Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

Modisett, Katharine L.; Walsh, Steven J.; Heffner, Alan C.; Pearson, David; Kerns, William

doi:10.1007/s13181-016-0536-x

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Other studies exist on the efficacy of TTM among patients with a drug-related etiology of cardiac arrest. A 2016 study noted no significant differences among survival good neurologic outcome among toxin-related cardiac arrests vs non-toxin-related arrests [4]. In this study, every cardiac arrest patient received TTM, and 48 patients were determined to suffer a toxin-related arrest.…”

Section: Discussionmentioning

confidence: 71%

“…As of 2016, there are more than 350,000 out-of-hospital cardiac arrests (OHCAs) occurring in the USA every year, with an estimated 10.6% survival rate to hospital discharge among adults [1][2][3][4][5]. Drug overdose is a rapidly worsening public health crisis in the USA, with recent data showing that the age-adjusted rate of overdose-related deaths has increased by 5.5% per year [6].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Targeted Temperature Management on ED Patients with Drug Overdose–Related Cardiac Arrest

et al. 2018

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Introduction Drug overdose is the leading cause of non-traumatic out-of-hospital cardiac arrest (OHCA) among young adults. This study investigates whether targeted temperature management (TTM) improves hospital survival from presumed overdose-related cardiac arrest. Methods Retrospective chart review of consecutive cardiac arrests presenting to an urban tertiary care hospital ED from 2011 to 2015. ED patients with cardiac arrest were included if < 50 years old, and excluded if there was a non-overdose etiology (e.g., trauma, ST-elevation myocardial infarction, subarachnoid hemorrhage). The main intervention was TTM, carried out with a combination of the Arctic Sun device and refrigerated crystalloid/antipyretics (goal temperature 33-36 °C). The primary outcome was survival to hospital discharge; neurologically intact survival was the secondary outcome.Results Of 923 patients with cardiac arrest, 802 (86.9%) met exclusion criteria, leaving 121 patients for final analysis. There were 29 patients in the TTM group (24.0%) vs 92 patients in the non-TTM group (76.0%). Eleven patients (9.1%) survived to hospital discharge. TTM was associated with increased odds of survival to hospital discharge (OR 11.3, 95% CI 2.8-46.3, p < 0.001), which increased substantially when palliative outcomes were excluded from the cohort (OR 117.3,, p < 0.001). Despite achieving statistical significance (OR 1.1, 95% CI 1.0-1.3), TTM had no clinically significant effect on neurologically intact survival. Conclusions TTM was associated with improved survival in ED patients with presumed drug overdose-related cardiac arrest. The impact of TTM on neurologically intact survival among these patients requires further study.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Impact of Targeted Temperature Management on ED Patients with Drug Overdose–Related Cardiac Arrest

et al. 2018

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“…showed no benefit conferred by TTM in patients suffering a toxin versus nontoxin-induced cardiac arrest. [ 12 ] However, larger studies are required to shed light on the optimal role and value of TTM in patients with coma related to acute toxicity.…”

Section: Discussionmentioning

confidence: 99%

Survival following intentional succinylcholine injection for self-harm

et al. 2020

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Succinylcholine is a short-acting depolarizing neuromuscular blocking agent. We describe a case where the above drug was employed for self-harm by a health-care worker. The patient, a 28-year-old female, was brought to the emergency department (ED) in impending respiratory arrest and altered mental status. On arrival, she had hypoxia, bradycardia, and hypotension. Although the cause for rapid deterioration in this patient was unknown, the ED physician still went ahead by resuscitating the patient's airway, breathing, and circulation. During the course of resuscitation, information was received that an empty ampoule of succinylcholine was recovered from her bathroom. Further clinical examination and laboratory investigations led the treating physicians to suspect deliberate intravenous injection of succinylcholine. She was mechanically ventilated and monitored in the critical care unit. Targeted temperature management was initiated in the ED and was continued for 24 h. The patient was discharged from the hospital without any neurological deficits after 4 days. Patients with acute poisoning are one of the major encounters in ED, and this case highlights the possibility of anesthetic drug misuse in any health-care workers coming to the ED with sudden cardiac arrest, altered sensorium, or abnormal vitals. This is the first report describing the survival of a patient following intentional succinylcholine injection for self-harm.

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“…Las muertes por sobredosis de opioides constituyen un problema de salud pública 235 . En el paro cardiaco asociado a intoxicación por opioides están indicadas la naloxona por vía nasal o parenteral 236 y la hipotermia terapéutica 237 .…”

Section: Sobredosis De Opioidesunclassified

Consenso Latinoamericano de Reanimación Cardiopulmonar

AUTORES¹,

García²,

Grajales-López³

et al. 2021

REIE

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Desde épocas remotas la humanidad ha intentado revertir la muerte, tal como en el episodio mitológico egipcio cuando Isis devolvió la vida a Osiris respirando dentro de su boca. A lo largo de la historia se aplicaron con este fin diversos métodos, iniciando la reanimación cardiopulmonar moderna en la década de 1950. Al evaluar las causas de muerte, la enfermedad cardiovascular continúa siendo la que ocupa el primer lugar. Aproximadamente la mitad se deben a enfermedad cardiaca isquémica, las cuales ocurren de manera súbita en hasta el 50% de los casos. A su vez, la enfermedad cardiaca isquémica es la causa del 80% de las muertes súbitas. Se estima que cada minuto mueren en el mundo 11 personas por paro cardiaco súbito, la mayoría adultos. En hombres es dos veces más frecuente que en mujeres y se presenta a una edad promedio de siete años menos. El 75-80% de los paros cardiacos extrahospitalarios (PCR-EH) ocurren en el domicilio de la víctima. El ritmo inicial del paro cardiaco puede ser arritmia ventricular (fibrilación o taquicardia ventriculares sin pulso), actividad eléctrica sin pulso o asistolia. El 20-38% de los paros cardiacos se presentan con arritmia ventricular, siendo más frecuente en eventos presenciados por testigos que en no presenciados. Se estima que la sobrevida al PCR-EH es del 2-22%. Lati-

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Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

Cited by 7 publications

References 21 publications

Impact of Targeted Temperature Management on ED Patients with Drug Overdose–Related Cardiac Arrest

Impact of Targeted Temperature Management on ED Patients with Drug Overdose–Related Cardiac Arrest

Survival following intentional succinylcholine injection for self-harm

Consenso Latinoamericano de Reanimación Cardiopulmonar

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