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Evaluation of Out-of-Hospital Cardiac Arrest using Transesophageal Echocardiography in the Emergency Department.

Resuscitation 2019 Feb 16. Epub 2019 Feb 16.

Department of Emergency Medicine, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA; Center for Resuscitation Science, University of Pennsylvania School of Medicine, University of Pennsylvania Blockley Hall, 423 Guardian Drive, Room 414A, Philadelphia, PA 19104, USA.

Background: Transesophageal echocardiography (TEE) has been proposed as a modality to assess patients in the setting of cardiac arrest, both during resuscitation care and following return of spontaneous circulation (ROSC). In this study we aimed to assess the feasibility and clinical impact of TEE during the Emergency Department (ED) evaluation during out-of-hospital cardiac arrest (OHCA).

Materials And Methods: We conducted a prospective observational study consisting of a convenience sample of adult patients presenting to the ED of an urban university medical center with non-traumatic OHCA. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.02.013DOI Listing
February 2019

Hemodynamic-Directed Cardiopulmonary Resuscitation Improves Neurologic Outcomes and Mitochondrial Function in the Heart and Brain.

Crit Care Med 2019 Mar;47(3):e241-e249

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Objectives: Less than half of the thousands of children who suffer in-hospital cardiac arrests annually survive, and neurologic injury is common among survivors. Hemodynamic-directed cardiopulmonary resuscitation improves short-term survival, but its impact on longer term survival and mitochondrial respiration-a potential neurotherapeutic target-remains unknown. The primary objectives of this study were to compare rates of 24-hour survival with favorable neurologic outcome after cardiac arrest treated with hemodynamic-directed cardiopulmonary resuscitation versus standard depth-guided cardiopulmonary resuscitation and to compare brain and heart mitochondrial respiration between groups 24 hours after resuscitation. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003620DOI Listing

Public Perceptions on Why Women Receive Less Bystander Cardiopulmonary Resuscitation Than Men in Out-of-Hospital Cardiac Arrest.

Circulation 2019 Feb;139(8):1060-1068

Center for Women's Health Research (S.M.P., C.K., S.L.D.), Department of Medicine, University of Colorado School of Medicine, Aurora.

Background: Women who suffer an out-of-hospital cardiac arrest receive bystander cardiopulmonary resuscitation (CPR) less often than men. Understanding public perceptions of why this occurs is a necessary first step toward equitable application of this potentially life-saving intervention.

Methods: We conducted a national survey of members of the public using Mechanical Turk, Amazon's crowdsourcing platform, to determine reasons why women might receive bystander CPR less often than men. Read More

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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.037692DOI Listing
February 2019

Teaching Hands-Only CPR in Schools: A Program Evaluation in San José, Costa Rica.

Ann Glob Health 2018 Nov 5;84(4):612-617. Epub 2018 Nov 5.

University of Colorado, Department of Emergency Medicine.

Background: Hands-only bystander CPR increases survival from out-of-hospital cardiac arrest. Video-based CPR instruction in schools has been proposed as a means to mass-educate laypersons in Hands-only CPR™ (HOCPR), in developed as well as developing countries.

Objectives: The purpose of this study is to determine whether a brief video- and mannequin-based instructional program, developed by the American Heart Association (AHA), is an effective strategy for teaching Costa Rican middle- and high-school age children to learn the steps of HOCPR. Read More

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http://dx.doi.org/10.9204/aogh.2367DOI Listing
November 2018

Targeting relatives: Impact of a cardiac rehabilitation programme including basic life support training on their skills and attitudes.

Eur J Prev Cardiol 2019 Feb 19:2047487319830190. Epub 2019 Feb 19.

2 Institute of Health Research of Santiago (IDIS), Santiago de Compostela, Spain.

Background: Training families of patients at risk for sudden cardiac death in basic life support (BLS) has been recommended, but remains challenging. This research aimed to determine the impact of embedding resuscitation training for patients in a cardiac rehabilitation programme on relatives' BLS skill retention at six months.

Design: Intervention community study. Read More

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http://dx.doi.org/10.1177/2047487319830190DOI Listing
February 2019

Rhein shows potent efficacy against non-small-cell lung cancer through inhibiting the STAT3 pathway.

