scholarly journals The Relationship Between Return of Spontaneous Circulation and Neutrophil Lymphocyte and Platelet Lymphocyte Ratios in Cardiac Arrest Cases

2019 ◽  
Author(s):  
Sedat Bilge ◽  
YAHYA AYHAN ACAR ◽  
DERYA CAN ◽  
GOKHAN OZKAN
Keyword(s):  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
The Relationship

Abstract 342: The Relationship Between Time Interval From Collapse to Return of Spontaneous Circulation After Out-of-Hospital Cardiac Arrest and Neurologically Intact Survival

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ken Nagao ◽  
Yoshio Tahara ◽  
Hiroshi Nonogi ◽  
Naohiro Yonemoto ◽  
David F Gaieski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Spontaneous Circulation ◽  
Adult Patients ◽  
Time Interval ◽  
Return Of Spontaneous Circulation ◽  
Favorable Neurological Outcome ◽  
The Relationship ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

Background: Early cardiopulmonary resuscitation (CPR) and early defibrillation are critical to survival from out-of-hospital cardiac arrest (OHCA). However, few studies have investigated the relationship between time interval from collapse to return of spontaneous circulation (ROSC) and neurologically intact survival. Methods: From the All-Japan OHCA Utstein Registry between 2005 and 2015, we enrolled adult patients achieving prehospital ROSC after witnessed OHCA, inclusive of arrest after emergency medical service responder arrival. The study patients were divided into two groups according to initial cardiac arrest rhythm (shockable versus non-shockable). The collapse-to-ROSC interval was calculated as the time interval from collapse to first achievement of prehospital ROSC. The primary endpoint was 30-day favorable neurological outcome after OHCA. Results: A total of 69,208 adult patients achieving prehospital ROSC after witnessed OHCA were enrolled; 23,017(33.3%) the shockable arrest group and 46,191 (66.7%) the non-shockable arrest group. The shockable arrest group compared with the non-shockable arrest group had significantly shorter collapse-to-ROSC interval (16±10 min vs. 20±13 min, P<0.001) and significantly higher frequency of the favorable neurological outcome (54.9% vs. 15.3%, P<0.001). Frequencies of the favorable neurological outcome after shockable OHCA decreased to 1.2% to 1.5% with every minute that the collapse-to-ROSC interval was delayed (78% at 1 minute of collapse, 68% at 10 minutes, 44% at 20 minutes, 34% at 30 minutes, 16% at 40 minutes, 4% at 50 minutes and 0% at 60 minutes, respectively, P<0.001), and those after non-shockable OHCA decreased to 0.8% to 1.8% with every minute that the collapse-to-ROSC interval was delayed (40% at 1 minute of collapse, 26% at 10 minutes, 11% at 20 minutes, 5% at 30 minutes, 2% at 40 minutes, 0% at 50 minutes and 0% at 60 minutes, respectively, P<0.001). Conclusions: Termination of the collapse-to-ROSC interval to achieve neurologically intact survival after witnessed OHCA was 50 minutes or longer irrespective of initial cardiac arrest rhythm (shockable versus non-shockable), although the neurologically intact survival rate was difference between the two groups.

scholarly journals Return of spontaneous circulation and heart rhythm during the first analysis of the heart electrical activity

2019 ◽  
Vol 18 (3) ◽  
pp. 147-150
Author(s):  
Sebastian Kowalski ◽  
Adrian Moskal ◽  
Karolina Żak-Kowalska ◽  
Mariusz Goniewicz
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Statistical Significance ◽  
Sudden Cardiac Arrest ◽  
Heart Rhythm ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Heart Electrical Activity ◽  
First Moment ◽  
The Relationship

AbstractIntroduction. Return of spontaneous circulation (ROSC) of a patient with cardiac arrest is the main goal of carrying out cardiopulmonary resuscitation.Aim. Evaluation of frequency of return of spontaneous circulation depending on the heart rhythms in the first moment of heart electrical activity.Material and methods. Analysis of 105 cases of sudden cardiac arrest in out-of-hospital conditions on the premises of Brzozow Emergency Medical Service from September 2016 to the end of February 2018. The data was collected from intervention medical cards and medical rescue procedure cards. Statistical analysis was carried out using STATISTICA software. Statistical significance was assumed to be p<0.05.Results. Sudden cardiac arrest in the analysed group applied to 62.9% of men. Return of spontaneous circulation was achieved only in 16 out of 105 cases (15.2%) of sudden cardiac arrest. The analysis has indicated that ROSC was successful among 66.67% of patients, who during the first analysis of the rhythm, represented cardiac arrest in VF/pVT, what constituted 75% of all ROSC cases in the analysed group. Comparison between ROSC and rhythm during the first evaluation of the rhythm showed statistical significance (p=0.00). Statistical significance was also shown in the relationship between ROSC and the average age of the patient (p=0.0155).Conclusions. Sudden cardiac arrest, when diagnosed in the first analysis of the rhythm VF/pVT, has bigger chances for return of spontaneous circulation than it has in other rhythms.

