Resuscitative Value of B-Type Natriuretic Peptide in Comatose Survivors Treated With Hypothermia After Out-of-Hospital Cardiac Arrest due to Cardiac Causes

Nagao, Ken; Mukoyama, Takeo; Kikushima, Kimio; Watanabe, Kazuhiro; Tachibana, Eizo; Iida, Kiyoshi; Tani, Sigemasa; Watanabe, Ichiro; Hayashi, Nariyuki; Kanmatsuse, Katsuo

doi:10.1253/circj.71.370

Cited by 19 publications

(10 citation statements)

References 31 publications

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“…Therapeutic hypothermia, coronary reperfusion therapy and/or glucose control might be useful options for the treatment of post cardiac arrest syndrome in adults with out-of-hospital cardiac arrest due to non-shockable rhythm. [33][34][35][36][37][38] In this study, there were a few adults treated with mild hypothermia and/or coronary reperfusion therapy and the proportion of each treatment was similar in the 2 groups (Tables 1 and 2). …”

Section: Study Limitationsmentioning

confidence: 99%

Atropine Sulfate for Patients With Out-of-Hospital Cardiac Arrest due to Asystole and Pulseless Electrical Activity

Nagao

Yagi

Sakamoto

et al. 2011

Circ J

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Background:The 2005 guidelines for cardiopulmonary resuscitation (CPR) have recommended that administration of atropine can be considered for non-shockable rhythm, but there are insufficient data in humans. Methods and Results:The effects of atropine were assessed in 7,448 adults with non-shockable rhythm from the SOS-KANTO study. The primary endpoint was a 30-day favorable neurological outcome after cardiac arrest. In the 6,419 adults with asystole, the epinephrine with atropine group (n=1,378) had a significantly higher return of spontaneous circulation (ROSC) rate than the epinephrine alone group (n=5,048) with an adjusted odds ratio of 1.6 (95% confidence interval (CI) 1.4-1.7, P<0.0001), but the 2 groups had similar 30-day favorable neurological outcome with an adjusted odds ratio of 0.6 (95%CI 0.2-1.7; P=0.37). In the 1,029 adults with pulseless electrical activity (PEA), the 2 groups had similar rates of ROSC and 30-day favorable neurological outcome, and the epinephrine with atropine group had a significantly lower 30-day survival rate than the epinephrine alone group with an adjusted odds ratio of 0.4 (95%CI 0.2-0.9, P=0.016).Conclusions: Administration of atropine had no long-term neurological benefit in adults with out-of-hospital cardiac arrest due to non-shockable rhythm. Atropine is not useful for adults with PEA. (Circ J 2011; 75: 580 -588)

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Section: Study Limitationsmentioning

confidence: 99%

Atropine Sulfate for Patients With Out-of-Hospital Cardiac Arrest due to Asystole and Pulseless Electrical Activity

Nagao

Yagi

Sakamoto

et al. 2011

Circ J

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“…15 Some reports on the B-type natriuretic peptides (BNP and NT-proBNP) in cardiac arrest are published, but the results have been diverging. Earlier work reported that BNP could provide important information for prognosis after cardiac arrest, 16,17 while a more recent study failed to demonstrate incremental prognostic information by NT-proBNP to the information available on ICU admission. 18 However, a limitation of the latter study was that only 59% of the patients had ventricular arrhythmia-induced cardiac arrest, which could influence the results as patients presenting with non-shockable rhythm have a worse prognosis.…”

Section: Introductionmentioning

confidence: 98%

NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study

et al. 2016

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“…[1][2][3] Recent guidelines also recommend that unconscious adult patients with spontaneous circulation after out-of-hospital ventricular fibrillation (VF) cardiac arrest should be cooled to 32-34°C for 12-24 h. [4][5][6] Although previous studies showed that extreme hypothermia (<29°C) might potentiate the occurrence of lethal ventricular arrhythmia, 7-9 the myocardial substrate properties in the therapeutic range of hypothermia (≥30°C) are not completely understood. Because 30°C is the lowest temperature that has proven to be feasible in clinical practice, [1][2][3] we chose it to test the ventricular substrate for arrhythmogenesis in the present study.…”