Cancer Manag Res 2019 1;11:1167-1176. Epub 2019 Feb 1.

Department of Respiratory Medicine, Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, People's Republic of China,

Background: Non-small-cell lung cancer (NSCLC) comprises about 85% of all lung cancers and is usually diagnosed at an advanced stage with poor prognosis. The IL-6/STAT3 signaling pathway plays a pivotal role in NSCLC biology. Rhein is a lipophilic anthraquinone extensively found in medicinal herbs. Read More

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February 2019

Association Between Body Mass Index and Mortality in Patients Requiring Cardiac Critical Care.

Circ J 2019 Feb 16. Epub 2019 Feb 16.

Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine.

Background: Data on the association between obesity and mortality in patients who require acute cardiac care are limited, so we investigated the effect of obesity on clinical outcomes in patients admitted to the cardiac intensive care unit (CICU). Methods and Results: We reviewed 2,429 eligible patients admitted to the CICU at Samsung Medical Center between January 2012 and December 2015. After excluding 197 patients with low body mass index (BMI) to adjust for the possibility of frailty, patients were divided into 3 categories: normal BMI (n=822), 18. Read More

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http://dx.doi.org/10.1253/circj.CJ-18-0873DOI Listing
February 2019

Unilateral Versus Bilateral Antegrade Cerebral Perfusion: A Meta-Analysis of Comparative Studies.

Heart Lung Circ 2019 Feb 3. Epub 2019 Feb 3.

The Collaborative Research (CORE) Group International, Macquarie University, Sydney, NSW, Australia; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Background: Antegrade cerebral perfusion (ACP) is an essential adjunct for prolonged hypothermic circulatory arrest (HCA) during aortic arch surgery. However, it has yet to be established whether ACP should be delivered unilaterally or bilaterally. The aim of the present meta-analysis is to investigate outcomes of unilateral ACP (uACP) compared to bilateral ACP (bACP) in comparative studies. Read More

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http://dx.doi.org/10.1016/j.hlc.2019.01.010DOI Listing
February 2019

Guideline removal of atropine and survival after adult in-hospital cardiac arrest with a non-shockable rhythm.

Resuscitation 2019 Feb 13. Epub 2019 Feb 13.

Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus Universitsy Hospital, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Aim: To determine whether the removal of atropine from the 2010 ACLS guidelines for non-shockable cardiac arrests was associated with a change in survival.

Methods: Using the Get With The Guidelines®-Resuscitation registry, we included adults with an index in-hospital cardiac arrest between 2006 and 2015. The primary outcome was survival to hospital discharge. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.02.002DOI Listing
February 2019

Clinical characteristics and outcomes of witnessed hypothermic cardiac arrest: a systematic review on rescue collapse.

Resuscitation 2019 Feb 13. Epub 2019 Feb 13.

Emergency Department, Lausanne University Hospital, Lausanne, Switzerland. Electronic address:

Aims: Cardiac arrest related to accidental hypothermia may occur at temperatures below 32 °C. Our goal was to describe the clinical characteristics and outcomes of patients who suffered from witnessed hypothermic cardiac arrest (CA) and assess the occurrence of hypothermic CA as a function of patient body temperature.

Methods: We conducted a systematic review of the literature on cases of hypothermic CA due to rescue collapse. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.02.001DOI Listing
February 2019

Risk of cardiac arrhythmias after electrical accident: a single-center study of 480 patients.

Clin Res Cardiol 2019 Feb 15. Epub 2019 Feb 15.

Semmelweis University Heart and Vascular Centre, Városmajor u. 68, Budapest, 1122, Hungary.

Objective: Patients with electrical injury are considered to be at high risk of cardiac arrhythmias. Due to the small number of studies, there is no widely accepted guideline regarding the risk assessment and management of arrhythmic complications after electrical accident (EA). Our retrospective observational study was designed to determine the prevalence of ECG abnormalities and cardiac arrhythmias after EA, to evaluate the predictive value of cardiac biomarkers for this condition and to assess in-hospital and 30-day mortality. Read More

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http://dx.doi.org/10.1007/s00392-019-01420-2DOI Listing
February 2019

Recurrent myocardial infarction in a 50-year-old woman.

