early Identification ◽  
Sudden Cardiac Arrest ◽  
Funding Source ◽  
Horizon 2020 ◽  
One Year ◽  
Public Grant ◽  
Hospital Cardiac Arrest

Abstract Background Patients who suffer a sudden out-of-hospital cardiac arrest (OHCA) may be preceded by warning symptoms and healthcare system contact. Though, is currently difficult early identification of sudden cardiac arrest patients. Purpose We aimed to examine contacts with the healthcare system up to two weeks and one year before OHCA. Methods OHCA patients were identified from the Danish Cardiac Arrest Registry (2001–2014). The pattern of healthcare contacts (with either general practitioner (GP) or hospital) within the year prior to OHCA of OHCA patients was compared with that of 9 sex- and age-matched controls from the background general population. Additionally, we evaluated characteristics of OHCA patients according to the type of healthcare contact (GP/hospital/both/no-contact) and the including characteristics of contacts, within two weeks prior their OHCA event. Results Out of 28,955 OHCA patients (median age of 72 (62–81) years and with 67% male) of presumed cardiac cause, 16,735 (57.8%) contacted the healthcare system (GP and hospital) within two weeks prior to OHCA. From one year before OHCA, the weekly percentages of contacts to GP were relatively constant (26%) until within 2 weeks prior to OHCA where they markedly increased (54%). In comparison, 14% of the general population contacted the GP during the same period (Figure). The weekly percentages of contacts with hospitals gradually increased in OHCA patients from 3.5% to 6.5% within 6 months, peaking at the second week (6.8%), prior to OHCA. In comparison, only 2% of the general population had a hospital contact in that period (Figure). Within 2 weeks of OHCA, patients contacted GP mainly by telephone (71.6%). Hospital diagnoses were heterogenous, where ischemic heart disease (8%) and heart failure (4.5%) were the most frequent. Conclusions There is an increase in healthcare contacts prior to “sudden” OHCA and overall, 54% of OHCA-patients had contacted GP within 2 weeks before the event. This could have implications for developing future strategies for early identification of patients prior to their cardiac arrest. Figure 1. The weekly percentages of contacts to GP (red) and hospital (blue) within one year before OHCA comparing the OHCA cases to the age- and sex-matched control population (N cases = 28,955; N controls = 260,595). Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020

scholarly journals Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients

2021 ◽  
Vol 10 (7) ◽  
pp. 1389
Author(s):  
Wojciech Wieczorek ◽  
Jarosław Meyer-Szary ◽  
Milosz J. Jaguszewski ◽  
Krzysztof J. Filipiak ◽  
Maciej Cyran ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Adverse Events ◽  
Therapeutic Hypothermia ◽  
Hospital Discharge ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
One Year

Cardiac arrest (CA) is associated with high mortality and poor life quality. Targeted temperature management (TTM) or therapeutic hypothermia is a therapy increasing the survival of adult patients after CA. The study aim was to assess the feasibility of therapeutic hypothermia after pediatric CA. We performed a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the use of TTM after pediatric CA. The primary outcome was survival to hospital discharge or 30-day survival. Secondary outcomes included a one-year survival rate, survival with a Vineland adaptive behavior scale (VABS-II) score ≥ 70, and occurrence of adverse events. Ten articles (n = 2002 patients) were included, comparing TTM patients (n = 638) with controls (n = 1364). In a fixed-effects meta-analysis, survival to hospital discharge in the TTM group was 49.7%, which was higher than in the non-TTM group (43.5%; odds ratio, OR = 1.22; 95% confidence interval, CI: 1.00, 1.50; p = 0.06). There were no differences in the one-year survival rate or the occurrence of adverse events between the TTM and non-TTM groups. Altogether, the use of TTM was associated with a higher survival to hospital discharge; however, it did not significantly increase the annual survival. Additional high-quality prospective studies are necessary to confer additional TTM benefits.

