Improving Survival From Cardiac Arrest: A Review of Contemporary Practice and Challenges

Jentzer, Jacob C.; Clements, Casey M.; Wright, R. Scott; White, Roger D.; Jaffe, Allan S.

doi:10.1016/j.annemergmed.2016.05.022

Cited by 51 publications

(36 citation statements)

References 99 publications

(140 reference statements)

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“…Nevertheless, other parameters may contribute to a worse outcome, such as high LUS score, severe LV dysfunction, etc. [ 55 , 56 ], However, our current study was not designed going to screen all the risk factors that predict ICU mortality.…”

Section: Discussionmentioning

confidence: 99%

The utilization of critical care ultrasound to assess hemodynamics and lung pathology on ICU admission and the potential for predicting outcome

Yin

Zeng

et al. 2017

PLoS ONE

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AimCritical care ultrasound (CCUS) has been used by many Intensive Care Units(ICUs) worldwide, so as to guiding the diagnosis and the treatment. However, none of the publications currently systematically describe the utilization of CCUS to analyze the characteristics of hemodynamics and lung pathology upon the new admission to ICU and its potential role in patients’ prognosis prediction. In this retrospective clinical study, we have demonstrated and analyzed the characteristics of hemodynamics and lung pathology assessed by CCUS and investigated its potential to predict patient outcome.MethodsWe have described and analyzed the epidemic characteristics of hemodynamics and lung pathology assessed by CCUS on ICU admission, which based on our database of 451 cases from the biggest medical center in Western China, between November 2014 and October 2015. The patients’ demographics, clinical characteristics, prognosis and ultrasonic pattern of hemodynamics and lung pathology had been analyzed. A bivariate logistic regression model was established to identify the correlation between the ultrasonic variables on admission and the ICU mortality.ResultsThe mean age of the 451 patients was 56.7±18.7 years; the mean APACHE II score was 19.0±7.9, the ICU mortality was 30.6%. Patients received CCUS examination of pericardial, right ventricle (RV) wall motion, left ventricle (LV) wall motion, LV systolic function, LV diastolic function, lung and volume of inferior vena cava (IVC) were 423(93.8%), 418(92.7%), 392(86.9%), 389(86.3%), 383(84.9%), 440(97.6%), 336(74.5%), respectively; The univariate analysis revealed that length of mechanical ventilation was significantly correlated with the diameter of IVC, tricuspid annular plane systolic excursion(TAPSE), mitral annular plane systolic excursion(MAPSE), early diastolic transmitral velocity to early mitral annulus diastolic velocity(E/e’) (p = 0.016, 0.011, 0.000, 0.049, respectively); The TAPSE, ejection fraction(EF), MAPSE, lung ultrasound score (LUS score) (p = 0.000, 0.028, 0.000, 0.011, respectively) were significantly related to ICU mortality. The multivariate analysis demonstrated that APACHE II, age, TAPSE, E/e’ are the independent risk factors for ICU mortality in our study.ConclusionCCUS examination on ICU admission which performed by the experienced physician provide valuable information to assist the caregivers in understanding the comprehensive outlook of the characteristics of hemodynamics and lung pathology. Those key variables obtained by CCUS predict the possible prognosis of patients, hence deserve more attention in clinical decision making.

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Section: Discussionmentioning

confidence: 99%

The utilization of critical care ultrasound to assess hemodynamics and lung pathology on ICU admission and the potential for predicting outcome

Yin

Zeng

et al. 2017

PLoS ONE

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“…1 Few advanced life support therapies have been shown to improve outcome following out-of-hospital cardiac arrest. 2 There is a lack of data from high-quality randomized clinical trials (RCTs), which are challenging to conduct in patients with out-of-hospital cardiac arrest. Consequently, many current clinical recommendations are based on observational studies and expert consensus.…”

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confidence: 99%

Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome

Benger

Kirby

Black

et al. 2018

JAMA

349

245

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“…Cardiac arrest is a common and intractable condition frequently encountered in hospitals and outside of hospitals [1]. Although more rapid and effective resuscitation is thought to alleviate the outcomes after cardio arrest (CA), the mortality and morbidity after CA/CPR remain high; that is due to ischemia-reperfusion injury occurring in organs in the body, especially in the brain [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Green Tea Polyphenols Modulated Cerebral SOD Expression and Endoplasmic Reticulum Stress in Cardiac Arrest/Cardiopulmonary Resuscitation Rats

Qin

Chen

et al. 2020

BioMed Research International

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Background. Reducing cerebral ischemia-reperfusion injury is crucial for improving survival and neurologic outcomes after cardiac arrest/cardiopulmonary resuscitation (CA/CPR). The purpose of this study is to investigate the neuroprotective effects of green tea polyphenols (GTPs) concern with the modulation of endogenous antioxidation and endoplasmic reticulum stress. Methods. After subjecting to CA/CPR, rats were randomized into the saline group (NS, n = 40) and the GTPs group (GTPs, n = 40). Each group was blindly located into four subgroups according to four time points (12 h, 24 h, 48 h, and 72 h). Other rats without experiencing CA/CPR severed as the Sham group (Sham, n = 10). Brain tissue samples were harvested at relative time points. The expressions of superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), caspase-3, and C/EBP-homologous protein (CHOP) were detected by immunofluorescence, dead neurons were assayed by TUNEL staining, and the expressions of caspase-12 and glucose-regulated proteins 78 kDa (GRP78) were evaluated by western blotting, respectively. Results. Comparing with that in NS group, GTPs increased the expression of SOD1 and SOD2 at 12 h, 24 h, 48 h, 72 h, and the expression of GRP78 at 24 h and 48 h (p<0.05) butdecreased caspase-12, CHOP, caspase-3 level, and apoptotic number of neurons (p<0.05) after restoration of spontaneous circulation (ROSC). Conclusion. GTPs exert neuroprotective effects via mechanisms that may be related to the enhancement of endogenous antioxidant capacity and inhibition of endoplasmic reticulum stress in CA/CPR rat models.

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Improving Survival From Cardiac Arrest: A Review of Contemporary Practice and Challenges

Cited by 51 publications

References 99 publications

The utilization of critical care ultrasound to assess hemodynamics and lung pathology on ICU admission and the potential for predicting outcome

The utilization of critical care ultrasound to assess hemodynamics and lung pathology on ICU admission and the potential for predicting outcome

Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome

Green Tea Polyphenols Modulated Cerebral SOD Expression and Endoplasmic Reticulum Stress in Cardiac Arrest/Cardiopulmonary Resuscitation Rats

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