scholarly journals Refractory Ventricle Arrhythmias Alternating with Pulseless Electrical Activity in a Young Woman Rescued by Extracorporeal Cardiopulmonary Resuscitation

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ilona Lálová ◽  
Lucie Filipovská ◽  
Hana Skalická ◽  
Ondřej Šmíd ◽  
Aleš Linhart ◽  
...  

Introduction. Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation. The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator. Conclusion. Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.

2013 ◽  
Vol 13 (1) ◽  
pp. 3-6
Author(s):  
Anita Kaleja ◽  
Elina Snucina ◽  
Indulis Vanags

Summary Introduction.Survival rate among patients with cardiac arrest remains unclear. Return of spontaneous circulation (ROSC) is just the first step toward the goal of complete recovery from cardiac arrest. It depends on quality of cardiopulmonary resuscitation (CPR) during resuscitation and factors of postresuscitation care. Regular CPR analysis has not been carried out in Latvia. Aim of the study was to evaluate survival rate among patients with out-of-hospital cardiac arrest and in-hospital cardiac arrest. Materials and methods. The study was conducted in the State Emergency service of Latvia and Pauls Stradins Clinical University Hospital during 15 months in 2010/2011. There were 221 adult patients with in-hospital cardiac arrest and 162 adult patients with out-of-hospital cardiac arrest and performed CPR included in retrospective research. The information was analyzed by medical records. The obtained results were expressed in percents and compared, using the Pearson’s Chi-square (Pearson χ2) test. Results. The short-term ROSC was achieved among patients with out-of-hospital cardiac arrest (OHCA) in 62 cases and among patients with in-hospital cardiac arrest (IHCA) in 186 cases. Survival to discharge was achieved in 20.3% among patients with OHCA and 15.8% among patients with IHCA. The most commonly used CPR algorithm was pulseless electrical activity/asystole (72 - 73%). Short-term ROSC was achieved most frequently by ventricular fibrillation/pulseless ventricular tachycardia (41.3-56%), but the largest number of unsuccessful CPR episodes was observed by pulseless electrical activity/ asystole. Conclusion. Results of CPR were different among patients with OHCA and IHCA. ROSC is rhythm-specific outcome.


Author(s):  
Christopher Gaisendrees ◽  
Matias Vollmer ◽  
Sebastian G Walter ◽  
Ilija Djordjevic ◽  
Kaveh Eghbalzadeh ◽  
...  

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Gunnar W Skjeflo ◽  
Eirik Skogvoll ◽  
Jan Pål Loennechen ◽  
Theresa M Olasveengen ◽  
Lars Wik ◽  
...  

Introduction: Presence of electrocardiographic rhythm, documented by the electrocardiogram (ECG), in the absence of palpable pulses defines pulseless electrical activity (PEA). Our aims were to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-Hospital-Cardiac-Arrest (OHCA) with initial PEA, and to explore the effects of epinephrine on these characteristics. Methods: Patients with OHCA and initial PEA in a randomized controlled trial of ALS with or without intravenous access and medications were included. QRS widths and heart-rates were measured in recorded ECG signals during pauses in compressions. Statistical analysis was carried out by multivariate regression (MANOVA). Results: Defibrillator recordings from 170 episodes of cardiac arrest were analyzed, 4840 combined measurements of QRS complex width and heart rate were made. By the multivariate regression model both whether epinephrine was administered and whether return of spontaneous circulation (ROSC) was obtained were significantly associated with changes in QRS width and heart rate. For both control and epinephrine groups, ROSC was preceded by decreasing QRS width and increasing rate, but in the epinephrine group an increase in rate without a decrease in QRS width was associated with poor outcome (fig). Conclusion: The QRS complex characteristics are affected by epinephrine administration during ALS, but still yields valuable prognostic information.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tetsuya Sakamoto ◽  
Yasufumi Asai ◽  
Ken Nagao ◽  
Yoshio Tahara ◽  
Takahiro Atsumi ◽  
...  

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.


Resuscitation ◽  
2018 ◽  
Vol 130 ◽  
pp. e48-e49
Author(s):  
Antonella Vezzani ◽  
Tullio Manca ◽  
Andrea Ramelli ◽  
Bruno Borrello ◽  
Andrea Agostinelli ◽  
...  

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