Abstract 11617: Personalizing Outcomes After Child Cardiac Arrest (POCCA): A Preliminary Biomarker Report

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ericka L Fink ◽  
Patrick M Kochanek ◽  
Ashok Panigrahy ◽  
Sue R Beers ◽  
Rachel P Berger ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Cerebral Performance Category ◽  
Pediatric Intensive Care ◽  
Early Brain Injury ◽  
Unfavorable Outcome ◽  
Neurofilament Light ◽  
Multicenter Observational Study ◽  
Child Centered ◽  
One Year

Blood-based brain injury biomarkers show promise to prognosticate outcome for children resuscitated from cardiac arrest. The objective of this multicenter, observational study was to validate promising biomarkers to accurately prognosticate outcome at 1 year. Early brain injury biomarkers will be associated with outcome at one year for children with cardiac arrest. Fourteen centers in the US enrolled children aged < 18 years with in- or out-of-hospital cardiac arrest and pediatric intensive care unit admission if pre-cardiac arrest Pediatric Cerebral Performance Category score was 1-3. Glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal esterase L1 (UCHL1), neurofilament light (NfL), and Tau protein concentrations were measured in samples drawn post-arrest day 1 using Quanterix Simoa 4-Plex assay. The primary outcome was unfavorable outcome at one year (Vineland Adaptive Behavioral Scale < 70). Of 164 children enrolled, 120 children had evaluable data (n=50 with unfavorable outcome). Children were median (interquartile range) 1 (0-8.5) years of age, 41% female, and 60% had asphyxia etiology. Of children with unfavorable outcome, 93% had unwitnessed arrests and 43 died. While all 4 day 1 biomarkers were increased in children with unfavorable vs. favorable outcome at 1-year post-arrest, NfL had the best univariate area under the receiver operator curve to predict 1 year outcome at 0.731. In a multivariate logistic regression, NfL concentration trended toward significance on day 1 and was associated with unfavorable outcome at 1-year on days 2 and 3 (day 1: Odds Ratio [95% Confidence Interval] 1.004 [1.000-1.008], p=.062; day 2: 1.005 [1.002-1.008], p=.003, and day 3: 1.002 [1.001-1.004], p=.003, respectively). UCHL1 was associated with outcome on days 2: 1.005 [1.002-1.009], p=.003 and 3: 1.001 [1.000-1.002], p=.019) and Tau trended toward association with outcome on days 2: 1.003 [1.000-1.005], p=.08) and 3: 1.001 [1.000-1.002], p=.077. Brain injury biomarkers predict unfavorable outcome post-pediatric cardiac arrest. Accuracy of biomarkers alone and together with other prognostication tools should be evaluated to predict long term child centered outcomes post-cardiac arrest.

Abstract 11974: Impact of Routine ECPR Service on Availability of Donor Organs

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Jana Smalcova ◽  
Katerina Rusinova ◽  
Iván Ortega-Deballon ◽  
Eva Pokorna ◽  
Ondrej Franek ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Single Case ◽  
Organ Donor ◽  
High Volume ◽  
Donation After Cardiac Death ◽  
Daily Routine ◽  
Organ Donors ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
One Year ◽  
Transplanted Organs

Introduction: In refractory cardiac arrest, extracorporeal cardiopulmonary resuscitation (ECPR) may increase the chance of survival. However, in brain death or donation after cardiac death scenario, ECPR may also become an important organ donor source. Hypothesis: We hypothesized that 1/ the implementation of ECPR into the daily routine of a high volume cardiac arrest centre might increase the availability of organ donors, and 2/ ECPR might assure the same long-term function of donated organs as non-ECPR care. Methods: We retrospectively evaluated pre-ECPR (2007-2011) and ECPR (2012-2020) periods in terms of donors recruited from the out-of-hospital and in-hospital cardiac arrest population. We assessed the number of donors referred, the number of organs harvested and their one- and five-year survival. Results: In the pre-ECPR period, 11 donors were referred, of which 7 were accepted. During the ECPR period, the number of donors increased to 80, of which 42 were accepted. The number of donated organs in respective periods were 18 and 119, corresponding to 3,6 vs 13,2 (p =0.033) organs per year harvested. One-year survival of transplanted organs was 94.4% vs 100%, and five-year survival was 94.4% vs 87,5%, in relevant periods. Survival of organs obtained from donors after CPR and ECPR at one year (98.9% vs 100%) and five years (90,2% vs 88.9%) was the same. Graft failure was not the cause of death in any single case. Conclusions: Establishing a high volume cardiac arrest/ECPR centre may lead to a higher number of potential and subsequently accepted organ donors. The length of survival of donated organs is high and comparable between ECPR vs non-ECPR cardiac arrest donors.

