scholarly journals A big white dot after CPR

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Sushma Kola ◽  
Alexander D. Ginsburg ◽  
Laura Harper ◽  
Laura E. Walker ◽  
Sherri Braksick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Basilar Artery ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Successful Resuscitation ◽  
Ct Angiogram ◽  
Neurologic Event

Abstract Introduction Patients may remain comatose after the resumption of spontaneous circulation with cardiopulmonary resuscitation. A primary neurologic event may precede a cardiac standstill. Case report We present a 33-year-old patient with successful resuscitation for pulseless electrical activity and a “normal computed tomography (CT) scan.” Further scrutiny showed a hyperdense basilar artery sign (‘big white dot’) that led to a CT angiogram confirming an embolus to the proximal basilar artery. His examination showed fixed and dilated midsize (mesencephalic) pupils and extensor posturing. Endovascular retrieval of the clot was successful, but there was a devastating ischemic injury to the brainstem. Conclusion This case reminds us to consider neurologic causes of cardiac arrest.

scholarly journals Older female relatives of Covid-19 patients have an unsatisfactory perception of emergency room performance by clinical staf

2021 ◽  
Vol 3 (2) ◽  
pp. 37-38
Author(s):  
Tiziana Ciarambino ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Adverse Reactions ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Cardiac Arrhythmia Suppression Trial ◽  
Supraventricular Tachyarrhythmias

Flecainide is a class I antiarrhythmic used for supraventricular tachyarrhythmias with mild adverse reactions. We present a case report in a 78-year-old male that came to the emergency department with atrial fibrillation and was subsequently treated with flecainide. During the infusion, the patient went into cardiac arrest. Cardiopulmonary resuscitation was performed until the return of spontaneous circulation was achieved after 1min and 40 seconds. Conclusion. Some trials, like The Cardiac Arrhythmia Suppression Trial (CAST), consider flecainide to be safe, but our case report, together with several other published reports brings attention to the use of flecainide in pharmacologic cardioversion of atrial fibrillation as a cause of cardiac arrest. Keywords: Older man, atrial fibrillation, emergency department, cardiac arrest, flecainide

scholarly journals Cardiac arrest in an older male patient treated with flecainide for atrial fibrillation

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Tiziana Ciarambino ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Male Patient ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Cardiac Arrhythmia Suppression Trial ◽  
Supraventricular Tachyarrhythmias

Flecainide is a class I antiarrhythmic used for supraventricular tachyarrhythmias with mild adverse reactions.We present a case report in a 78-year-old male that came to the emergency department with atrial fibrillation and was subsequently treated with flecainide. During the infusion, the patient went into cardiac arrest. Cardiopulmonary resuscitation was performed until the return of spontaneous circulation was achieved after 1 min and 40 seconds. Conclusion. Some trials, like The Cardiac Arrhythmia Suppression Trial (CAST), consider flecainide to be safe, but our case report, together with several other published reports brings attention to the use of flecainide in pharmacologic cardioversion of atrial fibrillation as a cause of cardiac arrest. Keywords: Older man, atrial fibrillation, emergency department, cardiac arrest, flecainide

scholarly journals P003: Which factors predict resuscitation outcomes in patients arriving to the emergency department in cardiac arrest? A SHoC series study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S57-S58
Author(s):  
P. Atkinson ◽  
N. Beckett ◽  
D. Lewis ◽  
J. Fraser ◽  
A. Banerjee ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Electrical Activity ◽  
Odds Ratio ◽  
Cardiac Rhythm ◽  
Point Of Care ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Point Of Care Ultrasound ◽  
Successful Resuscitation