Heart 2019 Feb 14. Epub 2019 Feb 14.

University Hospital Hairmyres, East Kilbridge, UK.

CLINICAL INTRODUCTION: A 50-year-old woman presented with an inferoposterior ST-elevation myocardial infarction (STEMI) and underwent emergency percutaneous coronary intervention (PCI). Angiography revealed acute occlusion of the circumflex and right coronary (RCA) arteries. PCI was uncomplicated. Read More

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http://heart.bmj.com/lookup/doi/10.1136/heartjnl-2018-314114
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http://dx.doi.org/10.1136/heartjnl-2018-314114DOI Listing
February 2019
1 Read

Syncope after administration of epidural analgesia in an obstetric patient with a vagus nerve stimulator.

Authors:
J E Tang J B Hyman

Int J Obstet Anesth 2019 Jan 6. Epub 2019 Jan 6.

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box 1010, New York, NY 10029, United States. Electronic address:

Vagus nerve stimulation (VNS) is an adjunctive therapy for medically refractory epilepsy and depression. Vagus nerve stimulation is generally well-tolerated, but cardiac arrhythmias or asystole are rare complications that have been reported. This case report describes an obstetric patient who received epidural analgesia and subsequently experienced two episodes of syncope synchronous with stimulation from her VNS device. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.011DOI Listing
January 2019

Venoarterial ECMO for Adults: JACC Scientific Expert Panel.

J Am Coll Cardiol 2019 Feb;73(6):698-716

Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.

Venoarterial extracorporeal membrane oxygenation (ECMO) is a rescue therapy that can stabilize patients with hemodynamic compromise, with or without respiratory failure, for days or weeks. In cardiology, the main indications for ECMO include cardiac arrest, cardiogenic shock, post-cardiotomy shock, refractory ventricular tachycardia, and acute management of complications of invasive procedures. The fundamental premise underlying ECMO is that it is a bridge-to recovery, to a more durable bridge, to definitive treatment, or to decision. Read More

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http://dx.doi.org/10.1016/j.jacc.2018.11.038DOI Listing
February 2019

Exercise Testing Oversights Underlie Missed and Delayed Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia in Young Sudden Cardiac Arrest Survivors.

Heart Rhythm 2019 Feb 11. Epub 2019 Feb 11.

Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN. Electronic address:

Background: Catecholamingergic polymorphic ventricular tachycardia (CPVT) is characterized by adrenergically-induced VT, syncope, and sudden cardiac arrest (SCA). In the absence of structural disease, exercise-provoked premature ventricular contractions in bigeminy/couplets and non-sustained VT are highly predictive of CPVT.

Objective: To determine the number of missed/delayed CPVT diagnoses attributable to exercise testing oversights in a cohort of young SCA survivors. Read More

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http://dx.doi.org/10.1016/j.hrthm.2019.02.012DOI Listing
February 2019

The Evolving Role of the Cardiac Catheterization Laboratory in the Management of Patients With Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association.

Circulation 2019 Feb 14:CIR0000000000000630. Epub 2019 Feb 14.

Coronary artery disease is prevalent in different causes of out-of-hospital cardiac arrest (OHCA), especially in individuals presenting with shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). The purpose of this report is to review the known prevalence and potential importance of coronary artery disease in patients with OHCA and to describe the emerging paradigm of treatment with advanced perfusion/reperfusion techniques and their potential benefits on the basis of available evidence. Although randomized clinical trials are planned or ongoing, current scientific evidence rests principally on observational case series with their potential confounding selection bias. Read More

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https://www.ahajournals.org/doi/10.1161/CIR.0000000000000630
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http://dx.doi.org/10.1161/CIR.0000000000000630DOI Listing
February 2019
2 Reads

Left ventricular mechanical dispersion predicts arrhythmic risk in mitral valve prolapse.

Heart 2019 Feb 12. Epub 2019 Feb 12.

Division of Cardiovascular Medicine, University of California, San Francisco, San Francisco, California, USA.

