Causes of Perioperative Cardiac Arrest: Mnemonic, Classification, Monitoring, and Actions

Meng, Lingzhong; Rasmussen, Mads; Abcejo, Arnoley S.; Meng, Deyi M.; Tong, Chuanyao; Liu, Hong

doi:10.1213/ane.0000000000006664

Cited by 4 publications

References 145 publications

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The Identification of Key Genes and Biological Pathways in Cardiac Arrest by Integrated Bioinformatics and Next Generation Sequencing Data Analysis

Vastrad,

Vastrad

2024

Preprint

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Cardiac arrest (CA) is a common cause of death world wide. The disease has lacks effective treatment. Efforts have been made to elucidate the molecular pathogenesis of CA, but the molecular mechanisms remain elusive. To identify key genes and pathways in CA, the next generation sequencing (NGS) GSE200117 dataset was downloaded from the Gene Expression Omnibus (GEO) database. DESeq2 tool was used to recognize differentially expressed genes (DEGs). Gene ontology (GO) and REACTOME pathway enrichment analyses were performed to analyze the DEGs and associated signal pathways in the g:Profiler database. The IID database was used to construct the protein-protein interaction (PPI) network, and modules analysis was performed using Cytoscape. A miRNA-hub gene regulatory network and TF-hub gene regulatory network were then constructed to screen miRNAs, TFs and hub genes by miRNet and NetworkAnalyst database and Cityscape software. Receiver operating characteristic curve (ROC) analysis used to verified the hub genes. In total, 844 DEGs were identified, comprising 414 up regulated genes and 430 down regulated genes. GO and REACTOME pathway enrichment analyses indicated that the DEGs for CA were mainly enriched in organonitrogen compound metabolic process, response to stimulus, translation and immune system. Ten hub genes (up-regulated: HSPA8, HOXA1, INCA1 and TP53; down-regulated: HSPB1, LMNA, SNCA, ADAMTSL4 and PDLIM7) were screened. We also predicted miRNAs (hsa-mir-1914-5p and hsa-mir-598-3p) and TFs (JUN and PRRX2) targeting hub genes. This study uses a series of bioinformatics technologies to obtain hug genes, miRNAs and TFs, and key pathways related to CA. These analysis results provide us with new ideas for finding biomarkers and treatment methods for CA.

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The Identification of Key Genes and Biological Pathways in Cardiac Arrest by Integrated Bioinformatics and Next Generation Sequencing Data Analysis

Vastrad,

Vastrad

2024

Preprint

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Advanced life support interventions during intra‐operative cardiac arrest among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists

Nolan,

Armstrong,

Kane

et al. 2024

Anaesthesia

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SummaryBackgroundFew existing resuscitation guidelines include specific reference to intra‐operative cardiac arrest, but its optimal treatment is likely to require some adaptation of standard protocols.MethodsWe analysed data from the 7th National Audit Project of the Royal College of Anaesthetists to determine the incidence and outcome from intra‐operative cardiac arrest and to summarise the advanced life support interventions reported as being used by anaesthetists.ResultsIn the baseline survey, > 50% of anaesthetists responded that they would start chest compressions when the non‐invasive systolic pressure was < 40–50 mmHg. Of the 881 registry patients, 548 were adult patients (aged > 18 years) having non‐obstetric procedures under the care of an anaesthetist, and who had arrested during anaesthesia (from induction to emergence). Sustained return of spontaneous circulation was achieved in 425 (78%) patients and 338 (62%) were alive at the time of reporting. In the 365 patients with pulseless electrical activity or bradycardia, adrenaline was given as a 1 mg bolus in 237 (65%). A precordial thump was used in 14 (3%) patients, and although this was associated with return of spontaneous circulation at the next rhythm check in almost three‐quarters of patients, in only one of these was the initial rhythm shockable. Calcium (gluconate or chloride) and 8.4% sodium bicarbonate were given to 51 (9%) and 25 (5%) patients, but there were specific indications for these treatments in less than half of the patients. A thrombolytic drug was given to 5 (1%) patients, and extracorporeal cardiopulmonary resuscitation was used in 9 (2%) of which eight occurred during cardiac procedures.ConclusionsThe specific characteristics of intra‐operative cardiac arrest imply that its optimal treatment requires modifications to standard advanced life support guidelines.

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Eighteen‐year trends in the rates of intra‐operative cardiac arrest and associated mortality at a public university hospital in Brazil*

Morais,

Braz,

Soares

et al. 2024

Anaesthesia

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SummaryBackgroundIntra‐operative cardiac arrest is a rare but life‐threatening event. Over the past two decades, various initiatives have improved the care of patients undergoing surgery at our quaternary teaching hospital in Brazil. We aimed to evaluate the epidemiology of intra‐operative cardiac arrest and associated 30‐day mortality over an 18‐year period. A secondary aim was to identify associated risk factors.MethodsWe conducted a retrospective observational study using data collected from 1 January 2005 to 31 December 2022. Factors associated with cardiac arrest and mortality were identified using multivariable logistic regression analysis.ResultsAmong the 154,178 cases, the overall rates of intra‐operative cardiac arrest (n = 297) and associated 30‐day mortality (n = 248) were 19.3 (95%CI (16.6–21.9)) and 16.1 (95% CI 13.9–18.3) per 10,000 anaesthetics, respectively. These decreased over time (2005–2010 vs. 2017–2022) from 26.3 (95%CI 21.0–31.6) to 15.4 (95%CI 12.0–18.7) per 10,000 anaesthetics, and from 23.4 (95%CI 18.8–28.1) to 13.7 (95%CI 10.8–16.7) per 10,000 anaesthetics, respectively. Factors associated with intra‐operative cardiac arrest included children aged < 1 year (adjusted OR (95%CI) 3.51 (1.87–6.57)); ASA physical status 3–5 (adjusted OR (95%CI) 13.85 (8.86–21.65)); emergency surgery (adjusted OR (95%CI) 10.06 (7.85–12.89)); general anaesthesia (adjusted OR (95%CI) 8.79 (4.60–19.64)); surgical procedure involving multiple specialities (adjusted OR (95%CI) 9.13 (4.24–19.64)); cardiac surgery (adjusted OR (95%CI) 7.69 (5.05–11.71)); vascular surgery (adjusted OR (95%CI) 6.21 (4.05–9.51)); and gastrointestinal surgery (adjusted OR (95%CI) 2.98 (1.91–4.65)).DiscussionWe have shown an important reduction in intra‐operative cardiac arrest and associated 30‐day mortality over an 18‐year period. Identification of relative risk factors associated with intra‐operative cardiac arrest can be used to improve the safety and quality of patient care, especially in a resource‐limited setting.

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Causes of Perioperative Cardiac Arrest: Mnemonic, Classification, Monitoring, and Actions

Cited by 4 publications

References 145 publications

The Identification of Key Genes and Biological Pathways in Cardiac Arrest by Integrated Bioinformatics and Next Generation Sequencing Data Analysis

The Identification of Key Genes and Biological Pathways in Cardiac Arrest by Integrated Bioinformatics and Next Generation Sequencing Data Analysis

Advanced life support interventions during intra‐operative cardiac arrest among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists

Eighteen‐year trends in the rates of intra‐operative cardiac arrest and associated mortality at a public university hospital in Brazil*

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