959 results match your criteria Pulseless Electrical Activity


Outcomes for in-hospital cardiac arrest for COVID-19 patients at a rural hospital in Southern California.

Am J Emerg Med 2021 Apr 27;47:244-247. Epub 2021 Apr 27.

Department of Emergency Medicine, University of California, San Diego, CA, United States of America; Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, United States of America.

Background: In-hospital cardiac arrest (IHCA) carries a high mortality and providing resuscitation to COVID-19 patients presents additional challenges for emergency physicians. Our objective was to describe outcomes of COVID-19 patients suffering IHCA at a rural hospital in Southern California.

Methods: Single-center retrospective observational study. Read More

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Effect of Amiodarone and Hypothermia on Arrhythmia Substrates During Resuscitation.

J Am Heart Assoc 2021 May 3:e016676. Epub 2021 May 3.

Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH.

Background Amiodarone is administered during resuscitation, but its antiarrhythmic effects during targeted temperature management are unknown. The purpose of this study was to determine the effect of both therapeutic hypothermia and amiodarone on arrhythmia substrates during resuscitation from cardiac arrest. Methods and Results We utilized 2 complementary models: (1) In vitro no-flow global ischemia canine left ventricular transmural wedge preparation. Read More

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Cardiac Arrest Upon Induction of General Anesthesia.

Anesth Prog 2021 03;68(1):38-44

Division of Oral and Maxillofacial Surgery and Dental Anesthesiology, The Ohio State University, Columbus, Ohio.

There are numerous causes of cardiac arrest in the perioperative period, including hypoxia, hypovolemia, and vagal response to medications or procedures during routine anesthetics. Initiation of adequate cardiopulmonary resuscitation, administration of epinephrine, and application of a defibrillator, with shocking when applicable, are all essential steps in achieving return of spontaneous circulation. Knowledge and utilization of monitoring equipment can alert the provider to problems leading to cardiac arrest as well as ensure proper resuscitative efforts during the event. Read More

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Tracheobronchial Obstruction Due to Blood Clots in Acute Pulmonary Embolism with Cardiac Arrest Managed with Extracorporeal Membrane Oxygenation.

Intern Med 2021 Mar 15. Epub 2021 Mar 15.

Department of Cardiology, Fujieda Municipal General Hospital, Japan.

A 66-year-old Japanese woman developed pulseless electrical activity following an acute pulmonary embolism and was treated with thrombolytic therapy. She remained hemodynamically unstable and therefore underwent extracorporeal membrane oxygenation (ECMO). While receiving treatment with ECMO, blood clots induced by endobronchial hemorrhage caused tracheobronchial airway obstruction, leading to ventilatory defect. Read More

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A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients With Coronavirus Disease 2019.

Crit Care Med 2021 Mar 12. Epub 2021 Mar 12.

Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, Australia. Department of Intensive Care Medicine, Calvary Hospital, Canberra, ACT, Australia. Cambia Palliative Care Centre of Excellence, University of Washington, Seattle, WA. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Centre for Integrated Critical Care, Department of Medicine and Radiology, Melbourne Medical School, Melbourne, VIC, Australia. Division of Pulmonary and Critical Care Medicine, Mount Sinai Morningside, New York City, NY. Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Centre, Ann Arbor, MI. Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA. Division of Cardiology, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, NY. Department of Cardiology, Phoebe Putney Memorial Hospital, Albany, GA. Division of Cardiology, Department of Medicine, NYU Langone Medical Center, New York City, NY. Department of Intensive Care Medicine, Austin Hospital, Heidelberg, VIC, Australia. Department of Intensive Care Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia. School of Medicine, University of Queensland, Brisbane, QLD, Australia. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. Department of Intensive Care Medicine, Peninsula Health, Frankston, VIC, Australia. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.

Objectives: To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest. Finally, we evaluated outcomes stratified by age.

Data Sources: A systematic review of PubMed, EMBASE, and preprint websites was conducted between January 1, 2020, and December 10, 2020. Read More

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Effect of replacing ambulance physicians with paramedics on outcome of resuscitation for prehospital cardiac arrest.

Eur J Emerg Med 2021 Jun;28(3):227-232

Department of Cardiology, Landspitali-The National University Hospital of Iceland. Reykjavik, Iceland.

Introduction: Limited evidence suggests that the presence of a prehospital physician improves survival from cardiac arrest. A retrospective study is undertaken to examine this question. In Reykjavik, Iceland, prehospital physicians on ambulances were replaced by emergency medical technicians (EMTs) in 2007. Read More

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Impact of left ventricular ejection fraction and preoperative hemoglobin level on perioperative adverse cardiovascular events in noncardiac surgery.

Heart Vessels 2021 Mar 9. Epub 2021 Mar 9.

Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.

