scholarly journals The Contrast Agent Pooling (C.A.P.) Sign and Imminent Cardiac Arrest: A Retrospective Study

2021 ◽  
Author(s):  
Yu-Husan Lee ◽  
Jiashan Chen ◽  
Po-An Chen ◽  
Jen-Tang Sun ◽  
Bo-Hwi Kang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Contrast Agent ◽  
Ct Scan ◽  
Case Reports ◽  
Sudden Cardiac Arrest ◽  
Positive Association ◽  
Secondary Outcome ◽  
Dependent Part ◽  
Far Eastern

Abstract BackgroundThe sign of contrast agent pooling (C.A.P.) in dependent part of the venous system were reported in some case reports, which happened in the patients before sudden cardiac arrest. Until now, there is no solid evidence enough to address the importance of the sign. This study aimed to assess the accuracy of the C.A.P. sign in predicting imminent cardiac arrest and the association of the C.A.P. sign with patient’s survival.MethodsThis is a retrospective cohort study. The study included 128 patients who visited the emergency department of Far Eastern Memorial Hospital, who received contrast computed tomography (CT) scan and then experienced cardiac arrest at the emergency department (from January 1, 2016 to December 31, 2018). With positive C.A.P. sign, the primary outcome is whether in-hospital cardiac arrest happens within an hour; the secondary outcome is survival to discharge.ResultsIn the study, 8.6% (N=11) patients had positive C.A.P. sign and 91.4% (N=117) patients did not. The accuracy of C.A.P. sign in predicting cardiac arrest within 1 hour is 85.94%. The C.A.P. sign had a positive association with IHCA within 1 hour after the CT scan (adjusted odds ratio 11.60, 95% confidence interval [CI] 1.97 – 68.20). The odd ration of survival to discharge is 0.0081 with positive C.A.P. sign (95% CI 0.00697 – 2.188).ConclusionThe C.A.P. sign can be considered as an alarm for imminent cardiac arrest and poor prognosis. The patients with positive C.A.P. sign were more likely to experience imminent cardiac arrest; in contrast, less likely to survive. Trial registrationThe study was approved by our institutional ethical committee (IRB No.108107-E).

Emergency department factors associated with survival after sudden cardiac arrest

Resuscitation ◽  
2013 ◽  
Vol 84 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Nicholas J. Johnson ◽  
Rama A. Salhi ◽  
Benjamin S. Abella ◽  
Robert W. Neumar ◽  
David F. Gaieski ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Factors Associated

Sudden Cardiac Arrest during Adenotonsillectomy in a Patient with Subclinical Duchenne's Muscular Dystrophy

1993 ◽  
Vol 72 (2) ◽  
pp. 130-131 ◽  
Author(s):  
Nick C. Benton ◽  
Robert A. Wolgat
Keyword(s):  
Cardiac Arrest ◽  
Muscular Dystrophy ◽  
General Anesthesia ◽  
Case Reports ◽  
Sudden Cardiac Arrest ◽  
Elevated Serum ◽  
Serum Creatine Kinase ◽  
Strong Family History ◽  
History Of ◽  
Duchenne's Muscular Dystrophy

We describe a four-year-old boy of Indian descent who had elective adenotonsillectomy for chronic sore throat and partial airway obstruction. About 10 minutes into the procedure, the patient suddenly developed cardiac asystole. After prolonged cardiac resuscitation, recovery was achieved. No permanent neurologic deficits resulted. The child was later found to have a strong family history of Duchenne's muscular dystrophy (DMD) and an elevated serum creatine kinase level documented since shortly after birth. We reviewed several case reports substantiating the risk for cardiac arrest during general anesthesia in DMD patients, and we concluded that DMD is a little-known risk for cardiac arrest during general anesthesia. The otolaryngologist must be aware of this potential complication, because tonsillectomy and adenoidectomy are commonly indicated for children at an age when DMD may be subclinical.

