Retrospective Study of the Utility of Point-of-care Blood Testing During Cardiac Arrest

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 207C
Author(s):  
Sumedh Hoskote ◽  
Elizabeth Hassebroek ◽  
Shihab Sugeir ◽  
Sumanjit Kaur ◽  
Aysen Erdogan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Study ◽  
Point Of Care ◽  
Blood Testing

Abstract 17116: Incidence and Outcomes of Out-of-hospital Maternal Cardiac Arrest and Compliance With Resuscitation Guidelines

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alan A Lipowicz ◽  
Sheldon Cheskes ◽  
Sarah H Gray ◽  
Farida Jeejeebhoy ◽  
Janice Lee ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Performance Metrics ◽  
Point Of Care ◽  
Survival Rates ◽  
Rare Event ◽  
Population Based ◽  
Childbearing Age ◽  
Child Bearing ◽  
Resuscitation Guidelines ◽  
Regional Health Authorities

Background: Published survival rates after out-of-hospital cardiac arrests (OHCA) are lower than in-hospital cardiac arrest (IHCA). Current estimates for the incidence and rate of survival for maternal cardiac arrest are published only for IHCA. There are no studies that report the incidence and outcomes of maternal OHCA. Current cardiopulmonary resuscitation guidelines contain specific maternal recommendations, although compliance with recommended benchmarks has not been reported. The objective of this study was to report maternal OHCA incidence, outcomes, and compliance with resuscitation and maternal specific guidelines. Methods: This was a population-based cohort study of consecutive maternal OHCA between May 2010 and April 2014. The denominator was estimated from the total regional population of all women of childbearing age obtained from census and age-specific pregnancy rates provided by regional health authorities. Resuscitation performance was measured against the 2010 AHA Guidelines. Results: A total of 6 maternal OHCA occurred amongst 1,085 OHCA occurring in females of child bearing age (15-49) over 4yrs; Incidence-1.85:100,000 (95% CI 1.76 to 1.95) vs. 19.4 per 100,000 (95% CI, 19.37 to 19.43). Maternal and neonatal survival to discharge was 16.7% and 33.3%, respectively. Compliance with CPR quality metrics averaged 83% with a range from 75% to 100%. Compliance with maternal-specific resuscitation guidelines averaged 46.9%, with a range from 0% to 100%. The only performance metrics with 100% compliance was intravenous line insertion above the diaphragm and prehospital activation of the maternal cardiac arrest team. Uterine displacement compliance was low at 0%. Conclusion: The incidence of maternal OHCA was 1.85:100,000, which is lower than the published estimate for maternal IHCA. Survival after OHCA for mother and for child was higher than OHCA occurring in non-pregnant adult females of child bearing age; however, the number of survivors was small (<5). Compliance rates with recommended resuscitation guidelines were high, yet compliance with maternal-specific guidelines were low suggesting targeted training and implementation optimization at the point of care is required to prepare for this rare event involving two lives.

scholarly journals ReTEECA Trial. Rescue TransEsophageal Echocardiography for In-Hospital Cardiac Arrest.

2022 ◽  
Author(s):  
Asad Ali Usman ◽  
Samantha Stein ◽  
Audrey Spelde ◽  
Felipe Teran-merino ◽  
John Augoustides ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cardiac Arrest ◽  
Transesophageal Echocardiography ◽  
Hospital Discharge ◽  
Phase Ii ◽  
Point Of Care ◽  
Phase Ii Clinical Trial ◽  
Image Guided ◽  
Hospital Cardiac Arrest

Abstract This trial is aimed at studying the utility and interventional outcomes of rescue transesophageal echocardiography (RescueTEE) to aid in diagnosis, change in management, and outcomes during CPR by using a point of care RescueTEE protocol in the evaluation of in-hospital cardiac arrest (IHCA). This is an interventional prospective convenience sampled partially blinded phase II clinical trial with primary outcomes of survival to hospital discharge (SHD) with RescueTEE image guided ACLS versus conventional ACLS.

scholarly journals Intensive care–treated cardiac arrest: A retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

2021 ◽  
Author(s):  
Ester Elisabet Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
Cost Effectiveness ◽  
Neurological Outcome ◽  
Age Groups ◽  
The Elderly ◽  
Treatment Intensity ◽  
One Year ◽  
Healthcare Associated

Abstract Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.

scholarly journals Use of systemic thrombolytic therapy in patients with non-traumatic cardiac arrest: A systematic review and meta-analysis

2019 ◽  
Vol 7 (28) ◽  
pp. 7-17
Author(s):  
Daniel Cordoba ◽  
Eneko Larumbe ◽  
Brittany Rosales ◽  
Kenneth Nugent
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Study ◽  
Thrombolytic Therapy ◽  
Major Bleeding ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Spontaneous Circulation ◽  
Study Analysis ◽  
Bleeding Events ◽  
Systemic Thrombolytic Therapy

Objective: To better delineate the benefits and risks of systemic thrombolytic therapy inpatients with cardiac arrest from non-traumatic etiologies.Data sources: MEDLINE, EMBASE, and SCOPUS were systematically searched up toNovember of 2017.Study Selection: All retrospective and prospective studies in which systemic thrombolytictherapy was used during the sequence of cardiopulmonary resuscitation (CPR) or shortly afterachieving return of spontaneous circulation (ROSC) were included.Data extraction: The following variable results were extracted from intervention and controlgroups if available: rate of ROSC, survival after 24 hours, survival at discharge, neurologicalperformance at 6 months based on a favorable Cerebral Performance Categories Scale (1 or 2)and major bleeding events.Data Synthesis: Eight retrospective studies and 6 prospective studies were included in thequalitative analysis. Research synthesis was conducted when at least 4 studies were availablefor an outcome, which limited the analysis of major bleeding events and neurologic outcomes.Benefit of thrombolytic therapy in survival to discharge showed a moderate beneficial effect(OR = 2.79, 2.11–3.69) in the retrospective study analysis while in the prospective study analysisno statistically significant benefit was found (OR = 1.27, 0.77–2.10). Benefit of thrombolysis inthe rate of ROSC was not statistically significant in the prospective analysis (OR = 1.59, 0.92–2.76, p = 0.138) as well as survival at 24 hours (OR = 1.17, 0.72–1.71).Conclusions: The widespread use of thrombolytics in patients with non-traumatic cardiacarrest does not seem to improve major outcomes, including survival to discharge. However,the modest benefit found in the retrospective study analysis suggests a subgroup of patientsthat may benefit from this therapy.

Development of microfluidic lab-on-disc based portable blood testing point-of-care diagnostic device

2016 ◽  
Author(s):  
Abdul Basit Zia ◽  
Muhammad Arslan Ali ◽  
Muhammad Omar Zeb ◽  
Unsub Shafiq ◽  
Syed Rehan Fida ◽  
...  
Keyword(s):  
Point Of Care ◽  
Diagnostic Device ◽  
Blood Testing
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