The prediction of a perioperative adverse cardiovascular event (PACE) is an important clinical issue in the medical management of patients undergoing noncardiac surgery. Although several predictors have been reported, simpler and more practical predictors of PACE have been needed. The aim of this study was to investigate the predictors of PACE in noncardiac surgery. Read More

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Association between wide QRS pulseless electrical activity and hyperkalemia in cardiac arrest patients.

Am J Emerg Med 2021 Feb 18;45:86-91. Epub 2021 Feb 18.

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

Aim: We evaluated the relationship between hyperkalemia and wide QRS complex in patients with pulseless electrical activity (PEA) cardiac arrest.

Methods: This was a single-center, retrospective observational study of patients over the age of 18 treated for cardiac arrest at a tertiary referral hospital whose initial electrocardiogram rhythm was PEA from February 2010 to December 2019. Wide QRS PEA was defined as a QRS interval of 120 ms or more. Read More

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February 2021

Emergency Thrombolysis During Cardiac Arrest Due to Pulmonary Thromboembolism: Our Experience Over 6 Years.

Open Access Emerg Med 2021 22;13:67-73. Epub 2021 Feb 22.

Department of Emergency Service, Fundación Valle del Lili, Cali, 760032, Colombia.

Introduction: Cardiac arrest (CA) is one of the leading causes of death worldwide. Among patients with CA, pulmonary embolism (PE) accounts for approximately 10% of all cases.

Objective: To compare the outcomes after cardiopulmonary-cerebral resuscitation (CCPR) with and without thrombolytic therapy (TT) in patients with CA secondary to PE. Read More

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February 2021

Return of Spontaneous Circulation Depends on Cardiac Rhythm During Neonatal Cardiac Arrest in Asphyxiated Newborn Animals.

Front Pediatr 2021 12;9:641132. Epub 2021 Feb 12.

Neonatal Research Unit, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, Canada.

Pulseless electrical activity (PEA) occurs in asphyxiated newborn piglets and infants. We aimed to examine whether different cardiac rhythms (asystole, bradycardia, PEA) affects the resuscitation outcomes during continuous chest compressions (CC) during sustained inflations (CC+SI). This study is a secondary analysis of four previous randomized controlled animal trials that compared CC+SI with different CC rate (90 or 120/min), SI duration (20 or 60 s), peak inflation pressure (10, 20, or 30 cmHO), and oxygen concentration (18, 21, or 100%). Read More

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February 2021

Extracorporeal cardiopulmonary resuscitation for the treatment of amlodipine overdose in a pediatric patient.

J Surg Case Rep 2021 Feb 16;2021(2):rjab014. Epub 2021 Feb 16.

Department of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

We present the case of a 16-year-old female with systemic lupus erythematosus who presented with shock of unclear etiology, refractory to fluid resuscitation and triple vasopressors. She suffered pulseless electrical activity and underwent cannulation onto veno-arterial extracorporeal membrane oxygenation (ECMO). After cannulation, it was discovered she had intentionally overdosed on her home medication, amlodipine, a calcium channel blocker (CCB). Read More

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February 2021

Association between cardiac rhythm conversion and neurological outcome among cardiac arrest patients with initial shockable rhythm: a nationwide prospective study in Japan.

Eur Heart J Acute Cardiovasc Care 2021 Apr;10(2):119-126

Department of Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini Hospital, 355-5 Haruobicho, Kamigyo-ku, Kyoto 602-8026, Japan.

Aims: Initial cardiac rhythm, particularly shockable rhythm, is a key factor in resuscitation for out-of-hospital cardiac arrest (OHCA) patients. The purpose of this study was to clarify the association between cardiac rhythm conversion and neurologic prognosis in OHCA patients with initial shockable rhythm at the scene.

Methods And Results: The study included adult patients with OHCA due to medical causes with pre-hospital initial shockable rhythm and who were still in cardiac arrest at hospital arrival. Read More

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Evaluation of the blue code system established in the health campus of a university hospital.

Turk J Emerg Med 2021 Jan-Mar;21(1):14-19. Epub 2020 Dec 1.

Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objective: We report the hospital outcomes after implementing the blue code system in our hospital and health campus. We also aimed to determine factors related to mortality.

Methods: This is a retrospective observational study of the patients who received cardiopulmonary resuscitation (CPR). Read More

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December 2020

A 47-Year Old Woman With Rapidly Progressive Hypoxemic Respiratory Failure.

Chest 2021 Feb;159(2):e69-e73

Division of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL.

Case Presentation: A 47-year-old Hispanic woman presented to a pulmonology clinic with 2 weeks of cough productive of white sputum and worsening dyspnea on exertion, requiring increasing supplemental oxygen. In addition, she reported fatigue, night sweats, diffuse myalgias, and extremity weakness. She denied hemoptysis, fevers, chills, weight loss, or rash. Read More

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February 2021

A case of AL amyloidosis presenting with refractory ventricular fibrillation.

