scholarly journals Peripartum Cardiomyopathy with Respiratory Failure and Cardiac Arrest

2018 ◽  
Vol 1 (1-3) ◽  
pp. 11-16
Author(s):  
Sakura Minami ◽  
Hayato Taniguchi ◽  
Takeru Abe ◽  
Tomoki Doi ◽  
Ichiro Takeuchi
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Heart Diseases ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Postpartum Woman ◽  
Return Of Spontaneous Circulation ◽  
Vv Ecmo

We describe the case of a 33-year-old female who went into cardiac arrest outside the hospital 7 days postpartum. We diagnosed her with peripartum cardiomyopathy (PPCM). After the return of spontaneous circulation, she suffered from acute pulmonary edema and hypoxia. The patient received intensive care after gaining return of spontaneous circulation. We also present an effective use of venovenous extracorporeal membrane oxygenation (VV-ECMO), which led to a rather short stay in the intensive care unit (ICU). An echocardiogram showed global hypokinesis with an ejection fraction of 28% and a left ventricular dilation with a diastolic dimension. The patient’s lungs recovered steadily during her stay in the ICU. VV-ECMO was disconnected on the seventh day of hospitalization, and intubation was withdrawn on the tenth day. On the thirteenth day, she was released from the ICU and transferred to another hospital. If a pregnant or postpartum woman presents with cardiopulmonary arrest, heart diseases such as PPCM should be considered.

scholarly journals Utility of opening rhythms in predicting time to return of spontaneous circulation in cardiac arrest victims in a resource constrained setting: a single centre prospective observational study

2019 ◽  
Vol 7 (12) ◽  
pp. 4709
Author(s):  
Appu Suseel ◽  
Siju V. Abraham ◽  
Radha K. R.
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Secondary Outcome ◽  
Resource Constrained ◽  
Return Of Spontaneous Circulation ◽  
Shockable Rhythm ◽  
Significant Difference ◽  
Mean Time

Background: Time to ROSC has been shown to be an important and independent predictor of mortality and adverse neurological outcome. In resource limited situations judicious deployment of resources is crucial. Prognostication of arrest victims may aid in better resource allocation. This study aimed to assess the time to Return of Spontaneous Circulation (ROSC) in cardiac arrest victims and its relationship with opening rhythms.Methods: Consecutive victims of cardiopulmonary arrest who presented to a single center were included in this study if they met the inclusion and exclusion criteria. Time at which opening rhythm was analyzed and time at which ROSC was achieved was noted. This was done for all cases and mean time to ROSC was calculated for each opening rhythm. All those patients who achieved ROSC were followed up till hospital discharge or death.  Primary outcome measured was achievement of ROSC and the secondary outcome was the survival to hospital discharge.Results: A sample size of 100 was calculated to yield a significance criterion of 0.05 and a power of 0.80 based on prior studies. Out of 100 patients studied. 58% had shockable rhythms and 42% had non-shockable rhythms.  Mean time to ROSC for shockable rhythm was 5.55±3.51 minutes, and for non-shockable rhythm is 17.29±4.18 minutes.  There was a statistically significant difference between opening rhythms in terms of survival to hospital discharge (p=0.0329).Conclusions: Cardiac arrests with shockable rhythms attained ROSC faster when compared to nonshockable rhythms. Shockable rhythms have a better survival to hospital discharge when compared to shockable rhythms. Opening rhythms may aid the clinician in better utility of resources in a resource constrained setting.

scholarly journals Two-dimensional echocardiography after return of spontaneous circulation and its association with in-hospital survival after in-hospital cardiopulmonary resuscitation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
In-Ae Song ◽  
Jun Kwon Cha ◽  
Tak Kyu Oh ◽  
You Hwan Jo ◽  
Yeonyee E. Yoon
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Two Dimensional ◽  
Return Of Spontaneous Circulation ◽  
Hospital Survival ◽  
2D Echocardiography ◽  
Dimensional Echocardiography ◽  
Two Dimensional Echocardiography

AbstractThis retrospective cohort study investigated the association between in-hospital survival and two-dimensional (2D) echocardiography within 24 hours after the return of spontaneous circulation (ROSC) in patients who underwent in-hospital cardiopulmonary resuscitation (ICPR) after in-hospital cardiopulmonary arrest (IHCA). The 2D-echo and non-2D-echo groups comprised eligible patients who underwent transthoracic 2D echocardiography performed by the cardiology team within 24 hours after ROSC and those who did not, respectively. After propensity score (PS) matching, 142 and 284 patients in the 2D-echo and non-2D-echo groups, respectively, were included. A logistic regression analysis showed that the likelihood of in-hospital survival was 2.35-fold higher in the 2D-echo group than in the non-2D-echo group (P < 0.001). Regarding IHCA aetiology, in-hospital survival after cardiac arrest of a cardiac cause was 2.51-fold more likely in the 2D-echo group than in the non-2D-echo group (P < 0.001), with no significant inter-group difference in survival after cardiac arrest of a non-cardiac cause (P = 0.120). In this study, 2D echocardiography performed within 24 hours after ROSC was associated with better in-hospital survival outcomes for patients who underwent ICPR for IHCA with a cardiac aetiology. Thus, 2D echocardiography may be performed within 24 hours after ROSC in patients experiencing IHCA to enable better treatment.