Objective: Bileaflet mitral valve prolapse (MVP) with either focal or diffuse myocardial fibrosis has been linked to ventricular arrhythmia and/or sudden cardiac arrest. Left ventricular (LV) mechanical dispersion by speckle-tracking echocardiography (STE) is a measure of heterogeneity of ventricular contraction previously associated with myocardial fibrosis. The aim of this study is to determine whether mechanical dispersion can identify MVP at higher arrhythmic risk. Read More

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http://dx.doi.org/10.1136/heartjnl-2018-314269DOI Listing
February 2019
1 Read

Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery: Evidence from the Canadian Thoracic Aortic Collaborative.

Circulation 2019 Feb 13. Epub 2019 Feb 13.

Surgery, London Health Sciences Center, Canada.

Background: Contemporary outcomes following surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood.

Methods: A total of 1653 patients (498 (30.1%) female) underwent thoracic aortic surgery with hypothermic circulatory arrest between 2002 and 2017 in ten institutions of the Canadian Thoracic Aortic Collaborative. Read More

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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035805DOI Listing
February 2019
1 Read

Outcomes After Extracorporeal Cardiopulmonary Resuscitation of Pediatric In-Hospital Cardiac Arrest: A Report From the Get With the Guidelines-Resuscitation and the Extracorporeal Life Support Organization Registries.

Crit Care Med 2019 Feb 8. Epub 2019 Feb 8.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Objectives: The aim of this study was to determine cardiac arrest- and extracorporeal membrane oxygenation-related risk factors associated with unfavorable outcomes after extracorporeal cardiopulmonary resuscitation.

Design: We performed an analysis of merged data from the Extracorporeal Life Support Organization and the American Heart Association Get With the Guidelines-Resuscitation registries.

Setting: A total of 32 hospitals reporting to both registries between 2000 and 2014. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003622DOI Listing
February 2019
1 Read

Outcome of pediatric cardiac surgery and predictors of major complication in a developing country.

Ann Pediatr Cardiol 2019 Jan-Apr;12(1):38-44

Integrated Cardiac Centre, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Background: Evaluating outcome and identifying predictors of major complications among children undergoing cardiac surgery are essential to improve care. We evaluated short-term outcomes of postcardiac surgery and predictors of major complications in a national referral hospital in Indonesia.

Methods: A prospective cohort study was conducted from April 2014 to March 2015 on all children undergoing cardiac surgery. Read More

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http://dx.doi.org/10.4103/apc.APC_146_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343386PMC
February 2019
1 Read

Pulseless Electric Activity with Pre-Excitation.

Int Heart J 2019 Feb 8. Epub 2019 Feb 8.

Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.

A 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test revealed the existence of inducible atrial fibrillation and a fasciculoventricular accessory pathway (FVAP). Read More

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http://dx.doi.org/10.1536/ihj.18-546DOI Listing
February 2019
1 Read

Neonatal Cerebral Air Embolism.

Indian Pediatr 2018 Dec;55(12):1089-1090

Department of Neonatalogy, Surya Children Medicare, Mumbai, India.

Background: Vascular air embolism (VAE) is rare but potentially lethal condition, and survival is rarely reported in newborn.

Characteristics: A preterm (27+1 weeks) neonate on Continuous positive airway pressure developed sudden cardiac asystole on day 3 of life and required 30 minutes of cardiopulmonary resuscitation.

Observation: Infant had air embolism in liver and brain. Read More

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December 2018
1 Read

Severe cardiovascular morbidity in women with hypertensive diseases during delivery hospitalization.

Am J Obstet Gynecol 2019 Feb 8. Epub 2019 Feb 8.

New Haven CT, Yale School of Medicine.

Background: Cardiovascular disease (CVD) is the leading cause of pregnancy-related death in the United States. (1) Identification of short-term indicators of cardiovascular morbidity has the potential to alter the course of this devastating disease among women. It has been established that hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease 10-30 years after delivery; however, little is known about the association of hypertensive disorders of pregnancy with cardiovascular (CV) morbidity during the delivery hospitalization. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.010DOI Listing
February 2019
1 Read

Relationship between the albumin level and the anesthesia method and the effect on clinical course in patients with major burns.

