Early antibiotics improve survival following out-of hospital cardiac arrest

Davies, Keith; Walters, James; Kerslake, Ian; Greenwood, Rosemary; Thomas, Matthew

doi:10.1016/j.resuscitation.2012.11.004

Cited by 68 publications

(43 citation statements)

References 15 publications

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“…A recent study by Davies et al 17 showed better outcomes in OHCA patients who received early antibiotic treatment within the first 7 days. In our cohort, 75% of all subjects received antibiotic treatment, with a trend toward more antibiotic use in subjects with EOP than in those without.…”

Section: Impact Of Microbiologic Findings and Antibiotic Treatmentmentioning

confidence: 97%

Predictors and Outcome of Early-Onset Pneumonia After Out-of-Hospital Cardiac Arrest

Pabst¹,

Römer²,

Samol³

et al. 2013

Respir Care

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BACKGROUND: Early-onset pneumonia (EOP) after out-of-hospital cardiac arrest is frequently observed. Causative factors are loss of airway protection during cardiac arrest, pulmonary contusion, and emergency airway management. We assessed the incidence, risk factors, and clinical course of EOP, and evaluated the impact of an early exchange of the prehospitally inserted endotracheal tube (ETT). METHODS: In our retrospective analysis we included 104 consecutive subjects admitted to our ICU after out-of-hospital cardiac arrest between 2007 and 2012. All subjects underwent therapeutic hypothermia. We analyzed clinical course, inflammation indicators, Clinical Pulmonary Infection Score, occurrence of EOP, duration of ventilatory support, microbiological findings, and short-term outcome. RESULTS: Of the 104 subjects, 46.2% received an exchange of ETT directly after hospital admission. Neither ETT exchange nor observed aspiration were associated with elevated CPIS or EOP, nor with proof of microorganisms in respiratory secretions. We found no differences in duration of ventilatory support, P aO 2 /F IO 2 , ICU days, or outcome. C-reactive protein was significantly higher in subjects with aspiration (P ‫؍‬ .046). Sex, age, smoking status, aspiration, cause of cardiac arrest, first detected heart rhythm, and use of supraglottic airways devices were not associated with EOP. Subjects with EOP had a longer need for ventilatory support (P ‫؍‬ .005), higher tracheotomy rate (P ‫؍‬ .03), longer ICU stay (P ‫؍‬ .005), higher C-reactive protein (P < .001), higher body temperature (P ‫؍‬ .003), higher Clinical Pulmonary Infection Score (P < .001), and lower P aO 2 /F IO 2 (P ‫؍‬ .008). CONCLUSIONS: The rate of EOP was not significantly influenced by the exchange of the preclinically inserted ETT, but was associated with longer need for mechanical ventilation and ICU stay.

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Section: Impact Of Microbiologic Findings and Antibiotic Treatmentmentioning

confidence: 97%

Predictors and Outcome of Early-Onset Pneumonia After Out-of-Hospital Cardiac Arrest

Pabst¹,

Römer²,

Samol³

et al. 2013

Respir Care

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“…Generally, Gram-negative bacteria seem to be more frequently isolated than Gram-positive bacteria. 4,9,61 Gram-positive cocci seem to predominate during the early phase, while Gram-negative bacteria are present throughout the intensive care unit stay. 7e9 Isolation of pathogenic microorganisms has been reported in about two thirds of patients diagnosed with EOP through quantitative culture of the bronchopulmonary samples.…”

Section: Pathogensmentioning

confidence: 99%

“…5,70 Similarly, antibiotic use has been reported as an independent predictor of survival in resuscitated patients after OHCA, suggesting potential avoidance of further septic complications. 61 Prophylactic use of antibiotics in patients undergoing therapeutic hypothermia should be addressed in future prospective trials, given the association between this therapeutic modality and EOP. Along this line, selective digestive tract decontamination has never been assessed after OHCA.…”