Respir Med Case Rep 2021 24;32:101349. Epub 2021 Jan 24.

Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.

A 66-year-old male with recent diagnosis of heart failure with reduced ejection fraction was referred to our institution for management of cardiogenic/vasodilatory shock. During his evaluation, he suffered a sudden cardiac arrest from refractory ventricular tachycardia/fibrillation (VT/VF) despite normal electrolytes and no evidence of prior ventricular arrhythmias. He was placed on rescue peripheral veno-arterial extracorporeal membrane oxygenation support (VA-ECMO) for 4 days and was decannulated without end-organ damage. Read More

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January 2021

Outcomes of in-hospital cardiac arrest in COVID-19 patients: A proportional prevalence meta-analysis.

Catheter Cardiovasc Interv 2021 Feb 4. Epub 2021 Feb 4.

University of Massachusetts School of Medicine, Worcester, Massachusetts, USA.

Background: Limited epidemiological data are available on the outcomes of in-hospital cardiac arrest (CA) in COVID-19 patients.

Methods: We performed literature search of PubMed, EMBASE, Cochrane, and Ovid to identify research articles that studied outcomes of in-hospital cardiac arrest in COVID-19 patients. The primary outcome was survival at discharge. Read More

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February 2021

A case report of stomach perforation during automatic mechanical chest compression following pulseless electrical activity due to cibenzoline intoxication.

Acute Med Surg 2021 Jan-Dec;8(1):e629. Epub 2021 Jan 26.

Division of Cardiology Department of Internal Medicine Yahaba Japan.

Background: The current report describes a case of stomach perforation, a rare but serious complication, that occurred during cardiopulmonary resuscitation following severe cibenzoline intoxication.

Case Presentation: A woman aged in her 30s was brought into our hospital while receiving cardiopulmonary resuscitation for pulseless electrical activity. After starting extracorporeal membrane oxygenation (ECMO), her abdominal X-ray examination revealed free air in her abdomen. Read More

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January 2021

In-hospital cardiac arrest in patients with coronavirus 2019.

Resuscitation 2021 03 27;160:72-78. Epub 2021 Jan 27.

Center for Resuscitation Science, University of Pennsylvania, United States; Department of Emergency Medicine, University of Pennsylvania, United States.

Background: Coronavirus Disease 2019 (COVID-19) has caused over 1 200 000 deaths worldwide as of November 2020. However, little is known about the clinical outcomes among hospitalized patients with active COVID-19 after in-hospital cardiac arrest (IHCA).

Aim: We aimed to characterize outcomes from IHCA in patients with COVID-19 and to identify patient- and hospital-level variables associated with 30-day survival. Read More

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Unusual Clinical Course of Odontoid Fracture: Transient Prehospital Cardiopulmonary Arrest.

Cureus 2020 Dec 18;12(12):e12157. Epub 2020 Dec 18.

Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, JPN.

Odontoid fracture is the most common type of cervical spine fracture in the elderly. Neurological injury due to odontoid fracture is uncommon, but if the injury is severe, it can lead to cardiac arrest. We present a case of odontoid fracture with transient cardiac arrest just after the fall, which fully recovered in a few minutes before arrival at the hospital. Read More

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December 2020

Venoarterial extracorporeal membrane oxygenation for ruptured sinus of Valsalva aneurysm.

Ann Thorac Surg 2021 Jan 20. Epub 2021 Jan 20.

Department of Cardiothoracic surgery, Prince of Wales Hospital, Sydney, Australia.

Sinus of Valsalva aneurysm rupture is a potentially fatal condition that requires urgent surgical intervention. We report a case of right sinus of Valsalva aneurysm rupture into the right atrium, in a patient with a monocuspid aortic valve successfully managed with femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after pulseless electrical activity (PEA) cardiac arrest to facilitate complete surgical repair. The patient made a full recovery and was discharged home with no neurological deficit and had no limitations at one-year follow-up. Read More

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January 2021

UK ambulance service resuscitation management of pulseless electrical activity: a systematic review protocol of text and opinion.

Br Paramed J 2020 Jun;5(1):20-25

The University of Plymouth.

Background: Out-of-hospital cardiac arrest patients with pulseless electrical activity are treated by paramedics using basic and advanced life support resuscitation. When resuscitation fails to achieve return of spontaneous circulation, there are limited evidence and national guidelines on when to continue or stop resuscitation. This has led to ambulance services in the United Kingdom developing local guidelines to support paramedics in the resuscitative management of pulseless electrical activity. Read More

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Can We Predict Good Survival Outcomes by Classifying Initial and Re-Arrest Rhythm Change Patterns in Out-of-Hospital Cardiac Arrest Settings?