Introduction: The decision as to whether to end resuscitation for pre-hospital cardiac arrest (CA) patients in the field or in the emergency department (ED) is commonly made based upon standard criteria. We studied the reliability of several easily determined criteria as predictors of resuscitation outcomes in a population of adults in CA transported to the ED. Methods: A retrospective database and chart analysis was completed for patients arriving to a tertiary ED in cardiac arrest, between 2010 and 2014. Patients were excluded if aged under 19. Multiple data were abstracted from charts using a standardized form. Regression analysis was used to compare criteria that predicted return of spontaneous circulation (ROSC) and survival to hospital admission (SHA). Results: 264 patients met the study inclusion criteria. Logistic regression was used to identify predictors of ROSC and SHA. The criteria that emerged as significant predictors for ROSC included; longer ED resuscitation time (Odds ratio 1.11 (1.06- 1.18)), witnessed arrest (Odds ratio 9.43 (2.58- 53.0)) and having an initial cardiac rhythm of Pulseless Electrical Activity (Odds Ratio 3.23 (1.07-9.811)) over Asystole. Receiving point of care ultrasound (PoCUS; Odds ratio 0.22 (0.07-0.69)); and having an initial cardiac rhythm of Pulseless Electrical Activity (Odds Ratio 4.10 (1.43-11.88)) were the significant predictors for SHA. Longer times for ED resuscitation was close to reaching significance for predicting SHA Conclusion: Our results suggest that both fixed and adaptable factors, including increasing resuscitation time, and PoCUS use in the ED were important independent predictors of successful resuscitation. Several commonly used criteria were unreliable predictors.

Successful resuscitation after hyperkalemic cardiac arrest during liver transplantation by converting veno-venous bypass to veno-arterial ECMO

Perfusion ◽  
2020 ◽  
pp. 026765912096389
Author(s):  
Lucas Van Hoof ◽  
Filip Rega ◽  
Sarah Devroe ◽  
Karlien Degezelle ◽  
Jacques Pirenne ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Neurological Outcome ◽  
Successful Resuscitation ◽  
Venous Bypass ◽  
Anhepatic Phase ◽  
Va Ecmo

Introduction: Intraoperative cardiac arrest (ICA) is a feared complication during liver transplantation (LTx), typically occurring during reperfusion. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used for post-reperfusion cardiac arrest. Case report: We present a case of successful resuscitation after hyperkalemic ICA during the pre-anhepatic phase of a second liver transplantation by converting veno-venous bypass (VVB) to VA-ECMO. Discussion: While this technique has been recommended for ICA during reperfusion, it has never been reported during the pre-anhepatic phase. VA-ECMO can be a lifesaving extension to cardiopulmonary resuscitation for ICA during LTx with beneficial neurological outcome by providing perfusion while the cause of ICA is reversed. Conclusion: Conversion of VVB to VA-ECMO should be considered in all patients who suffer from ICA during LTx with use of VVB. With VVB installed, conversion to VA-ECMO is fast and effective. If VVB is not used, early VA-ECMO should be considered for ICA.

scholarly journals Cardiopulmonary resuscitation in a swine model of cardiac arrest

2017 ◽  
Vol 58 (3) ◽  
pp. 232
Author(s):  
T. XANTHOS (Θ. ΞΑΝΘΟΣ) ◽  
E. BASSIAKOU (Ε. ΜΠΑΣΙΑΚΟΥ) ◽  
D. PAPADIMITRIOU (Δ. ΠΑΠΑΔΗΜΗΤΡΙΟΥ) ◽  
E. KOUDOUNA (Ε. ΚΟΥΔΟΥΝΑ) ◽  
P. LELOVAS (Π. ΛΕΛΟΒΑΣ) ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Lithium Battery ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Medical Emergency ◽  
Swine Model ◽  
Coronary Perfusion ◽  
Jugular Veins ◽  
Successful Resuscitation

Introduction: Cardiac arrest (CA) is a daunting medical emergency. In order to answer various questions regarding CA, and furthermore to implement novel therapeutic strategies, various animal models have been used.Aim: The aim of the present study is to describe the experimental model of CA and cardiopulmonary resuscitation (CPR), developed in our department.Materials and methods: Twenty pigs were anaesthetized and intubated. The internal jugular veins were surgically prepared, together with the carotid artery. Ventricular fibrillation (VF) was induced with an ordinary lithium battery through a pacing wire inserted into the right ventricle. The animals were resuscitated with the 2005 advanced life support algorythm (ALS), as proposed by International organizations. If the animals restored spontaneous circulation, they were further monitored for 30 minutes.Results: Nine animals restored spontaneous circulation with the implementation of the aforementioned protocol. Successful resuscitation was associated with the coronary perfusion pressure and PETCQ2 during external cardiac compressions.Conclusions: The use of an ordinary lithium battery is a safe and efficient way to induce CA. Swine baseline hemodynamics closely resemble those of human, making the swine model, a favorable model for experimental CA-induction and CPR.

