The American journal of emergency medicine
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To indicate predictors of witnessed hypothermic cardiac arrest. ⋯ In patients with severe accidental hypothermia, the occurrence of HCA is associated with a lower heart rate, hypoxemia, ventricular arrhythmia, lower BE, and lower blood pressure. These parameters can be helpful in the early selection of high-risk patients and their allocation to extracorporeal rewarming facilities.
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The role of lactate measurement in out-of-hospital cardiac arrest (OHCA) survivors remains controversial. We assessed the association between early lactate-related variables, OHCA characteristics, and long-term neurological outcome. ⋯ Early lactate levels, especially at 24 h, and TWCL were independent predictors of neurologic outcome in these patients, whereas lactate clearance was not. The prognostic ability of lactate-related variables varied depending on the OHCA characteristics.
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Traumatic cardiac arrest (TCA) is a severe condition with a high mortality rate, and patients who survive from TCA face a poor prognosis due to post-resuscitation injury, including cardiac and cerebral injury, which remains a serious challenge. Sodium octanoate has shown protective effects against various diseases. The present study aims to investigate sodium octanoate's protective effects against cardiac and cerebral injury after TCA in a porcine model. ⋯ Our study's findings suggest that early infusion of sodium octanoate significantly alleviates post-resuscitation cardiac and cerebral injury in a porcine model of TCA, possibly through inhibition of cell apoptosis and GPX4-mediated ferroptosis. Therefore, sodium octanoate could be a potential therapeutic strategy for patients with TCA.
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Recent literature has explored the psychological well-being of physicians, addressing conditions like perfectionism, imposter phenomenon/syndrome (IP), depression, burnout, and, less frequently, magical thinking. But recognizing the connections among these psychological factors is vital for developing targeted interventions to prevent or alleviate their impact. This article examines the often-sequential emergence of these five conditions within a physician's career, with a specific emphasis on their prevalence among emergency physicians (EPs), who must manage a diverse array of acute illnesses and injuries. ⋯ Recognizing unrealistic expectations as a major contributor to burnout, depression, and even suicide within the medical profession, the article advocates for the development of targeted interventions and support structures to assist medical students and professionals in managing IP. Practical strategies involve acknowledging unrealistic expectations, setting attainable goals, seeking support, taking breaks, and prioritizing self-care. Addressing this pervasive issue aims to cultivate a culture where medical professionals can thrive, ensuring optimal care for patients.
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Multicenter Study Observational Study
The prognostic value of the phosphate-to-albumin ratio in patients with OHCA: A multicenter observational study.
In patients with out-of-hospital cardiac arrest (OHCA), early and accurate outcome prediction is crucial for making treatment decisions and informing their relatives. A previous study reported an association between high phosphate levels and unfavorable neurological outcomes after return of spontaneous circulation (ROSC); however, its prognostic value was insufficient when used independently. Therefore, this study aimed to validate the usefulness of the phosphate-to-albumin ratio (PAR) in predicting neurological outcomes and in-hospital mortality by incorporating albumin, another known prognostic indicator. ⋯ The PAR is a readily obtainable and independent prognostic indicator for patients with ROSC after OHCA, helping healthcare providers in predicting outcomes.