Ulus Travma Acil Cerrahi Derg 2019 Jan;25(1):55-59

Department of Anesthesiology and Reanimation, Health Sciences University Ankara Numune Training and Research Hospital, Ankara-Turkey.

Background: Due to a massive increase in capillary permeability during the state of shock caused by burns, albumin and intravascular fluid rapidly move to the extravascular areas. Therefore, hypoalbuminemia is seen as an early and prolonged finding in major burns. Hypoalbuminemia leads to various problems. Read More

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http://dx.doi.org/10.5505/tjtes.2018.71278DOI Listing
January 2019
1 Read

Personalized physiology-guided resuscitation in highly monitored patients with cardiac arrest-the PERSEUS resuscitation protocol.

Heart Fail Rev 2019 Feb 11. Epub 2019 Feb 11.

School of Medicine, European University Cyprus, Nicosia, Cyprus.

Resuscitation guidelines remain uniform across all cardiac arrest patients, focusing on the delivery of chest compressions to a standardized rate and depth and algorithmic vasopressor dosing. However, individualizing resuscitation to the appropriate hemodynamic and ventilatory goals rather than a standard "one-size-fits-all" treatment seems a promising new therapeutic strategy. In this article, we present a new physiology-guided treatment strategy to titrate the resuscitation efforts to patient's physiologic response after cardiac arrest. Read More

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http://dx.doi.org/10.1007/s10741-019-09772-7DOI Listing
February 2019
1 Read

Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial.

Am Heart J 2018 Dec 14;210:58-68. Epub 2018 Dec 14.

Department of Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands; NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. Read More

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http://dx.doi.org/10.1016/j.ahj.2018.12.008DOI Listing
December 2018
1 Read

[Sudden cardiac arrests in years 2013-2016 within operation area of siedlce emergency ambulance service].

Wiad Lek 2018 ;71(9):1729-1737

Zakład Ratownictwa Medycznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska.

Objective: Introduction: SCA is an unexpected, and potentially of reversible effect, in which occurs a cessation of hemodynamically heart beat as a pump, and cessation of cardiovascular circulation.

Patients And Methods: Materials and methods: Our analysis is based on 1032 SCA occurrences where cardiopulmonary resuscitation have been applied. The analysis covers operating region of Siedlce Emergency Medical Services in years 2013-2016. Read More

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January 2018
1 Read

Bradycardia During Laparoscopic Surgeries: A Retrospective Cohort Study.

World J Surg 2019 Feb 8. Epub 2019 Feb 8.

Division of Anesthesiology and Intensive Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel.

Background: A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited.

Methods: Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, between June 2008 and August 2013 at a tertiary, academic medical center, were screened for intraoperative bradycardia (heart rate <50 beats/min for at least three consecutive measures). Read More

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http://dx.doi.org/10.1007/s00268-019-04935-xDOI Listing
February 2019

Phosphorylation-Dependent Intra-Domain Interaction of the Cx37 Carboxyl-Terminus Controls Cell Survival.

Cancers (Basel) 2019 Feb 6;11(2). Epub 2019 Feb 6.

Department of Physiology, University of Arizona, Tucson, AZ 85724, USA.

Differential phosphorylation of the carboxyl-terminus of connexin 37 (Cx37-CT) regulates phenotypic switching between cell growth phenotypes (cell death, cell cycle arrest, proliferation). The specific phosphorylation events in the Cx37-CT that are necessary for these growth regulatory effects are currently unknown. Through the combined use of deletion and site specific (de)phospho-mimetic Cx37-CT mutants, our data suggest a phosphorylation-dependent interaction between the mid-tail (aa 273⁻317) and end-tail (aa 318⁻333) portions of the Cx37-CT that regulates cell survival. Read More

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http://dx.doi.org/10.3390/cancers11020188DOI Listing
February 2019
1 Read

'External Plication of the Atrialised Right Ventricle in the Repair of Ebstein's Anomaly'.

Semin Thorac Cardiovasc Surg 2019 Feb 5. Epub 2019 Feb 5.

Department of Pediatrics, Artemis Hospital, Delhi, India.