scholarly journals The Outcomes of Endotracheal Intubation versus Non-Endotracheal Intubation during Cardiopulmonary Arrest in the Emergency Department

2019 ◽  
Vol 26 (1) ◽  
pp. 3-10
Author(s):  
Abdullah A. Bakhsh ◽  
Daniah S. Allali ◽  
Ahmad H. Bakhribah ◽  
Ali A. Faydhi
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Neurological Outcome ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Good Neurological Outcome ◽  
Return Of Spontaneous Circulation ◽  
Management Techniques

Airway management techniques during cardiopulmonary arrest in the emergency department may impact short and long-term outcomes of these patients. Prior studies addressing airway management of patients in cardiopulmonary arrest in the emergency department are limited. We aimed to evaluate the one-month neurological outcomes post cardiac arrest as a primary endpoint. Our secondary endpoint was to look at return of spontaneous circulation rates and survival to discharge. We retrospectively reviewed cardiac arrest flow sheets of patients sustaining in-emergency department cardiopulmonary arrest between January 2017 and September 2017. We looked at the different types of airway management techniques and their effect on patient outcomes. Patients who received non-endotracheal intubation during cardiopulmonary arrest had higher rates of good neurological outcome (GCS > 9) at one month when compared with patients who received endotracheal intubation: 8 (32%) vs. 2 (5.3%), respectively. Our results revealed a significant association of non-endotracheal intubation (bag-valve mask or laryngeal mask airway) with return of spontaneous circulation rates (p 0.044), survival to discharge (p < 0.001), and good neurological outcome (GCS > 9) (p 0.008). Although non-endotracheal intubation during cardiopulmonary arrest is not common, we encourage the increased use of bag-valve mask and laryngeal mask airways during cardiopulmonary arrest as they are associated with better outcomes.

scholarly journals Effects of extracorporeal cardiopulmonary resuscitation on neurological and cardiac outcome after ischaemic refractory cardiac arrest

2017 ◽  
Vol 7 (5) ◽  
pp. 432-441 ◽  
Author(s):  
Francesca Cesana ◽  
Leonello Avalli ◽  
Laura Garatti ◽  
Anna Coppo ◽  
Stefano Righetti ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Left Ventricular Ejection Fraction ◽  
Cardiopulmonary Resuscitation ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Ventricular Ejection Fraction ◽  
Return Of Spontaneous Circulation ◽  
Refractory Cardiac Arrest

Background: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation. Methods: We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011–2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months). Results: Patients in the extracorporeal cardiopulmonary resuscitation group ( n=63, 43%) were younger (59±9 vs 63±8 year-old, p=0.02) with lower incidence of atherosclerosis risk factors than those with conventional cardiopulmonary resuscitation. In the extracorporeal cardiopulmonary resuscitation group, left ventricular ejection fraction was lower than conventional cardiopulmonary resuscitation at early echocardiography (19±16% vs 37±11 p<0.01). Survivors in both groups showed similar left ventricular ejection fraction 15 days and 4–6 months after cardiac arrest (46±8% vs 49±10, 47±11% vs 45±13%, p not significant for both), despite a major extent and duration of cardiac ischaemia in extracorporeal cardiopulmonary resuscitation patients. At multivariate analysis, the total cardiac arrest time was the only independent predictor of survival. Conclusions: Extracorporeal cardiopulmonary resuscitation patients are younger and have less comorbidities than conventional cardiopulmonary resuscitation, but they have worse survival and lower early left ventricular ejection fraction. Survivors after extracorporeal cardiopulmonary resuscitation have a neurological outcome and recovery of heart function comparable to subjects with return of spontaneous circulation. Total cardiac arrest time is the only predictor of survival after cardiopulmonary resuscitation in both groups.

scholarly journals Case Report: Left Ventricular Unloading Using a Mechanical CPR Device in a Prolonged Accidental Hypothermic Cardiac Arrest Treated by VA-ECMO – a Novel Approach

2021 ◽  
Vol 8 ◽  
Author(s):  
Simon A. Amacher ◽  
Jonas Quitt ◽  
Eva Hammel ◽  
Urs Zenklusen ◽  
Ayham Darwisch ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Alcohol Intoxication ◽  
Kidney Injury ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Severe Injuries ◽  
Return Of Spontaneous Circulation ◽  
Multiple Rib Fractures ◽  
Novel Approach