scholarly journals An Intraoperative Case of Spontaneous Restoration of Circulation from Asystole: A Case of Lazarus Phenomenon

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Konstantinos A. Ekmektzoglou ◽  
Eleni Koudouna ◽  
Eleni Bassiakou ◽  
Konstantinos Stroumpoulis ◽  
Phyllis Clouva-Molyvdas ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Total Dose ◽  
Venous Return ◽  
Sinus Node ◽  
Spontaneous Circulation ◽  
Adequate Explanation ◽  
High Total Dose

This case report refers to a victim of intraoperative cardiac arrest, who restored spontaneous circulation despite of cessation of cardiopulmonary resuscitation (CPR). The victim, a 53-year-old man, was undergoing a surgical investigation and rehabilitation of a thigh hematoma. Two minutes after discontinuation of a 46 min CPR, a normotensive sinus node rhythm appeared at monitor. Despite of lack of an adequate explanation, the authors believe that the combination of the high total dose of adrenaline with the cessation of mechanical ventilation might augment venous return and lead to restoration of spontaneous circulation.

scholarly journals The Effect of Implementing Mechanical Cardiopulmonary Resuscitation Devices on Out-of-Hospital Cardiac Arrest Patients in an Urban City of Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3636
Author(s):  
Yi-Rong Chen ◽  
Chi-Jiang Liao ◽  
Han-Chun Huang ◽  
Cheng-Han Tsai ◽  
Yao-Sing Su ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Primary Outcome ◽  
Medical Service ◽  
Spontaneous Circulation ◽  
High Quality ◽  
Urban City ◽  
Service Response Time ◽  
Mechanical Cpr ◽  
Hospital Cardiac Arrest

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.

scholarly journals Non-invasive diffuse optical neuromonitoring during cardiopulmonary resuscitation predicts return of spontaneous circulation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tiffany S. Ko ◽  
Constantine D. Mavroudis ◽  
Ryan W. Morgan ◽  
Wesley B. Baker ◽  
Alexandra M. Marquez ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hemoglobin Concentration ◽  
Spontaneous Circulation ◽  
Youden Index ◽  
Swine Model ◽  
Return Of Spontaneous Circulation ◽  
Non Invasive ◽  
Tissue Optical Properties ◽  
Tenfold Cross Validation

AbstractNeurologic injury is a leading cause of morbidity and mortality following pediatric cardiac arrest. In this study, we assess the feasibility of quantitative, non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) neuromonitoring during cardiopulmonary resuscitation (CPR), and its predictive utility for return of spontaneous circulation (ROSC) in an established pediatric swine model of cardiac arrest. Cerebral tissue optical properties, oxy- and deoxy-hemoglobin concentration ([HbO2], [Hb]), oxygen saturation (StO2) and total hemoglobin concentration (THC) were measured by a FD-DOS probe placed on the forehead in 1-month-old swine (8–11 kg; n = 52) during seven minutes of asphyxiation followed by twenty minutes of CPR. ROSC prediction and time-dependent performance of prediction throughout early CPR (< 10 min), were assessed by the weighted Youden index (Jw, w = 0.1) with tenfold cross-validation. FD-DOS CPR data was successfully acquired in 48/52 animals; 37/48 achieved ROSC. Changes in scattering coefficient (785 nm), [HbO2], StO2 and THC from baseline were significantly different in ROSC versus No-ROSC subjects (p < 0.01) after 10 min of CPR. Change in [HbO2] of + 1.3 µmol/L from 1-min of CPR achieved the highest weighted Youden index (0.96) for ROSC prediction. We demonstrate feasibility of quantitative, non-invasive FD-DOS neuromonitoring, and stable, specific, early ROSC prediction from the third minute of CPR.

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