We describe a change in our technique for plication of the atrialised right ventricle during a Cone repair. The plication was performed from the 'Outside' -on a beating heart. Advantages that we expect are- all major coronaries are better seen when full of blood and can be avoided, if a major vessel is compromised - EKG changes should point it out immediately, there is a small but significant saving in terms of arrest time and if the plication needs to be taken down because of an adverse coronary event- this can be done without the need of another cardioplegia. Read More

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http://dx.doi.org/10.1053/j.semtcvs.2019.02.004DOI Listing
February 2019
1 Read

New 5-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Medical University of South Carolina Department of Orthopaedics 96 Jonathan Lucas Dr CSB 708 Charleston, SC 29425.

Introduction: While the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients aged 60 years and older who underwent surgical management for hip fractures between 2005-2016. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001455DOI Listing
January 2019
1 Read

Accuracy of risk prediction scores in pregnant women with congenital heart disease.

Congenit Heart Dis 2019 Feb 6. Epub 2019 Feb 6.

Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine Philadelphia, Pennsylvania.

Objective: To assess performance of risk stratification schemes in predicting adverse cardiac outcomes in pregnant women with congenital heart disease (CHD) and to compare these schemes to clinical factors alone.

Design: Single-center retrospective study.

Setting: Tertiary care academic hospital. Read More

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http://dx.doi.org/10.1111/chd.12750DOI Listing
February 2019
2 Reads

Extensive unroofing of myocardial bridge: A case report and literature review.

SAGE Open Med Case Rep 2019 16;7:2050313X18823380. Epub 2019 Jan 16.

Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: Myocardial bridge is defined as a segment of a coronary artery that takes an intramyocardial course. The presence of myocardial bridge has been observed in as many as 40%-80% of cases on autopsy, angiographically from 0.5% to 16. Read More

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http://dx.doi.org/10.1177/2050313X18823380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349980PMC
January 2019
1 Read

Cost-utility of extracorporeal cardiopulmonary resuscitation in patients with cardiac arrest.

Resuscitation 2019 Feb 1;136:126-130. Epub 2019 Feb 1.

Department of Medicine, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL, 60637, United States.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is a resource-intensive tool that provides haemodynamic and respiratory support in patients who have suffered cardiac arrest. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution.

Methods: We performed a retrospective review of patients who received ECPR following cardiac arrest between 2012 and 2018. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.01.027DOI Listing
February 2019
4 Reads

Takotsubo cardiomyopathy secondary to non-accidental trauma presenting as an "unwitnessed" arrest.

Cardiol Young 2019 Feb 4:1-3. Epub 2019 Feb 4.

Riley Hospital for Children,Pediatric Cardiology,Indianapolis,IN,USA.

Takotsubo cardiomyopathy is characterised by akinesis and ballooning of the left ventricular apex during contraction of the otherwise normal base of the heart. We describe the case of a 7-month-old previously healthy female who presented with an unwitnessed cardiac arrest. Workup raised suspicion for non-accidental trauma. Read More

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http://dx.doi.org/10.1017/S1047951118002366DOI Listing
February 2019
1 Read

Recent achievements and future developments in neonatal cardiopulmonary bypass.

Authors:
Mirela Bojan

Paediatr Anaesth 2019 Feb 3. Epub 2019 Feb 3.

Department of Anaesthesia, Congenital Cardiac Unit, Marie Lannelongue Hospital, 133 Avenue de la Resistance, 92350, Le Plessis-Robinson.

A primary goal of improving neonatal cardiopulmonary bypass has been making the circuit smaller and reduce the blood contacting surfaces. As bypass circuit size has decreased, bloodless surgery has become possible even in neonates. Since transfusion guidelines are difficult to construct based on existing literature, these technical advances should be taken advantage of in conjunction with an individualized transfusion scheme, based on monitoring of oxygen availability to the tissues. Read More

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http://dx.doi.org/10.1111/pan.13597DOI Listing
February 2019
1 Read

Raising the Dead: Mitochondrial Cardiolipin as a Key Target for Post-Cardiac Arrest Resuscitation, Ischaemia-Reperfusion Injury and Cardiomyopathy.