We recently treated a 36-year-old previously healthy male with a prolonged hypothermic (lowest temperature 22.3°C) cardiac arrest after an alcohol intoxication with a return of spontaneous circulation after 230min of mechanical cardiopulmonary resuscitation and rewarming by veno-arterial ECMO with femoral cannulation and retrograde perfusion of the aortic arch. Despite functional veno-arterial ECMO, we continued mechanical cardiopulmonary resuscitation (Auto Pulse™ device, ZOLL Medical Corporation, Chelmsford, USA) until return of spontaneous circulation to prevent left ventricular distention from persistent ventricular fibrillation. The case was further complicated by extensive trauma caused by mechanical cardiopulmonary resuscitation (multiple rib fractures, significant hemothorax, and a liver laceration requiring massive transfusion), lung failure necessitating a secondary switch to veno-venous ECMO, and acute kidney injury with the need for renal replacement therapy. Shortly after return of spontaneous circulation, the patient was already following commands and could be discharged 3 weeks later without neurologic, cardiac, or renal sequelae and being entirely well. Prolonged accidental hypothermic cardiac arrest might present with excellent outcomes when supported with veno-arterial ECMO. Until return of spontaneous circulation, one might consider continuing with mechanical cardiopulmonary resuscitation in addition to ECMO to allow some left ventricular unloading. However, the clinician should keep in mind that prolonged mechanical cardiopulmonary resuscitation may cause severe injuries.

Drowning, Hypothermia and Cardiac Arrest: An 18-year-old Woman with an Automated External Defibrillator Recording

2013 ◽  
Vol 28 (5) ◽  
pp. 517-519 ◽  
Author(s):  
Pierre-Géraud Claret ◽  
Xavier Bobbia ◽  
Geoffroy Dingemans ◽  
Olivier Onde ◽  
Mustapha Sebbane ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Automated External Defibrillator ◽  
Publication Type ◽  
Return Of Spontaneous Circulation ◽  
Ambient Temperatures ◽  
Cerebral Dysfunction ◽  
Prehospital Management ◽  
External Defibrillator

AbstractThis report describes the case of an 18-year-old woman who was found in the sea suffering from cardiac arrest and hypothermia, 90 minutes after she entered the water to swim. The rescue team used an automated external defibrillator to record prehospital management. This recording showed an isoelectric electrocardiogram followed by a ventricular fibrillation, an unsuccessful defibrillation, and lastly, a return of spontaneous circulation with Osborn wave. When she was admitted to the intensive care unit two hours later, the woman's central temperature was 28°C.The case is interesting because of several points. First, to the best of the authors’ knowledge, this is the only case of cardiac arrest with severe hypothermia followed by a return of spontaneous circulation documented with an automated external defibrillator recording. Second, the hypothermia is an atypical case occurring in the summer. Hypothermia must be considered even in unlikely circumstances, such as summer in the south of France, when ambient temperatures are high. Lastly, after three days, the patient recovered successfully from cardiopulmonary arrest without cerebral dysfunction.ClaretP-G, BobbiaX, DingemansG, OndeO, SebbaneM, de La CoussayeJ-E. Drowning, hypothermia and cardiac arrest: an 18-year-old woman with an automated external defibrillator recording. Prehosp Disaster Med. 2013;28(5):1-3.

Left ventricular compressions improve return of spontaneous circulation and hemodynamics in a swine model of traumatic cardiopulmonary arrest

2018 ◽  
Vol 85 (2) ◽  
pp. 303-310 ◽  
Author(s):  
Kenton L. Anderson ◽  
Kristin C. Fiala ◽  
Maria G. Castaneda ◽  
Susan M. Boudreau ◽  
Allyson A. Araña ◽  
...  
Keyword(s):  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Swine Model ◽  
Return Of Spontaneous Circulation

scholarly journals Beyond return of spontaneous circulation: update on post-cardiac arrest management in the intensive care unit

2021 ◽  
Vol 62 (08) ◽  
pp. 444-451 ◽  
Author(s):  
YW Chia ◽  
◽  
SL Lim ◽  
JK Loh ◽  
BSH Leong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Spontaneous Circulation ◽  
Health Concern ◽  
Temperature Management ◽  
Return Of Spontaneous Circulation ◽  
Number Of Patients ◽  
Chain Of Survival ◽  
Resuscitated Patients

A well-functioning chain of survival is critical for good outcomes following out-of-hospital cardiac arrest, a major public health concern in Singapore. While the percentage of survivors to hospital admission has increased over the years, the percentage of survivors to hospital discharge and the number of patients with good neurological recovery can be greatly improved. This underscores the urgent need to focus on ‘post-cardiac arrest care’, the fifth link in the chain of survival, to improve the outcomes of patients who are admitted to the intensive care unit (ICU) after return of spontaneous circulation. This review builds on earlier recommendations of the Singapore National Targeted Temperature Management Workgroup in 2017 to provide a focused update on post-cardiac arrest management and a practical guide for physicians managing resuscitated patients with cardiac arrest in the ICU.

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