scholarly journals The Effect of Epinephrine Administration on Return of Spontaneous Circulation (ROSC) and One-Month Mortality in Cardiopulmonary Arrest Patients

2020 ◽  
Author(s):  
Mustafa Sabak ◽  
◽  
Behcet Al ◽  
Murat Oktay ◽  
Suat Zengin ◽  
...  
Keyword(s):  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Epinephrine Administration ◽  
Return Of Spontaneous Circulation

scholarly journals Immediate Intravenous Epinephrine Versus Early Intravenous Epinephrine for In-Hospital Cardiopulmonary Arrest

2021 ◽  
Author(s):  
Abdullah Bakhsh ◽  
Maha Safhi ◽  
Ashwaq Alghamdi ◽  
Amjad Alharazi ◽  
Bedoor Alshabibi ◽  
...  
Keyword(s):  
Chart Review ◽  
Cardiopulmonary Arrest ◽  
Retrospective Chart Review ◽  
Spontaneous Circulation ◽  
Chi Square ◽  
Epinephrine Administration ◽  
Return Of Spontaneous Circulation ◽  
Study Population ◽  
Epinephrine Dose ◽  
The Ideal

Abstract Background intravenous epinephrine has been a key treatment for cardiopulmonary arrest since the early 1960s. Although, many studies have questioned neurological outcome benefit, it remains to be recommended in international guidelines for its benefit on return of spontaneous circulation (ROSC). The ideal timing for the first epinephrine dose is uncertain. We aimed to look at the association of immediate epinephrine administration (within 1-minute of cardiac arrest recognition) with return of spontaneous circulation (ROSC) up to 24-hours and beyond 24-hours. Methods this was a multicenter retrospective chart review of patients undergoing cardiopulmonary resuscitation. Descriptive statistics were used to characterize study population, while t-test and chi-square were used to compare groups and outcomes. Results immediate epinephrine administration (within 1-minute) is associated with higher rates of ROSC up to 24-hours (OR = 2.36, 95% CI; [1.46–3.81]) and beyond 24-hours (OR = 2.26, 95% CI; [1.06–4.83]). Conclusions we encourage immediate administration of epinephrine in conjunction with high-quality CPR, as this is associated with higher rates of ROSC.

scholarly journals Immediate Intravenous Epinephrine (Within 1-minute) Versus Early Intravenous Epinephrine (After 1-minute) for In-Hospital Cardiopulmonary Arrest: A Multicenter Retrospective Review

2021 ◽  
Author(s):  
Abdullah Bakhsh ◽  
Maha Safhi ◽  
Ashwaq Alghamdi ◽  
Amjad Alharazi ◽  
Bedoor Alshabibi ◽  
...  
Keyword(s):  
Chart Review ◽  
Cardiopulmonary Arrest ◽  
Retrospective Chart Review ◽  
Spontaneous Circulation ◽  
High Quality ◽  
Epinephrine Administration ◽  
Return Of Spontaneous Circulation ◽  
Epinephrine Dose ◽  
Multicenter Retrospective Review ◽  
The Ideal

Abstract Background: intravenous epinephrine has been a key treatment for cardiopulmonary arrest since the early 1960s. Although, many studies have questioned neurological outcome benefit, it remains to be recommended in international guidelines for its benefit on return of spontaneous circulation (ROSC). The ideal timing for the first epinephrine dose is uncertain. We aimed to look at the association of immediate epinephrine administration (within 1-minute of cardiac arrest recognition) with return of spontaneous circulation (ROSC) up to 24-hours and beyond 24-hours.Methods: this was a multicenter retrospective chart review of patients undergoing cardiopulmonary resuscitation.Results: immediate epinephrine administration (within 1-minute) is associated with higher rates of ROSC up to 24-hours (OR=2.36, 95% CI; [1.46-3.81]) and beyond 24-hours (OR=2.26, 95% CI; [1.06-4.83]).Conclusions: we encourage immediate administration of epinephrine in conjunction with high-quality CPR, as this is associated with higher rates of ROSC.

scholarly journals Immediate intravenous epinephrine versus early intravenous epinephrine for in-hospital cardiopulmonary arrest