Authors:
Salvatore Pepe

Heart Lung Circ 2019 Mar;28(3):360-363

Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S14439506193000
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http://dx.doi.org/10.1016/j.hlc.2019.01.004DOI Listing
March 2019
5 Reads

Reasons for death in patients successfully resuscitated from out-of-hospital and in-hospital cardiac arrest.

Resuscitation 2019 Jan 30;136:93-99. Epub 2019 Jan 30.

Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:

Introduction: There is no standard for categorizing reasons for death in those who achieve return of spontaneous circulation (ROSC) after cardiac arrest but die before hospital discharge. Categorization is important for comparing outcomes across studies, assessing benefits of interventions, and developing quality-improvement initiatives. We developed and tested a method for categorizing reasons for death after cardiac arrest in both in-hospital (IHCA) and out-of-hospital (OHCA) arrests. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.01.031DOI Listing
January 2019
2 Reads

Commentary to "A 44-year old female with familial Mediterranean fever, cardiomyopathy, and end stage renal disease" by Magaki et al.

Brain Pathol 2019 Feb 1. Epub 2019 Feb 1.

Pathology, Tenon Hospital, Paris, France.

We would like to comment on the "Case of the Month" by Magaki et al, entitled "A 44-year old female with familial Mediterranean fever, cardiomyopathy, and end stage renal disease" (3). In this case report, the authors describe the autopsy findings in a patient with systemic AA amyloidosis secondary to familial Mediterranean fever. The patient also had cardiomyopathy with severely reduced left ventricular ejection and death due to cardiac arrest; however, no details about cardiovascular risk factors, cardiac pre-mortem explorations, and heart gross examination were provided. Read More

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http://dx.doi.org/10.1111/bpa.12712DOI Listing
February 2019
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Risk associated with anesthesia for non-cardiac surgery in children with congenital heart disease.

Paediatr Anaesth 2019 Feb 1. Epub 2019 Feb 1.

Department of Anaesthesiology, Pharmacology and Intensive Care, Paediatric Anaesthesia Unit, University Hospitals of Geneva, Geneva, Switzerland.

Database analysis has proved that peri-operative cardiac arrest occurs with increased frequency in children with congenital heart disease. Several case series and bigger data from ACS NSQIP, have elucidated subgroups at the highest risk. Consistently patients with single ventricle physiology (especially prior to cavo-pulmonary anastomosis), severe/supra-systemic pulmonary hypertension, complex lesions and cardiomyopathy with significantly reduced ventricular function have been shown to be of the greatest concern. Read More

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http://dx.doi.org/10.1111/pan.13595DOI Listing
February 2019
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Analyzing the Effectiveness of Different Forms of Cardiopulmonary Resuscitation.

Authors:
Steven J Holcomb

J Emerg Med 2019 Jan 29. Epub 2019 Jan 29.

Massachusetts Institute of Technology, Cambridge, Massachusetts.

Background: In order to simulate a heartbeat in a cardiac arrest patient, cardiopulmonary resuscitation (CPR) requires that chest compressions be delivered with a force of at least 560 N at a rate >100 compressions/min. Many new learners initially use CPR forms that may not meet these parameters sufficiently. We examined three forms of CPR: the form recommended by the American Heart Association (AHA) and two forms that are common among new learners but that are considered incorrect, using a CPR manikin placed on a force plate. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.12.041DOI Listing
January 2019
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The effect of intravenous adrenaline on electrocardiographic changes during resuscitation in patients with initial pulseless electrical activity in out of hospital cardiac arrest.

Resuscitation 2019 Jan 29;136:119-125. Epub 2019 Jan 29.

Department of Circulation and Medical Imaging, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; St Olavs Hospital, Trondheim University Hospital, Department of Emergency Medicine and Pre-Hospital Services, Trondheim, Norway.

Introduction: Presence of electrocardiographic rhythm in the absence of palpable pulses defines pulseless electrical activity (PEA) and the electrocardiogram (ECG) may provide a source of information during resuscitation. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-hospital cardiac arrest (OHCA) with initial PEA, and to explore the potential effects of adrenaline on these characteristics.

Methods: Patients with OHCA and initial PEA, part of randomized controlled trial of ALS with or without intravenous access and medications, were included. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.01.021DOI Listing
January 2019
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Survival to hospital discharge with biphasic fixed 360 joules versus 200 escalating to 360 joules defibrillation strategies in out-of-hospital cardiac arrest of presumed cardiac etiology.

