Articles: cardiac-arrest.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest.
To examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ Levosimendan use in ECPR did not improve survival. Future well-designed randomized trials are warranted to investigate the potential benefit of levosimendan in the ECPR setting.
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Airway management is a critical component of the care of patients experiencing cardiac arrest, but data from randomized trials on the use of video vs direct laryngoscopy for intubation in the setting of cardiac arrest are limited. Current AHA guidelines recommend placement of an endotracheal tube either during CPR or shortly after return of spontaneous circulation but do not provide guidance around intubation methods, including the choice of laryngoscope. ⋯ Among adults undergoing tracheal intubation after experiencing cardiac arrest, use of video laryngoscopy was associated with increased incidence of successful intubation on the first attempt and shortened duration of laryngoscopy, compared to use of direct laryngoscopy.
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Accurate prognostication in comatose survivors of cardiac arrest is a challenging and high-stakes endeavor. We sought to determine whether internal EEG subparameters extracted by the Bispectral Index (BIS) monitor, a device commonly used to estimate depth-of-anesthesia intraoperatively, could be repurposed to predict recovery of consciousness after cardiac arrest. ⋯ In patients comatose after cardiac arrest, four EEG features calculated internally by the BIS Engine were repurposed by a compact neural network to achieve a prognostic accuracy superior to the current clinical qualitative gold-standard, with high sensitivity for recovery. These features hold promise for assessing patients after cardiac arrest.
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The recommended epinephrine administration interval during CPR is between 3 and 5 min. However, the optimal interval for improving cerebral perfusion remains controversial. This study aimed to evaluate the effects of epinephrine administration interval of 3 min or 5 min on cerebral perfusion pressure (CEPP) and cortical cerebral blood flow (CCBF) in a porcine cardiac arrest model. ⋯ The 3-min epinephrine administration interval showed a higher CEPP compared with the 5-min interval. No significant differences were found in the CCBF between the two interval groups.