New Developments in Cardiac Arrest Management

Riess, Matthias L.

doi:10.1016/j.aan.2016.07.003

Cited by 5 publications

(4 citation statements)

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“…Experts suggest this may be the avoidance of hyperthermia, rather than induction of hypothermia, which is beneficial to the patient. 6 , 10 , 11 Although TTM is a relatively effective tool, patient's neurological outcomes may be further improved by introducing neuroprotective agents such as ketamine during post‐CA care. 12 , 13 , 14 In the emergency clinical setting, ketamine is one option that may be used for sedation of CA patients during routine resuscitation procedures.…”

Section: Introductionmentioning

confidence: 99%

“…This result was repeated in 2021, when Dankiewicz et al 6 showed no significant difference in death and functional outcome at 6 months in patients randomized to hypothermia versus normothermia groups. Experts suggest this may be the avoidance of hyperthermia, rather than induction of hypothermia, which is beneficial to the patient 6,10,11 . Although TTM is a relatively effective tool, patient's neurological outcomes may be further improved by introducing neuroprotective agents such as ketamine during post‐CA care 12‐14 .…”

Section: Introductionmentioning

confidence: 99%

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The use of ketamine as a neuroprotective agent following cardiac arrest: A scoping review of current literature

et al. 2022

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Aims The objective of this article is to summarize the state of the literature surrounding the use of ketamine as a neuroprotective agent following cardiac arrest. Methods Five electronic databases were used to search for studies related to the use of ketamine for neuroprotection following cardiac arrest. This search was performed once in May 2020, and an updated search was conducted in May 2021 and March 2022. Results All searches combined retrieved 181 results; no clinical trials were identified. As such, the authors were limited to writing a scoping review of the literature rather than a systematic review. Conclusions The current state of the literature describes the mechanism of action of ketamine as a neuroprotective agent through its action as an NMDA antagonist. There is evidence of its efficacy as a neuroprotective agent in preclinical models of cardiac arrest. Current published clinical work supports the use of ketamine ameliorating neurologic outcomes in other conditions such as epilepsy, traumatic brain injury, and depression. The current state of the literature is reflective of the notion that the use of ketamine following cardiac arrest may result in improved neurologic outcomes. Future research directions should focus on the use of ketamine as a possible clinical intervention following cardiac arrest.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of ketamine as a neuroprotective agent following cardiac arrest: A scoping review of current literature

et al. 2022

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“…Higher levels of patient expectations, increasing complexity of hospitalized care, and increasing cost of poor patient outcomes, hospital leaders are increasingly interested in management support systems that offer early identification of deteriorating patients (1). Nowadays, evidence showed that people in-hospital were dying or suffer unnecessarily (2), and cardiac arrest continues to be an important health care problem worldwide because of high frequency and low survival (3). Studies have shown that cardiac arrest can be preventable (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Hastanelerde kardiyak arrestlerin nasıl önlenebileceğine ilişkin model önerileri

Aslan

Erişkin

2019

Anadolu Güncel Tıp Dergisi

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Aim: Cardiac arrests are common in hospitals, and delays in treatment have resulted in lower survival and worse neurological outcomes. Evidence shows that patients' physiological parameters begin to deteriorate before cardiopulmonary arrest and vast majority of them can be prevented. The aim of this study is to develop early warning scoring models that will enable early identification of the changes in the physiological parameters of pediatric and adult patients with high risk before cardiopulmonary arrest. Material and Method:Evidence-based studies on early warning scoring have been reviewed, and model recommendations have been developed for pediatric and adult patients by taking specialist opinions.Results: An algorithm that includes heart rate, blood pressure, respiratory rate, body temperature, state of consciousness parameters, reference intervals and medical interventions given to the patient has been recommended for adults. For pediatric patients, an algorithm that includes respiratory, circulatory and behavioral / neurological system parameters, reference intervals and medical interventions given to the patient has been recommended. Conclusion:Early recognition of deterioriation patients reduces mortality, length of stay and costs in hospitals.

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“…Despite the notable progress in the field of resuscitation science, the survival rate of patients with out‐of‐hospital cardiac arrest (OHCA) with an initial nonshockable rhythm remains unacceptably low, 1 , 2 , 3 and better management strategies in prehospital settings are required to further improve patient outcomes. 4 , 5 The major challenges for emergency medical services (EMS) attending to such patients with a high mortality risk in the ambulance are 2‐fold: (1) Patients with cardiac arrest (CA) require immediate and intensive care as their outcomes are time sensitive; and (2) it is difficult for paramedics to solely focus on the patient alone because they must engage in multitasking while performing cardiopulmonary resuscitation (CPR), such as obtaining and recording medical information, securing vascular access to allow for timely pharmacological interventions, securing the airway by performing intubation when needed, and ensuring prompt transfer to the hospital.…”

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confidence: 99%

Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out‐of‐Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry

Emoto

Nishikimi

Shoaib

et al. 2022

JAHA

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Background Predicting a spontaneous rhythm change from nonshockable to shockable before hospital arrival in patients with out‐of‐hospital cardiac arrest can help emergency medical services develop better strategies for prehospital treatment. The aim of this study was to identify predictors of spontaneous rhythm change before hospital arrival in patients with out‐of‐hospital cardiac arrest and develop a predictive scoring system. Methods and Results We retrospectively reviewed data of eligible patients with out‐of‐hospital cardiac arrest with an initial nonshockable rhythm registered in a nationwide registry between June 2014 and December 2017. We performed a multivariable analysis using a Cox proportional hazards model to identify predictors of a spontaneous rhythm change, and a ridge regression model for predicting it. The data of 25 804 patients were analyzed (derivation cohort, n=17 743; validation cohort, n=8061). The rhythm change event rate was 4.1% (724/17 743) in the derivation cohort, and 4.0% (326/8061) in the validation cohorts. Age, sex, presence of a witness, initial rhythm, chest compression by a bystander, shock with an automated external defibrillator by a bystander, and cause of the cardiac arrest were all found to be independently associated with spontaneous rhythm change before hospital arrival. Based on this finding, we developed and validated the Rhythm Change Before Hospital Arrival for Nonshockable score. The Harrell’s concordance index values of the score were 0.71 and 0.67 in the internal and external validations, respectively. Conclusions Seven factors were identified as predictors of a spontaneous rhythm change from nonshockable to shockable before hospital arrival. We developed and validated a score to predict rhythm change before hospital arrival.

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New Developments in Cardiac Arrest Management

Cited by 5 publications

References 78 publications

The use of ketamine as a neuroprotective agent following cardiac arrest: A scoping review of current literature

The use of ketamine as a neuroprotective agent following cardiac arrest: A scoping review of current literature

Hastanelerde kardiyak arrestlerin nasıl önlenebileceğine ilişkin model önerileri

Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out‐of‐Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry

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