An International Multi-Center Cohort Study on β-blockers for the Treatment of Symptomatic Children with Catecholaminergic Polymorphic Ventricular Tachycardia

Circulation ◽  
2021 ◽  
Author(s):  
Puck J Peltenburg ◽  
Dania Kallas ◽  
Johan M. Bos ◽  
Krystien V. V. Lieve ◽  
Sonia Franciosi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Primary Outcome ◽  
Cox Regression ◽  
Sudden Cardiac Arrest ◽  
Interquartile Range ◽  
Catecholaminergic Polymorphic Ventricular Tachycardia ◽  
Polymorphic Ventricular Tachycardia ◽  
Secondary Outcome ◽  
First Occurrence

Background: Symptomatic children with catecholaminergic polymorphic ventricular tachycardia (CPVT) are at risk for recurrent arrhythmic events. Beta-blockers (BBs) decrease this risk, but studies comparing individual BBs in sizeable cohorts are lacking. We aimed to assess the association between risk for arrhythmic events and type of BB in a large cohort of symptomatic children with CPVT. Methods: From two international registries of patients with CPVT, RYR2 variant-carrying symptomatic children (defined as syncope or sudden cardiac arrest prior to BB initiation and age at start of BB therapy <18 years), treated with a BB were included. Cox-regression analyses with time-dependent covariates for BB and potential confounders were used to assess the hazard ratio (HR). The primary outcome was the first occurrence of sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter-defibrillator shock, or syncope. The secondary outcome was the first occurrence of any of the primary outcomes except syncope. Results: We included 329 patients (median age at diagnosis 12 [interquartile range, 7-15] years, 35% females). Ninety-nine (30.1%) patients experienced the primary and 74 (22.5%) experienced the secondary outcome during a median follow-up of 6.7 [interquartile range, 2.8-12.5] years. Two-hundred sixteen patients (66.0%) used a non-selective BB (predominantly nadolol [n=140] or propranolol [n=70]) and 111 (33.7%) used a β1-selective BB (predominantly atenolol [n=51], metoprolol [n=33], or bisoprolol [n=19]) as initial BB. Baseline characteristics did not differ. The HR for both the primary and secondary outcomes were higher for β1-selective compared with non-selective BBs (HR, 2.04 95% CI, 1.31-3.17; and HR, 1.99; 95% CI, 1.20-3.30, respectively). When assessed separately, the HR for the primary outcome was higher for atenolol (HR, 2.68; 95% CI, 1.44-4.99), bisoprolol (HR, 3.24; 95% CI, 1.47-7.18), and metoprolol (HR, 2.18; 95% CI, 1.08-4.40) compared with nadolol, but did not differ from propranolol. The HR of the secondary outcome was only higher in atenolol compared with nadolol (HR, 2.68; 95% CI, 1.30-5.55). Conclusions: B1-selective BBs were associated with a significantly higher risk for arrhythmic events in symptomatic children with CPVT compared with non-selective BBs, specifically nadolol. Nadolol, or propranolol if nadolol is unavailable, should be the preferred BB for treating symptomatic children with CPVT.

scholarly journals Evaluation of Skin and Soft Tissue Infection Outcomes and Admission Decisions in Emergency Department Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Nicholas Black ◽  
Jon W. Schrock
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Treatment Failure ◽  
Soft Tissue Infection ◽  
Clinical Information ◽  
Positive Association ◽  
Antibiotic Use ◽  
Tissue Infection ◽  
Secondary Outcome ◽  
Emergency Department Patients

Background. Skin and soft tissue infections are common presenting complaints for Emergency Department (ED) patients. Although they are common, there remain no definitive guidelines on decisions of admission for these patients. Objectives. To determine the influence of demographic and clinical information of those presenting with skin and soft tissue infection(s) (SSTI) on both disposition and treatment failure. Methods. We prospectively enrolled adults with SSTI seen at a large urban ED. Secondary outcome was treatment failure. Statistics utilized t-tests and multivariate logistic regression. Results. We enrolled 125 subjects and 32 were admitted. 15.2% of patients failed treatment with both increasing age and infection area correlating with admission. IV drug use (IVDU) (OR: 10.2; 95% confidence interval [CI]: 1.9 to 50.0) and recent antibiotic use (OR: 2.9; 95% CI 1.003 to 8.333) independently predicted admission. Age and recent surgery in the area of infection (OR: 6.4; 95% CI 1.3 to 30.8) showed positive association with treatment failure. IV antibiotics (OR: 22.3; 95% CI 2.8 to 179.4) and admission (OR: 12.1; 95% CI 2.9 to 50.4) strongly predicted treatment failure. Conclusions. Age, infection size, IVDU, and recent antibiotics predicted admission. Age, recent surgery at infection site, IV antibiotics, and admission correlated with treatment failure.

