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Tag: Cardiac Arrest

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Extracorporeal Cardiopulmonary Resuscitation for Cardiac Arrest

Does extracorporeal cardiopulmonary resuscitation (eCPR) improve survival rates? This Concise Critical Appraisal reviews a study that sought to determine whether patients who received eCPR after out-of-hospital cardiac arrest had a favorable neurologic outcome at 30 days compared to those who received conventional CPR.


SCCM Pod-467 PCCM: AHA Guidelines Address Calcium During Pediatric Cardiopulmonary Arrest

The American Heart Association’s cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest; however, IV calcium is routinely used. Learn more in this discussion of “Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival—A Report From the American Heart Association’s Get With the Guidelines-Resuscitation (GWTG-R) Registry."


SCCM Pod-465 PCCM: Who’s Got the Right Dose?

Pediatric advanced life support (PALS) guidelines include weight-based epinephrine dosing recommendations of 0.01 mg/kg with a maximum of 1 mg, which corresponds to a weight of 100 kg. But what are the actual practice patterns? This podcast discusses the Pediatric Critical Care Medicine article “Weight-Based Versus Flat Dosing of Epinephrine During Cardiac Arrest in the PICU: A Multicenter Survey.”


Concise Critical Appraisal: Impact of a Machine Learning Early Warning Score on Hospital Mortality

Common causes of death in hospitals, such as sepsis and respiratory failure, are treatable and benefit from early intervention. Machine learning algorithms or early warning scores can be used for early identification and recognition to potentially help accelerate interventions and limit morbidity and mortality. This Concise Critical Appraisal explores an article published in Critical Care Medicine that looked at the impact of one of these early warning scores—electronic cardiac arrest risk triage (eCART)—on mortality for elevated-risk adult inpatients.


SCCM Pod-430 Optimal Bundle of Management for Cardiac Arrest

Sudden cardiac arrest remains a leading cause of premature death worldwide and survival with favorable neurologic function is less than 10%. Review a practical, attainable roadmap for enhancing the likelihood of neurologically intact survival in this podcast.


Concise Critical Appraisal: Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest

Although several trials have examined in-hospital cardiac arrest (IHCA), only two trials in the past decade have examined the use of vasopressin and glucocorticoids for IHCA. Both trials found improved survival and favorable neurologic outcome with a vasopressin-epinephrine-methylprednisolone combination. Because of a lack of additional supporting evidence, neither the American nor European international guidelines have recommended this combination for IHCA. This Concise Critical Appraisal examines an article by Andersen et al that attempted to validate the results of these trials.
 


Concise Critical Appraisal: Epinephrine Dosing Intervals on Outcomes From Pediatric In-Hospital Cardiac Arrest

The average annual incidence of pediatric in-hospital cardiac arrest (IHCA) has recently been estimated at more than 15,000 cases.1 Survival rates for pediatric patients who have had pulseless cardiac arrest have remained below 50% for the past decade.2,3 The American Heart Association currently recommends epinephrine, the cornerstone medication for cardiac arrest, dosed every 3 to 5 minutes in adult and pediatric cardiac arrest, although there is conflicting evidence about whether this is the best interval.4,5 Epinephrine is believed to acutely increase coronary perfusion pressure by increasing diastolic blood pressure (DBP).


Concise Critical Appraisal: ARREST Trial: ECMO Versus Advanced Cardiac Life Support

The ARREST Trial compared extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation to advanced cardiac life support (ACLS) treatment in patients with out-of-hospital cardiac arrest (OHCA). This month’s Concise Critical Appraisal takes a deep dive into the trial, published in The Lancet.


Concise Critical Appraisal: Moderate Therapeutic Hypothermia in Patients with Nonshockable Rhythms

Lascarrou et al (N Engl J Med. 2019. Epub ahead of print) set out to test the effectiveness of moderate therapeutic hypothermia (MTH) in patients with nonshockable rhythms.
 


Concise Critical Appraisal: Cardiac Arrest in the ICU: An Assessment of Preventability

Moskowitz et al (Resuscitation. 2019. Epub ahead of print) set out to investigate the preventability of ICU-CAs and identify targets for future intervention.


Concise Critical Appraisal: Epinephrine in Out-of-Hospital Cardiac Arrest

Perkins et al (N Engl J Med. 2018;379:711-721) set out to examine the effects of epinephrine during OHCA.


Concise Critical Appraisal: Ultra-Low Tidal Volume Ventilation During CPR

Ruemmler et al (Resuscitation. 2018;132:56-62) set out to compare intermittent positive pressure ventilation to passive oxygenation (continuous positive airway pressure) and a novel ultra-low tidal volume ventilation (ULTVV) regimen.