scholarly journals Therapeutic hypothermia after cardiac arrest

2016 ◽  
Vol 63 (2) ◽  
pp. 15-18
Author(s):  
A. Iglica ◽  
K. Aganovic ◽  
A. Godinjak ◽  
A. Mujakovic ◽  
S. Jusufovic ◽  
...  

Therapeutic hypothermia in selected patients surviving sudden out-of-hospital cardiac arrest can significantly improve rates of long-term survival and is considered as one of the most important clinical advancements in the science of resuscitation. Since 2003 the American Heart Association/International Liaison Committee on Resuscitation guidelines endorsed the use of hypothermic therapies as standard care for patients suffering from cardiac arrest while in 2005 additional inclusion and exclusion criteria were applied to patients experiencing in or out-of-hospital cardiac arrest with an initial shockable and non shockable rhythm. The goals of treatment in 2015 include achieving targeted temperature as quickly as possible with immediate initiation of cooling methods accompanied with supportive therapy and controlled rewarming.

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Stephan Seewald ◽  
Jan Wnent ◽  
Barbara Jakisch ◽  
Andreas Bohn ◽  
Matthias Fischer ◽  
...  

Introduction: Cardiac arrest is a common event and one of the leading causes of death. Especially within the elderly judgment on if the treatment will be in favor of the patient is a major challenge for the medical team. We evaluated the influence of the age on short and long-term survival after out-of- hospital cardiac arrest (OHCA). Hypothesis: Elderly people survive an out-of-hospital cardiac arrest with good neurological outcome. Methods: For this purpose, we analyzed data of 24,686 out-of-hospital cardiac arrest patients prospectively registered between 2008 and 2017 within the German Resuscitation Registry (GRR). The data records were divided according to different age groups and within the age group after shockable and non-shockable rhythms. The data sets were examined with regard to short and long-term survival. Short term survival was measured by expected and observed return-of-spontaneous circulation based on the RACA-score. The RACA-score is a previously published score to predict ROSC based on readily available variables after arrival of the emergency medical service (EMS) on scene. Long-term survival was differentiated in 24-hour survival, 30-day survival and hospital discharge with good neurological outcome (Cerebral Performance Category 1 and 2). Results: (Table 1) Conclusions: Our data shows that shockable rhythm and younger age are important factors of good neurological outcome after OHCA. Nevertheless, the few cases with shockable rhythms (411 out of 3227) in the elderly (>85 years) showed a favorable neurological outcome in 12.2% (77,2% of all patients with hospital discharge). In the non-shockable group 1.4% (58,3%) of the >85 year old had a good outcome. Data show that a resuscitation attempt in the elderly is not futile, especially if a shockable rhythm is detected. Further studies are necessary to maintain this decision.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Baldi ◽  
S Buratti ◽  
E Contri ◽  
S Canevari ◽  
S Molinari ◽  
...  

Abstract Background Survival beyond 1-month after an out-of-hospital cardiac arrest (OHCA) is still considered a challenge for OHCA registries and it is often unexplored. However, a longer follow-up could help to better comprehend the long-term issues of OHCA survivors. Purpose Our aim was to evaluate the long-term outcome after OHCA via an Utstein-based cardiac arrest registry with a long follow-up (up to 5 years). Methods We enrolled all the people with an OHCA of any aetiology in our Province (about 55ehz748.1138 inhabitants in northern Italy) in whom CPR was attempted. The primary endpoint was the survival at 1 month, and the secondary endpoints were the survival at 6 months and then every year until 5 years after OHCA. Results In the first 45 months (October 2014–June 2018) 1774 resuscitation attempts for confirmed OHCAs were enrolled. Baseline characteristics: male 59.7%; mean age of 73.4±16 years; mean EMS response time was 11:31±5:09 mins; home location 78.8%; bystander-witnessed events were 56.1%; EMS witnessed event 15.6%; bystander CPR 39.5%; AED use before EMS arrival 2.5%; medical etiology 93%; first shockable rhythm 18.2% (90.7% VF, 2.5% VT without pulse, 6.8% AED shockable). When considering survival from the event (Figure 1 – left panel), survival was significantly higher for shockable Utstein categories (p<0.001). Considering only those patients discharged alive (Figure 1 – right panel) long term survival was significantly higher (p<0.01) once again for shockable rhythms. Interestingly, in this category survival continued to decrease over time ranging about from 90% in the first year to about 80% at four years. Figure 1 Conclusions Our results demonstrated that survival after OHCA can change over the time in all the Utstein categories, so we believe that a longer follow-up should be encouraged by next Utstein style revision.