scholarly journals An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest

Medicine ◽  
2018 ◽  
Vol 97 (30) ◽  
pp. e11607 ◽  
Author(s):  
Klaudiusz Nadolny ◽  
Lukasz Szarpak ◽  
Joanna Gotlib ◽  
Mariusz Panczyk ◽  
Maciej Sterlinski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
The Relationship

Abstract 13347: Oxygen Metabolism After Cardiac Arrest: Patterns and Association With Survival

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Katherine M Berg ◽  
Lakshman Balaji ◽  
Mahmoud S Issa ◽  
Michael W Donnino ◽  
Anne V Grossestreuer
Keyword(s):  
Cardiac Arrest ◽  
Area Under The Curve ◽  
Oxygen Metabolism ◽  
Spontaneous Circulation ◽  
Temperature Management ◽  
Return Of Spontaneous Circulation ◽  
Time Period ◽  
Time Periods ◽  
Metabolic Data ◽  
The Relationship

Introduction: How mitochondrial damage from cardiac arrest (CA) and resuscitation affects oxygen metabolism, and whether changes in metabolism are associated with outcome, is not well understood. We previously reported an association between higher oxygen consumption (VO2) in the first 12 hours after return of spontaneous circulation (ROSC) and survival in 17 post-arrest (PA) patients. The present study was conducted to investigate the association of VO2, VCO2 and RQ with survival in a larger PA cohort. Methods: From adult patients enrolled in several CA trials at our center, we selected those receiving targeted temperature management with ≥60 minutes of post-ROSC metabolic data collected in the first 24 hours after ROSC, using a gas exchange monitor that measures continuous VO2, VCO2 and RQ.The area under the curve (AUC) for VO2, VCO2 and RQ was calculated using all available values in the first 12 and 24 hours after ROSC. For both time periods, logistic regression was used to describe the relationship between survival and each AUC. We adjusted for temperature, sedation, and vasopressor s. Hourly medians were plotted by survival. Results: Of 64 patients included, 32 (50%) survived. There was no significant association between survival and AUC-VO2 or AUC-VCO2 in the first 12 (n=43) or 24 (n=64) hours after ROSC. 21 (49%) had a median RQ <0.7 in the first 12 hours, and there was an association between survival and AUC-RQ in this time period (see table). Conclusion: There were no significant associations between VO2, VCO2 and survival in the first 12 and 24 hours after ROSC. RQ was abnormally low in many patients, and higher RQ in the first 12 hours after ROSC was associated with survival.

Abstract 111: Impact of Time to Return of Spontaneous Circulation on Neurologically Intact Survival in Patients With Out-of-Hospital Cardiac Arrest According to Age: Evidence From a Large-Scale Registry in Japan

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Akira Funada ◽  
Yoshikazu Goto ◽  
Hayato Tada ◽  
Masaya Shimojima ◽  
Hirofumi Okada ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Large Scale ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Performance Category ◽  
Return Of Spontaneous Circulation ◽  
The Impact ◽  
The Relationship ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