Abstract 15317: Risk of Future Adverse Events in Patients Receiving Class IC Antiarrhythmic Drugs Who Have Elevated Coronary Artery Calcium Scores But Low-risk Cardiac Stress Test

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael J Cutler ◽  
Heidi T May ◽  
T Jared Bunch ◽  
Raymond O McCubrey ◽  
Brian G Crandall ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Coronary Artery ◽  
Adverse Events ◽  
Antiarrhythmic Drugs ◽  
Stress Test ◽  
Qualitative Assessment ◽  
Cardiac Stress ◽  
Quantitative Score ◽  
Stable Cad ◽  
One Year

Background: Class IC antiarrhythmic drugs (AAD) are a standard treatment of cardiac arrhythmias but are associated with harm in patients with prior myocardial infarction (MI)). Consensus guidelines have advocated that these drugs not be used in patients with coronary artery disease (CAD). However, the risk of Class IC AAD in patients with stable CAD, as demonstrated by an elevated coronary artery calcium (CAC) , but a low-risk cardiac stress test (LRCST), remains unclear. We hypothesized that the risk of future adverse cardiovascular events would not differ according to CAC severity among patients with an LRCST on Class Ic AAD treatment. Methods: We identified 355 patients without CAD and an LRCST (<5% ischemia) on cardiac stress PET before initiation of Class IC AAD. CAC was assessed using quantitative scores when available or qualitative CAC assessment on low-dose attenuation correction CT. Patients were divided into no/low CAC (i.e., quantitative score <100 or qualitative assessment of none/mild) or mod/severe CAC (i.e., quantitative score ≥100 or qualitative assessment of moderate/severe) The composite primary endpoint for this analysis was ventricular tachycardia/fibrillation (VT/VF), cardiac arrest, and all-cause death at one-year follow-up. Results: The majority of patients had no/low CAC (n = 278 [78.3%]) compared to mod/severe CAC (n = 77 [21.7%]). Those with no/low CAC were younger (62 vs 70, p<0.0001) and were more likely to have a higher BMI (33.1 v 30.4, p=0.007) when compared to the mod/severe CAC group. Other cardiovascular risk factors were similar between groups. There was no difference in the one-year primary composite outcome of VT/VF, cardiac arrest, and death between no/low CAC compared to mod/severe CAC (3.6% vs 5.2%, p=0.51). Conclusion: In patients receiving Class IC AAD therapy with an LRCST, an elevated CAC did not increase the risk of future adverse events. These data suggest that using Class IC AAD may be safe in patients with stable CAD (no ischemia/elevated CAC). Future prospective trials are needed to evaluate the safety of Class IC AAD in patients with elevated CAC.

scholarly journals Comparison of the Effectiveness of Full Negative Pressure with Half Negative Pressure on Suction Drain in Reducing Post-Modified Radical Mastectomy Seroma

2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir
Keyword(s):  
Breast Cancer ◽  
Negative Pressure ◽  
Radical Mastectomy ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Pressure Groups ◽  
Suction Drain ◽  
Significant Difference ◽  
June July

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.

scholarly journals Intensive care–treated cardiac arrest: A retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

2021 ◽  
Author(s):  
Ester Elisabet Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
Cost Effectiveness ◽  
Neurological Outcome ◽  
Age Groups ◽  
The Elderly ◽  
Treatment Intensity ◽  
One Year ◽  
Healthcare Associated

Abstract Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.

scholarly journals Lung Injury Resulting from Fluted Silastic Soft Drain Extraction under Negative Pressure Suction*

2013 ◽  
Vol 03 (03) ◽  
pp. 73-75
Author(s):  
Susumu Isoda ◽  
Tamizo Kimura ◽  
Kenji Nishimura ◽  
Nozomu Yamanaka ◽  
Shingo Nakamura ◽  
...  
Keyword(s):  
Lung Injury ◽  
Negative Pressure ◽  
Pressure Suction

scholarly journals Cardiac arrest center - One-year experience of the Regional Hospital Liberec

Cor et Vasa ◽  
2018 ◽  
Vol 60 (3) ◽  
pp. e234-e238 ◽  
Author(s):  
Jiří Seiner ◽  
Rostislav Polášek ◽  
Jan Lejsek ◽  
Matej Strýček ◽  
Jiří Karásek
Keyword(s):  
Cardiac Arrest ◽  
Regional Hospital ◽  
One Year
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