Resuscitation 2019 Jan 29;136:112-118. Epub 2019 Jan 29.

Norwegian National Advisory Unit on Prehospital Emergency Medicine, Oslo University Hospital, Oslo, Norway. Electronic address:

Introduction: Guidelines recommend constant or escalating energy levels for shocks after the initial defibrillation attempt. Studies comparing survival to hospital discharge with escalating vs fixed high energy level shocks are lacking. We compared survival to hospital discharge for 200 J escalating to 360 J vs fixed 360 J in patients with initial ventricular fibrillation/pulseless ventricular tachycardia in a post-hoc analysis of the Circulation Improving Resuscitation Care trial database. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.01.020DOI Listing
January 2019
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[Effect analysis of abdominal compression-decompression device in patients with cardiopulmonary resuscitation in pre-hospital first aid].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Jan;31(1):115-117

Department of Neurosurgery, Baiyin Central Hospital, Baiyin 730913, Gansu, China. Corresponding author: Wang Yonghong, Email:

Objective: To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest.

Methods: Forty-five patients with respiratory and cardiac arrest, and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled, and they were divided into two groups according to random number table. AACD-CPR (abdominal compression-decompression group, n = 24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group, n = 21) were performed respectively. Read More

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2019.01.023DOI Listing
January 2019
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[Comparison of differences in cardiac functions of cardiac arrest model rats induced by asphyxia and trans-oesophageal pacing].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Jan;31(1):50-54

Department of Critical Care Medicine, People's Hospital of Wuhan University, Wuhan 430060, Hubei, China. Corresponding author: Yu Zhui, Email:

Objective: To compare the differences in cardiac functions and myocardial injury between asphyxia and trans-oesophageal pacing induced rat cardiac arrest models.

Methods: Healthy adult male Sprague-Dawley (SD) rats were randomly divided into sham group, asphyxia group and electrical stimulation group by random number table. The rats in the latter two groups were randomly divided into two subgroups (24 hours and 72 hours) according to the sampling time after successful resuscitation, with 6 rats in each group. Read More

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2019.01.011DOI Listing
January 2019
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Delays in Cardiopulmonary Resuscitation, Defibrillation, and Epinephrine Administration All Decrease Survival in In-hospital Cardiac Arrest.

Anesthesiology 2019 Mar;130(3):414-422

From the Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (N.G.B., Y.X.) Saint Luke's Mid America Heart Institute, Kansas City, Missouri (P.S.C.) the University of Missouri, Kansas City, Missouri (P.S.C.). Albert Einstein College of Medicine, New York, New York University of Texas at Arlington, Arlington, Texas Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Parkland Health and Hospital System, Dallas, Texas Johns Hopkins Medicine Simulation Center, Baltimore, Maryland University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Virginia Commonwealth University Health System, Richmond, Virginia Virginia Commonwealth University Health System, Richmond, Virginia New York University School of Medicine, New York, New York University of Washington, Seattle, Washington University of Washington, Seattle, Washington Institute for Healthcare Improvement, Boston, Massachusetts Research Triangle Institute International, Research, Triangle Park, North Carolina University of Colorado, Aurora, Colorado Lucile Packard Children's Hospital at Stanford, Palo Alto, California Beth Israel Deaconess Medical Center, Boston, Massachusetts American Heart Association, Dallas, Texas American Heart Association, Dallas, Texas American Heart Association, Dallas, Texas Baystate Medical Center/Tufts University School of Medicine, Springfield, Massachusetts University of Arizona Medical Center, Tucson, Arizona Johns Hopkins School of Medicine, Baltimore, Maryland.

What We Already Know About This Topic: Rapid response to witnessed, pulseless cardiac arrest is associated with increased survival.

What This Article Tells Us That Is New: Assessment of witnessed, pulseless cardiac arrests occurring at 538 hospitals during a 9-yr period indicates that CPR did not occur immediately at 0 min in 5.7% of patients despite guidelines for instantaneous initiation. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002563DOI Listing
March 2019
2 Reads