Resuscitation ◽  
2007 ◽  
Vol 75 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Nana G. Holler ◽  
Teit Mantoni ◽  
Søren L. Nielsen ◽  
Freddy Lippert ◽  
Lars S. Rasmussen

Resuscitation ◽  
2021 ◽  
Vol 164 ◽  
pp. 30-37
Author(s):  
Richard Chocron ◽  
Carol Fahrenbruch ◽  
Lihua Yin ◽  
Sally Guan ◽  
Christopher Drucker ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041917
Author(s):  
Fei Shao ◽  
Haibin Li ◽  
Shengkui Ma ◽  
Dou Li ◽  
Chunsheng Li

ObjectiveThe purpose of this study was to assess the trends in outcomes of out-of-hospital cardiac arrest (OHCA) in Beijing over 5 years.DesignCross-sectional study.MethodsAdult patients with OHCA of all aetiologies who were treated by the Beijing emergency medical service (EMS) between January 2013 and December 2017 were analysed. Data were collected using the Utstein Style. Cases were followed up for 1 year. Descriptive statistics were used to characterise the sample and logistic regression was performed.ResultsOverall, 5016 patients with OHCA underwent attempted resuscitation by the EMS in urban areas of Beijing during the study period. Survival to hospital discharge was 1.2% in 2013 and 1.6% in 2017 (adjusted rate ratio=1.0, p for trend=0.60). Survival to admission and neurological outcome at discharge did not significantly improve from 2013 to 2017. Patient characteristics and the aetiology and location of cardiac arrest were consistent, but there was a decrease in the initial shockable rhythm (from 6.5% to 5.6%) over the 5 years. The rate of bystander cardiopulmonary resuscitation (CPR) increased steadily over the years (from 10.4% to 19.4%).ConclusionSurvival after OHCA in urban areas of Beijing did not improve significantly over 5 years, with long-term survival being unchanged, although the rate of bystander CPR increased steadily, which enhanced the outcomes of patients who underwent bystander CPR.


2014 ◽  
Vol 3 (4) ◽  
pp. 293-303 ◽  
Author(s):  
Per Nordberg ◽  
Jacob Hollenberg ◽  
Mårten Rosenqvist ◽  
Johan Herlitz ◽  
Martin Jonsson ◽  
...  

Resuscitation ◽  
2020 ◽  
Vol 157 ◽  
pp. 108-111
Author(s):  
David Majewski ◽  
Stephen Ball ◽  
Paul Bailey ◽  
Janet Bray ◽  
Judith Finn

Circulation ◽  
2019 ◽  
Vol 140 (24) ◽  
Author(s):  
Jonathan P. Duff ◽  
Alexis A. Topjian ◽  
Marc D. Berg ◽  
Melissa Chan ◽  
Sarah E. Haskell ◽  
...  

This 2019 focused update to the American Heart Association pediatric advanced life support guidelines follows the 2018 and 2019 systematic reviews performed by the Pediatric Life Support Task Force of the International Liaison Committee on Resuscitation. It aligns with the continuous evidence review process of the International Liaison Committee on Resuscitation, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendations for advanced airway management in pediatric cardiac arrest, extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest, and pediatric targeted temperature management during post–cardiac arrest care. The writing group analyzed the systematic reviews and the original research published for each of these topics. For airway management, the writing group concluded that it is reasonable to continue bag-mask ventilation (versus attempting an advanced airway such as endotracheal intubation) in patients with out-of-hospital cardiac arrest. When extracorporeal membrane oxygenation protocols and teams are readily available, extracorporeal cardiopulmonary resuscitation should be considered for patients with cardiac diagnoses and in-hospital cardiac arrest. Finally, it is reasonable to use targeted temperature management of 32°C to 34°C followed by 36°C to 37.5°C, or to use targeted temperature management of 36°C to 37.5°C, for pediatric patients who remain comatose after resuscitation from out-of-hospital cardiac arrest or in-hospital cardiac arrest.


Circulation ◽  
2019 ◽  
Vol 140 (24) ◽  
Author(s):  
Jonathan P. Duff ◽  
Alexis A. Topjian ◽  
Marc D. Berg ◽  
Melissa Chan ◽  
Sarah E. Haskell ◽  
...  

This 2019 focused update to the American Heart Association pediatric basic life support guidelines follows the 2019 systematic review of the effects of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) on survival of infants and children with out-of-hospital cardiac arrest. This systematic review and the primary studies identified were analyzed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation’s continuous evidence review process, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update summarizes the available pediatric evidence supporting DA-CPR and provides treatment recommendations for DA-CPR for pediatric out-of-hospital cardiac arrest. Four new pediatric studies were reviewed. A systematic review of this data identified the association of a significant improvement in the rates of bystander CPR and in survival 1 month after cardiac arrest with DA-CPR. The writing group recommends that emergency medical dispatch centers offer DA-CPR for presumed pediatric cardiac arrest, especially when no bystander CPR is in progress. No recommendation could be made for or against DA-CPR instructions when bystander CPR is already in progress.


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