scholarly journals Survival After In-Hospital Cardiac Arrest in Critically Ill Patients

2020 â—½  
Vol 13 (7) â—½  
Author(s):  
Saket Girotra â—½  
Yuanyuan Tang â—½  
Paul S. Chan â—½  
Brahmajee K. Nallamothu â—½  
Keyword(s):  
Cardiac Arrest â—½  
Critically Ill â—½  
Critically Ill Patients â—½  
Hospital Cardiac Arrest

scholarly journals In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study

BMJ â—½  
10.1136/bmj.m3513 â—½  
2020 â—½  
pp. m3513 â—½  
Author(s):  
Salim S Hayek â—½  
Samantha K Brenner â—½  
Tariq U Azam â—½  
Husam R Shadid â—½  
Elizabeth Anderson â—½  
...  
Keyword(s):  
Cardiac Arrest â—½  
Intensive Care â—½  
Cardiopulmonary Resuscitation â—½  
Hospital Discharge â—½  
Critically Ill â—½  
Critically Ill Patients â—½  
Multicenter Cohort Study â—½  
Critically Ill Adults â—½  
Ill Adults â—½  
Hospital Cardiac Arrest

Abstract Objectives To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). Design Multicenter cohort study. Setting Intensive care units at 68 geographically diverse hospitals across the United States. Participants Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. Main outcome measures In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. Results Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. Conclusions Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.

scholarly journals Blood Cultures and Broad-Spectrum Antimicrobials are Essential for Patients with Out-of-Hospital Cardiac Arrest

2020 â—½  
Author(s):  
Ching-Chi Lee â—½  
Po-Lin Chen â—½  
Ming-Yuan Hong â—½  
Chih-Hao Lin â—½  
Wen-Chien Ko
Keyword(s):  
Cardiac Arrest â—½  
Critically Ill â—½  
Broad Spectrum â—½  
Antimicrobial Therapy â—½  
Critically Ill Patients â—½  
Clinical Information â—½  
Bloodstream Infections â—½  
Extended Spectrum Beta Lactamase â—½  
Tract Infections â—½  
Hospital Cardiac Arrest

Abstract Background: Etiologies of out-of-hospital cardiac arrest (OHCA) have been majorly focused on cardiac origins. Little is known regarding the role of bloodstream infections (BSIs) in OHCA episodes. Our aim was to disclose clinical features and incidences of BSIs and the survival benefit of prompt administration of appropriate antimicrobial therapy (AAT) in adults with OHCA.Methods: In the 10-year multicenter cohort, clinical information was retrospectively collected and causative microorganisms were prospectively stored for species identification and susceptibilities. The effect of delayed AAT administration on 30-day mortality was examined after adjustment for independent predictors of mortality, recognized by a multivariate regression analysis.Results: Of 1,021,177 emergency department encounters, OHCA visits had a higher BSI incidence than non-OHCA visits (413/3,429, 12.0% vs. 7,429/242,302, 3.1%; P<0.001). Compared with the matched non-OHCA (2,478) patients, OHCA (413) patients experienced more bacteremic episodes due to lower respiratory tract infections, fewer urosepsis events, fewer Escherichia coli bacteremia, and more streptococcal and anaerobes bacteremia. More antimicrobial-resistant organisms, such as methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamase-producing Enterobacteriaceae, were evident in OHCA patients. Notably, each hour delay in AAT administration was associated with an average increase of 0.8% in crude 30-day mortality rates (adjusted odds ratio [AOR], 1.008; P = 0.04) in OHCA patients, 7% (AOR, 1.007; P < 0.001) in critically ill patients without OHCA, and 3% (AOR, 1.003; P < 0.001) in less critically ill patients.Conclusions: BSIs should be considered in patients experiencing OHCA; bacteremia sources, causative microorganisms, and antimicrobial susceptibilities differed between the OHCA and non-OHCA patients. The incorporation of blood culture samplings and rapid initiation of broad-spectrum antimicrobial therapy as the first-aids is essential for OHCA patients.

scholarly journals Predictive Value of Estimated Lean Body Mass for Neurological Outcomes after Out-of-Hospital Cardiac Arrest

10.3390/jcm10010071 â—½  
2020 â—½  
Vol 10 (1) â—½  
pp. 71
Author(s):  
Sung Eun Lee â—½  
Hyuk Hoon Kim â—½  
Minjung Kathy Chae â—½  
Eun Jung Park â—½  
Sangchun Choi
Keyword(s):  
Cardiac Arrest â—½  
Critically Ill â—½  
Lean Body Mass â—½  
Body Mass â—½  
Multivariate Regression â—½  
Characteristic Curve â—½  
Cerebral Performance Category â—½  
High Body Mass Index â—½  
Neurological Outcomes â—½  
Hospital Cardiac Arrest