scholarly journals Association between Novel Marker (Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, and Delta Neutrophil Index) and Outcomes in Sudden Cardiac Arrest Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Sang Il Han ◽  
Kyoung-Chul Cha ◽  
Young Il Roh ◽  
Sung Oh Hwang ◽  
Woo Jin Jung ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Complete Blood Count ◽  
Sudden Cardiac Arrest ◽  
University Hospital ◽  
Secondary Outcome ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Delta Neutrophil Index

Purpose. It is important that clinicians accurately predict the outcome of patients with sudden cardiac arrest (SCA). The complete blood count (CBC) is an easy and inexpensive test that provides information on blood content. Platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and delta neutrophil index (DNI) are relatively novel biomarkers that have been used in the prognosis of various diseases. We aimed to determine the usefulness of PLR, NLR, and DNI in predicting the outcomes of SCA. Materials and Methods. This retrospective observational study was performed on patients with SCA. Patients who visited the tertiary university hospital from January 2015 to December 2019 were targeted. The inclusion criteria were all nontraumatic adult out-hospital cardiac arrest patients. We analyzed DNI, PLR, and NLR based on the CBC results of all enrolled patients. The exclusion criteria were as follows: no data on laboratory study, traumatic arrest, age < 18 years, and a history of leukemia, myelodysplastic syndrome, and myelofibrosis. The primary outcome was assessed as return of spontaneous circulation (ROSC), the secondary outcome as survival to discharge, and the tertiary outcome as neurological outcome. Results. From January 1, 2015, to December 31, 2019, 739 patients were enrolled. ROSC was seen in 324 patients, of whom 60 had survival to discharge and 24 had good neurological outcome at the time of discharge (cerebral performance categories (CPCs) 1-2). The PLR of the ROSC group was 42.41 (range: 4.21–508.7), which was higher than that of the No-ROSC group ( p = 0.006 ). The DNI value of the survival group was 0.00 (range: 0.00–40.9), which was lower than that of the nonsurvival group. Conclusions. Patients with SCA and subsequent ROSC had higher PLR and NLR, while those with survival to discharge had lower DNI values than those with nonsurvival to discharge ( p = 0.005 ).

scholarly journals Haloperidol Induced Sudden Cardiac Arrest—Report of a Very Rare Case and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Parvez Mohi-Ud-Din Dar ◽  
Supreet Kaur ◽  
Jogendra Boddeda ◽  
Sajid Mohammad Wani
Keyword(s):  
Cardiac Arrest ◽  
Psychotic Disorders ◽  
Cardiopulmonary Arrest ◽  
Case Reports ◽  
Sudden Cardiac Arrest ◽  
General Medicine ◽  
Typical Antipsychotic ◽  
Review Of Literature ◽  
Acute Confusional State ◽  
Confusional State

Haloperidol is a typical antipsychotic drug. This drug is still widely used in emergency medicine, psychiatry, and general medicine departments. It is mostly used for acute confusional state, psychotic disorders, agitation, delirium, and aggressive behaviour. Overdose of haloperidol can cause sudden deaths. Cardiopulmonary arrest related to use of haloperidol had been reported in literature as case reports but are very few. No such cases have been reported in India till now. We report a case of cardiac arrest due to the use of haloperidol.