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdullah Bakhsh ◽  
Maha Safhi ◽  
Ashwaq Alghamdi ◽  
Amjad Alharazi ◽  
Bedoor Alshabibi ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Do Not Resuscitate ◽  
High Quality ◽  
Epinephrine Administration ◽  
Return Of Spontaneous Circulation ◽  
Administration Time ◽  
Resuscitation Attempt ◽  
The Ideal

Abstract Background Intravenous epinephrine has been a key treatment in cardiopulmonary arrest since the early 1960s. The ideal timing for the first dose of epinephrinee is uncertain. We aimed to investigate the association of immediate epinephrine administration (within 1-min of recognition of cardiac arrest) with return of spontaneous circulation (ROSC) up to 24-h. Methods This was a multicenter retrospective analysis of patients who underwent cardiopulmonary resuscitation. We included the following patients: 1) ≥18 years-old, 2) non-shockable rhythms, 3) received intravenous epinephrine during cardiopulmonary resuscitation, 4) witnessed in-hospital arrest and 5) first resuscitation attempt (for patients requiring more than one resuscitation attempt). We excluded patients who suffered from traumatic arrest, were pregnant, had shockable rhythms, arrested in the operating room, with Do-Not-Resuscitate (DNR) order, and patient aged 17 years-old or less. Results A total of 360 patients were included in the analysis. Median age was 62 years old and median epinephrine administration time was two minutes. We found that immediate epinephrine administration (within 1-min) is associated with higher rates of ROSC up to 24-h (OR = 1.25, 95% CI; [1.01–1.56]), compared with early epinephrine (≥2-min) administration. After adjusting for confounding covariates, earlier administration of epinephrine predicted higher rates of ROSC sustained for up to 24-h (OR 1.33 95%CI [1.13–1.55]). Conclusions Immediate administration of epinephrine in conjunction with high-quality CPR is associated with higher rates of ROSC.

Abstract 308: Pupil Diameter Predicts the Outcome in Patients With Cardiopulmonary Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Shunichi Imamura ◽  
Masaaki Miyata ◽  
Risa Kamata ◽  
Yutaro Nomoto ◽  
Issei Yoshimoto ◽  
...  
Keyword(s):  
Area Under Curve ◽  
Operating Characteristic ◽  
Pupil Diameter ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Optimal Management ◽  
Return Of Spontaneous Circulation ◽  
Significant Difference ◽  
The Mean ◽  
Age And Sex

Introduction: Early prediction of the outcome in patients with cardiopulmonary arrest (CPA) is important to select the optimal management. The pupil diameter is a simple neurological examination and it predicts the prognosis in patient with stroke. However, the clinical significance of pupil diameter in CPA has not been elucidated. Hypothesis: We hypothesized that pupil diameter would predict the prognosis of CPA patients. Methods: We retrospectively analyzed consecutive 45 patients with CPA and return of spontaneous circulation (ROSC) after cardiopulmonary resuscitation in our hospital. We analyzed age, sex, cause of CPA, time during CPA, pupil diameter at admission and death in hospital. Results: The mean of age was 67±20 years and male were 34 (76%). The median of CPA time was 33 min [25%, 75%; 22, 46] and pupil diameter was 4.8 mm [3.0, 6.0]. The 26 (58%) patients died in hospital after ROSC. There was no significant difference in age and sex between survival (n=19) and dead (n=26). The CPA time was significantly shorter in survival than that in dead (21 min [10, 39] vs 30 min [30, 52], p=0.005). Furthermore, pupil diameter was significantly smaller in survival compared with dead (3.0mm [2.5, 4.3] vs 5.0mm [4.4, 6.0]) (Figure). The receiver-operating characteristic (ROC) curve for survival after ROSC demonstrated that the area under curve was 0.73 and provided an optimal cut-off value at 4.0mm in pupil diameter with 75% sensitivity and 75% specificity. When CPA time was 28 minutes, the area under curve was 0.76, and sensitivity and specificity were 78% and 71%, respectively. Conclusion: As same as CPA time, pupil diameter is suggested to predict the outcome after ROSC in CPA patients.

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 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 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.

Sign in / Sign up

Export Citation Format

Share Document