Introduction: Time to return of spontaneous circulation (ROSC) is a more important predictor of neurologically intact survival than the presence of ROSC in patients with out-of-hospital cardiac arrest (OHCA). However, the differences in the relationship between time to ROSC and neurologically intact survival in patients with OHCA based on age is unclear. Hypothesis: We hypothesized that the impact of time to ROSC on neurologically intact survival differs according to age. Methods: We analyzed the data of 34,905 patients with OHCA (age ≥18 years) who exhibited prehospital ROSC from the prospectively recorded all-Japan OHCA registry (2011-2014). The primary outcome was neurologically intact survival at 1 month after OHCA (cerebral performance category [CPC] 1 or 2). Time to ROSC was defined as the interval from the initiation of cardiopulmonary resuscitation (CPR) by emergency medical service (EMS) providers to the achievement of ROSC. We categorized time to ROSC by every 4-min interval (2 cycles of CPR) from 1 to 32 min and ≥33 min, and age into 4 groups: 18-64, 65-74, 75-89, and ≥90 years. Results: The overall CPC 1-2 rate was 21.1% (7,353/34,905). Increasing time to ROSC (per min) was negatively associated with CPC 1-2 (adjusted odds ratio, 0.91; 95% confidence interval, 0.90-0.91). The CPC 1-2 rates decreased as time to ROSC increased in each age group: from 58.8% (1,247/2,122) in 1-4 min to 2.8% (7/246) in ≥33 min for patients aged 18-64 years, from 51.1% (721/1,410) in 1-4 min to 1.6% (4/244) in ≥33 min for 65-74 years, from 37.3% (765/2,051) in 1-4 min to 0.7% (4/539) in 29-32 min for 75-89 years, and from 23.4% (92/393) in 1-4 min to 0.2% (1/481) in 17-20 min for ≥90 years (all p for trend <0.001). Conclusions: The CPC 1-2 rates of patients aged 18-64 and 65-74 years were above the 1% futility rate when prehospital ROSC was achieved after prolonged CPR, ≥33 min from initiation by EMS providers. However, the CPC 1-2 rates were below the 1% futility rate when prehospital ROSC was achieved ≥29 min and ≥17 min for patients aged 75-89 years and ≥90 years, respectively.

scholarly journals Relationship between the Plasma Levels of Catecholamines and Return of Spontaneous Circulation in Patients with Out-of-Hospital Cardiac Arrest

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yumi Ichikawa ◽  
Yusuke Sawada ◽  
Jun Nakajima ◽  
Yuta Isshiki ◽  
Kazunori Fukushima ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Study ◽  
Plasma Levels ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Dynamic State ◽  
Blood Samples ◽  
Return Of Spontaneous Circulation ◽  
The Relationship ◽  
Hospital Cardiac Arrest

Purpose. The dynamic state of epinephrine (Ep) in the plasma of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. The purpose of this study was to evaluate the relationship between the plasma levels of catecholamines (such as epinephrine (Ep), norepinephrine (Nep), and dopamine) and vasopressin (antidiuretic hormone (ADH)) and the acquisition of return of spontaneous circulation (ROSC) in OHCA patients. Methods. This was a prospective, observational clinical study. Patients with OHCA transferred to our hospital between July 2014 and July 2017 were enrolled. The levels of catecholamines and ADH in the plasma were measured using blood samples immediately obtained on arrival at our hospital and before the administration of Ep. Patients in whom Ep was already administered prior to obtaining blood samples were excluded. Patients were divided into two groups: with and without ROSC, that is, ROSC (+) and ROSC (−) groups, respectively. The plasma levels of these agents and the conditions of resuscitation were compared between the two groups. Results. A total of 96 patients with OHCA were analyzed. The ROSC (+) and ROSC (−) groups included 34 and 62 patients, respectively. There were no significant differences observed between the two groups in age, cause of cardiopulmonary arrest, and prehospital resuscitation time. The plasma levels of Ep and Nep were significantly lower in the ROSC (+) group than in the ROSC (−) group. However, there were no significant differences in the plasma levels of dopamine and ADH between the two groups. Conclusion. Increased levels of Ep in the plasma may not be associated with the acquisition of ROSC in patients with OHCA.

Loperamide Induced Recurrent Torsades de Pointes: A Case Report

2021 ◽  
pp. 089719002110048
Author(s):  
Gregory G. Jackson ◽  
Christine R. Lopez ◽  
Elizabeth S. Bermudez ◽  
Nina E. Hill ◽  
Dan M. Roden ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes ◽  
Altered Mental Status ◽  
Spontaneous Circulation ◽  
Prior History ◽  
Common Phenomenon ◽  
Medical Providers ◽  
Return Of Spontaneous Circulation ◽  
History Of ◽  
Overdrive Pacing

Purpose: A case of loperamide-induced recurrent torsades de pointes is reported to raise awareness of an increasingly common phenomenon that could be encountered by medical providers during the current opioid epidemic. Summary: A 40 year-old-man with a prior history of opioid abuse who presented to the emergency department after taking up to 100 tablets of loperamide 2 mg daily for 5 years to blunt opioid withdrawal symptoms and was subsequently admitted to the intensive care unit for altered mental status and hyperthermia. The patient had prolonged QTc and 2 episodes of torsades de pointes (TdP) that resulted in cardiac arrest with return of spontaneous circulation. He was managed with isoproterenol, overdrive pacing, and methylnatrexone with no other events of TdP or cardiac arrest. Conclusion: A 40-year-old male who developed torsades de pointes from loperamide overdose effectively treated with overdrive pacing, isoproterenol, and methylnatrexone.

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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