Abstract 10906: Association of Serum Magnesium Level on Emergency Department Arrival and Favorable Neurologic Outcome After Out-of-Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Jooyeong Kim ◽  
Kim Sung Jin ◽  
Jonghak Park ◽  
Sejoong Ahn ◽  
Juhyun Song ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Serum Magnesium ◽  
Sudden Cardiac Arrest ◽  
Cerebral Performance Category ◽  
Normal Group ◽  
Neurologic Outcome ◽  
High Group ◽  
Icu Admission ◽  
Hospital Cardiac Arrest

Introduction: Electrolyte disturbances are associated with sudden cardiac arrest based on several cohort studies. However little is known about the association between serum magnesium(S-Mg) level at ED arrival and survival of out-of-hospital cardiac arrest (OHCA) patients. Hypothesis: We hypothesized S-Mg level at ED arrival is associated with favorable neurologic outcome of OHCA patients. Methods: This is an observational study using Korean Cardiac Arrest Research Consortium (KoCARC) data from October 2015 to June 2020. EMS treated OHCA patients over 18 years old who survived to ICU admission were included. Those without S-Mg level were excluded. Exposure is S-Mg level at emergency department (ED) arrival and outcome was favorable neurologic outcome (cerebral performance category 1 or 2) at hospital discharge. S-Mg was categorized into three groups; Low group; 0-1.7mg/dl, Normal group;1.7-2.3mg/dl, High group; over 2.3mg/dl). Multivariable logistic regression was performed to calculate adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) for outcome. Results: From total 10,897 OHCA patients, 2,789 patients survived to ICU admission and 1,370 patients had initial S-Mg result. Favorable neurologic outcome was 27.4% in low group, 55.7% in normal group and 23.0% in high group. After adjusting potential confounders in multivariable logistic analysis, compared to the normal group, AOR was 0.28 (95% CI 0.11-0.75) at low group and 0.43 (95% CI 0.23-0.82) at high group. Conclusion: Low (S-Mg less than 1.7 mg/dl) or high (S-Mg over 2.3mg/dl) S-Mg level measured initially at ED arrival for OHCA patients was associated with worse neurologic outcome compared to normal S-Mg level (S-Mg 1.7-2.3mg/dl). Based on this study, further study is needed to investigate the optimized S-Mg level for OHCA patient under resuscitation.

scholarly journals Ventricular fibrillation and sudden cardiac arrest in apical hypertrophic cardiomyopathy: Two case reports

2021 ◽  
Vol 9 (35) ◽  
pp. 11102-11107
Author(s):  
Yae Min Park ◽  
Albert Youngwoo Jang ◽  
Wook-Jin Chung ◽  
Seung Hwan Han ◽  
Christopher Semsarian ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hypertrophic Cardiomyopathy ◽  
Ventricular Fibrillation ◽  
Case Reports ◽  
Sudden Cardiac Arrest ◽  
Apical Hypertrophic Cardiomyopathy

scholarly journals The risky side of weight-loss dietary supplements: disrupting arrhythmias causing sudden cardiac arrest

2018 ◽  
Vol 11 (1) ◽  
pp. e227531 ◽  
Author(s):  
Faisal Inayat ◽  
Chaudhry Nasir Majeed ◽  
Nouman Safdar Ali ◽  
Maham Hayat ◽  
Izzah Vasim
Keyword(s):  
Weight Loss ◽  
Cardiac Arrest ◽  
Dietary Supplements ◽  
Cardiac Arrhythmias ◽  
De Novo ◽  
Case Reports ◽  
Sudden Cardiac Arrest ◽  
Healthy Woman ◽  
Regulatory Oversight ◽  
Prevalence Of Obesity

The worldwide increasing prevalence of obesity has led to a corresponding increase in consumption of weight-loss dietary supplements. The limited de novo regulatory oversight and under-reported toxicity profile of these products reflect as a constellation of newer adverse events. We chronicle here the case of an otherwise healthy woman who developed ventricular fibrillation-related cardiac arrest secondary to the use of Hydroxycut and Metaboost preparations. Published medical literature has a handful of case reports associating these products with potentially life-threatening cardiac arrhythmias. The proposed hypothesis implicates ingredients of these diet aids to have proarrhythmogenic effects. Physicians should remain vigilant for possible cardiotoxicity associated with the use of dietary supplements. Individuals who are at risk of developing cardiac arrhythmias should avoid herbal weight-loss formulas, given the serious clinical implications. Additionally, this paper highlights the need for a proper framework to delineate the magnitude and scope of this association.

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