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confidence: 99%

Therapeutic Hypothermia (30.DEG.C) Enhances Arrhythmogenic Substrates, Including Spatially Discordant Alternans, and Facilitates Pacing-Induced Ventricular Fibrillation in Isolated Rabbit Hearts

Hsieh

Lin

et al. 2009

Circ J

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herapeutic hypothermia (TH, 30°C) has decreased intracranial pressure, slowed cerebral metabolic processes, and protected the brain from anoxic injury in animal models and human scenarios. [1][2][3] Recent guidelines also recommend that unconscious adult patients with spontaneous circulation after out-of-hospital ventricular fibrillation (VF) cardiac arrest should be cooled to 32-34°C for 12-24 h. [4][5][6] Although previous studies showed that extreme hypothermia (<29°C) might potentiate the occurrence of lethal ventricular arrhythmia, 7-9 the myocardial substrate properties in the therapeutic range of hypothermia (≥30°C) are not completely understood. Because 30°C is the lowest temperature that has proven to be feasible in clinical practice, 1-3 we chose it to test the ventricular substrate for arrhythmogenesis in the present study.One mechanism for determining the maintenance of VF is its wavefront characteristics during VF. 10,11 Harada et al found that in 2-dimensional rabbit ventricular preparations, TH (30°C) enhanced wavebreaks and regeneration of new spiral waves during VF, facilitating the maintenance of ventricular tachycardia (VT) and VF. 12 While using a clinically appropriate temperature of 32-34°C, they demonstrated that the spiral waves of VT/VF frequently collided and dissipated in favor of self-termination of VT/VF, a different effect from that of TH at 30°C. 12 Whether the wavefront characteristics (ie, wavebreaks) of VF in this 2-dimensional model also occur in 3-dimensional intact hearts at TH (30°C) remains unclear. Cardiac alternans, particularly spatially discordant alternans (SDA), is a key arrhythmogenic factor for ventricular tachyarrhythmia. 13 However, limited information is available regarding cardiac alternans properties during TH (30°C). 14 In this study, using an optical mapping system, we investigated the wavefront characteristics of VF (ie, wavebreaks, spatiotemporal periodicities), cardiac electrophysiological/ alternans properties, and the vulnerability of pacing-induced VF specifically at TH (30°C) in 3-dimensional Langendorffperfused isolated rabbit hearts. We hypothesized that TH (30°C) enhances wavebreaks during VF and S1 pacing, facilitates pacing-induced SDA, and increases the vulnerability of pacing-induced VF. Background: Therapeutic hypothermia (TH, 30°C) protects the brain from hypoxic injury. However, TH may potentiate the occurrence of lethal ventricular fibrillation (VF), although the mechanism remains unclear. The present study explored the hypothesis that TH enhances wavebreaks during VF and S1 pacing, facilitates pacinginduced spatially discordant alternans (SDA), and increases the vulnerability of pacing-induced VF. Methods and Results:Using an optical mapping system, epicardial activations of VF were studied in 7 Langendorff-perfused isolated rabbit hearts at baseline (37°C), TH (30°C), and rewarming (37°C). Action potential duration (APD)/conduction velocity (CV) restitution and APD alternans (n=6 hearts) were determined by S1 pacing at these 3 stages. Duri...

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Resuscitative Value of B-Type Natriuretic Peptide in Comatose Survivors Treated With Hypothermia After Out-of-Hospital Cardiac Arrest due to Cardiac Causes

Cited by 19 publications

References 31 publications

Atropine Sulfate for Patients With Out-of-Hospital Cardiac Arrest due to Asystole and Pulseless Electrical Activity

Atropine Sulfate for Patients With Out-of-Hospital Cardiac Arrest due to Asystole and Pulseless Electrical Activity

NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study

Therapeutic Hypothermia (30.DEG.C) Enhances Arrhythmogenic Substrates, Including Spatially Discordant Alternans, and Facilitates Pacing-Induced Ventricular Fibrillation in Isolated Rabbit Hearts

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