Cureus 2020 Dec 10;12(12):e12019. Epub 2020 Dec 10.

Emergency Medicine, Catholic University of Korea St. Vincent's Hospital, Suwon, KOR.

Objective The purpose of this study was to investigate whether a change in prehospital arrest rhythms could allow medical personnel to predict survival outcomes in patients who achieved a return of spontaneous circulation (ROSC) in the setting of out-of-hospital cardiac arrest (OHCA). Methods The design of this study was retrospective, multi-regional, observational, and cross-sectional with a determining period between August 2015 and July 2016. Cardiac arrest rhythms were defined as a shockable rhythm (S), which refers to ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT), and non-shockable rhythm (NS), which refers to pulseless electrical activity or asystole. Read More

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December 2020

Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19.

Resusc Plus 2020 Dec 21;4:100054. Epub 2020 Nov 21.

Division of Cardiology, Department of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016, United States.

Aims: To define outcomes of patients with COVID-19 compared to patients without COVID-19 suffering in-hospital cardiac arrest (IHCA).

Materials And Methods: We performed a single-center retrospective study of IHCA cases. Patients with COVID-19 were compared to consecutive patients without COVID-19 from the prior year. Read More

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December 2020

Domino living donor liver transplantation of familial amyloid polyneuropathy patient - A case report.

Anesth Pain Med (Seoul) 2020 Oct 14;15(4):472-477. Epub 2020 Oct 14.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Seoul, Korea.

Background: Familial amyloid polyneuropathy (FAP) is caused by mutation in a gene transcribing transport protein produced mainly by the liver. Liver transplantation is required to stop FAP progression, but the pathology causes anesthetic management challenges.

Case: We report a case of domino living donor liver transplantation in an FAP patient. Read More

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October 2020

A case of pulseless electrical activity due to takotsubo syndrome following radiofrequency catheter ablation for atrial fibrillation.

J Cardiol Cases 2020 Dec 1;22(6):294-298. Epub 2020 Sep 1.

Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan.

A 51-year-old man with normal left ventricular ejection fraction (LVEF) underwent radiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (AF). After isolating the pulmonary veins (PV), we attempted to ablate multiple non-PV AF triggers evoked by isoproterenol and performed repetitive intracardiac electrical cardioversion under considerable dose of barbiturate. Finally, administration of pilsicainide was required to maintain sinus rhythm. Read More

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December 2020

Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia.

Int J Emerg Med 2020 Dec 4;13(1):62. Epub 2020 Dec 4.

Department of Emergency Medicine, Universidad del Rosario, Bogotá, Colombia.

Background: The cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound. Read More

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December 2020

Reduction of in-hospital cardiac arrest with sequential deployment of rapid response team and medical emergency team to the emergency department and acute care wards.

PLoS One 2020 1;15(12):e0241816. Epub 2020 Dec 1.

Department of Medicine, Baylor College of Medicine, Baylor St Luke's Medical Center, Houston, Texas, United States of America.

Purpose: This study aimed to determine if sequential deployment of a nurse-led Rapid Response Team (RRT) and an intensivist-led Medical Emergency Team (MET) for critically ill patients in the Emergency Department (ED) and acute care wards improved hospital-wide cardiac arrest rates.

Methods: In this single-center, retrospective observational cohort study, we compared the cardiac arrest rates per 1000 patient-days during two time periods. Our hospital instituted a nurse-led RRT in 2012 and added an intensivist-led MET in 2014. Read More

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January 2021

Pulseless Electrical Activity: Detection of Underlying Causes in a Prehospital Setting.

Med Princ Pract 2020 Nov 30. Epub 2020 Nov 30.

The proportion of out-of-hospital cardiac arrests (OHCA) with pulseless electrical activity (PEA) as initial rhythm is increasing. PEA should be managed by identifying the underlying cause of the arrest and treating it accordingly. This often poses a challenge in the chaotic prehospital environment with only limited resources available. Read More

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November 2020

Acute respiratory failure as initial manifestation of conventional osteosarcoma rich in giant cells: a case report.

J Med Case Rep 2020 Nov 23;14(1):228. Epub 2020 Nov 23.

Faculty of Health Sciences, Universidad Icesi, Calle 18 #122-135, 760032, Cali, Colombia.

Background: Osteosarcoma is a malignant tumor of the bone. The giant cell-rich osteosarcoma (GCRO) is a rare histological variant of the conventional osteosarcoma, accounting for 3% of all osteosarcomas. It has a variable clinical presentation, ranging from asymptomatic to multiple pathological fractures, mainly involving long bones, and less frequently the axial skeleton and soft tissues. Read More

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November 2020