Background: Postcardiac arrest patients with a return of spontaneous circulation (ROSC) are critically ill, and high body mass index (BMI) is ascertained to be associated with good prognosis in patients with a critically ill condition. However, the exact mechanism has been unknown. To assess the effectiveness of skeletal muscles in reducing neuronal injury after the initial damage owing to cardiac arrest, we investigated the relationship between estimated lean body mass (LBM) and the prognosis of postcardiac arrest patients. Methods: This retrospective cohort study included adult patients with ROSC after out-of-hospital cardiac arrest from January 2015 to March 2020. The enrolled patients were allocated into good- and poor-outcome groups (cerebral performance category (CPC) scores 1–2 and 3–5, respectively). Estimated LBM was categorized into quartiles. Multivariate regression models were used to evaluate the association between LBM and a good CPC score. The area under the receiver operating characteristic curve (AUROC) was assessed. Results: In total, 155 patients were analyzed (CPC score 1–2 vs. 3–5, n = 70 vs. n = 85). Patients’ age, first monitored rhythm, no-flow time, presumed cause of arrest, BMI, and LBM were different (p < 0.05). Fourth-quartile LBM (≥48.98 kg) was associated with good neurological outcome of postcardiac arrest patients (odds ratio = 4.81, 95% confidence interval (CI), 1.10–25.55, p = 0.04). Initial high LBM was also a predictor of good neurological outcomes (AUROC of multivariate regression model including LBM: 0.918). Conclusions: Initial LBM above 48.98kg is a feasible prognostic factor for good neurological outcomes in postcardiac arrest patients.

scholarly journals Prediction of cardiac arrest in critically ill patients presenting to the emergency department using a machine learning score incorporating heart rate variability compared with the modified early warning score

Critical Care â—½  
10.1186/cc11396 â—½  
2012 â—½  
Vol 16 (3) â—½  
pp. R108 â—½  
Author(s):  
Marcus Eng Hock Ong â—½  
Christina Hui Lee Ng â—½  
Ken Goh â—½  
Nan Liu â—½  
Zhi Koh â—½  
...  
Keyword(s):  
Machine Learning â—½  
Emergency Department â—½  
Heart Rate â—½  
Heart Rate Variability â—½  
Cardiac Arrest â—½  
Critically Ill â—½  
Early Warning â—½  
Critically Ill Patients â—½  
Early Warning Score â—½  
Learning Score

Influence of core body temperature on Tryptophan metabolism, kynurenines, and estimated IDO activity in critically ill patients receiving target temperature management following cardiac arrest

Resuscitation â—½  
2016 â—½  
Vol 107 â—½  
pp. 107-114 â—½  
Author(s):  
Joerg C. Schefold â—½  
Nora Fritschi â—½  
Gerhard Fusch â—½  
Aldin Bahonjic â—½  
Wolfram Doehner â—½  
...  
Keyword(s):  
Cardiac Arrest â—½  
Body Temperature â—½  
Critically Ill â—½  
Critically Ill Patients â—½  
Core Body Temperature â—½  
Tryptophan Metabolism â—½  
Temperature Management â—½  
Target Temperature Management â—½  
Target Temperature â—½  
Core Body

Electrocardiomatrix facilitates qualitative identification of diminished heart rate variability in critically ill patients shortly before cardiac arrest

2018 â—½  
Vol 51 (6) â—½  
pp. 955-961 â—½  
Author(s):  
Gang Xu â—½  
Sneha Dodaballapur â—½  
Temenuzhka Mihaylova â—½  
Jimo Borjigin
Keyword(s):  
Heart Rate â—½  
Heart Rate Variability â—½  
Cardiac Arrest â—½  
Critically Ill â—½  
Critically Ill Patients

Epidemiology and outcomes of in-hospital cardiac arrest in critically ill children across hospitals of varied center volume: A multi-center analysis

Resuscitation â—½  
2014 â—½  
Vol 85 (11) â—½  
pp. 1473-1479 â—½  
Author(s):  
Punkaj Gupta â—½  
Xinyu Tang â—½  
Christine M. Gall â—½  
Casey Lauer â—½  
Tom B. Rice â—½  
...  
Keyword(s):  
Cardiac Arrest â—½  
Critically Ill â—½  
Critically Ill Children â—½  
Center Volume â—½  
Hospital Cardiac Arrest
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