Section: Preventive Measuresmentioning

confidence: 99%

Early-onset pneumonia after out-of-hospital cardiac arrest

Kakavas¹,

Cariou²,

Gulati³

et al. 2015

Journal of Infection

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“…A korai szakban antibiotikummal kezelt betegek túlélése egy megfigyelés szerint ugyanis jobb, a gyakorlatban pedig például aspiráció megalapozott gyanúja esetén profilaktikus antibiotikus terápia is indokolt lehet [29], noha egyértelmű ajánlás nincsen.…”

Section: A Terápiás Hypothermia Mellékhatásai éS Potenciális Szövődméunclassified

A terápiás hypothermia szerepe a postresuscitatiós ellátásban – irodalmi áttekintés és saját tapasztalatok

et al. 2016

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Az enyhe terápiás hypothermia az utóbbi évtizedben elfogadott és elterjedt intenzív terápiás módszerré vált a hirtelen szívhalált elszenvedett és sikeresen resuscitált betegek kezelésében. Bár a rendelkezésre álló evidenciák alapján a terá-piás hypothermia a resuscitatiós irányelvek részét alkotja, terápiás alkalmazása számos ponton csupán tapasztalati té-nyekre alapszik. Különösen intenzív szakmai vita tárgyát képezi az ideális célhőmérséklet és a nem sokkolandó ritmussal feltalált betegek hűtésének kérdése. A hypothermia szinte az összes szervrendszer működését befolyásolja, ezért ezek ismerete elengedhetetlen a mellékhatások korai felismerésében és kezelésében. A szerzők célja, hogy a rendelkezésre álló vizsgálati eredmények és saját gyakorlati tapasztalataik alapján összegezzék a terápiás hypothermia klinikai szerepét a resuscitatión átesett betegek kezelésében. Orv. Hetil., 2016, 157(16), 611-617. Kulcsszavak: resuscitatio, post-cardiac arrest ellátás, terápiás hypothermia, prognózisbecslésThe role of therapeutic hypothermia in post-resuscitation carereview of the literature and personal experienceIn the last fifteen years mild therapeutic hypothermia became an accepted and widespread therapeutic method in the treatment of successfully resuscitated patients due to sudden cardiac death. Based on the available evidence therapeutic hypothermia is part of the resuscitation guidelines, however, many aspects of its therapeutic use are based on empirical facts. In particular, the subjects of intense debate are the ideal target temperature and the benefit of hypothermia in patients found with non-shockable rhythm. Hypothermia affects almost all organ systems and, therefore, early detection and treatment of side effects are essential. The aim of the authors is to summarize the clinical role and pathophysiologic effects of therapeutic hypothermia in the treatment of resuscitated patients based on current evidence and their practical experience.Keywords: resuscitation, post-cardiac arrest care, therapeutic hypothermia, prognosis Pilecky, D., Szudi, G., Kovács, E., Jenei, Zs., Gellér, L., Heltai, K., Molnár, L., Bárczi, Gy., Becker, D., Merkely, B., Zima, E. [The role of therapeutic hypothermia in post-resuscitation care -review of the literature and personal experience]. Orv. Hetil., 2016, 157(16), 611-617. (Beérkezett: 2016 elfogadva: 2016. Rövidítések CPR = cardiopulmonalis resuscitatio; NSE = neuronspecifikus enoláz; PCAS = post-cardiac arrest syndrome; PCI = percutan coronariaintervenció; STEMI = ST-elevációs szívizominfark-tus; THT = terápiás hypothermia A fiziológiástól eltérő, alacsonyabb testhőmérséklet, azaz hypothermia, mintegy tizenöt éve elfogadott terápiás módszer a postresuscitatiós neurológiai károsodások megelőzésében. Két nagy esetszámú, randomizált tanul-

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Early antibiotics improve survival following out-of hospital cardiac arrest

Cited by 68 publications

References 15 publications

Predictors and Outcome of Early-Onset Pneumonia After Out-of-Hospital Cardiac Arrest

Predictors and Outcome of Early-Onset Pneumonia After Out-of-Hospital Cardiac Arrest

Early-onset pneumonia after out-of-hospital cardiac arrest

A terápiás hypothermia szerepe a postresuscitatiós ellátásban – irodalmi áttekintés és saját tapasztalatok

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