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Coronary Angiography in Patients with and without STEMI Following out-of-hospital Cardiac Arrest

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Open Journal of Internal Medicine 2014年第4期4卷 115-122页

作者： Martin Christ Katharina Isabel von Auenmueller Wolfgang Dierschke Jan Peter Noelke Thomas Butz Jeanette Liebeton Hans-Joachim Trappe Department of Cardiology and Angiology Marienhospital Herne Ruhr-University Bochum Germany

Introduction: Little is known about discrepancies between patients who present with or without STEMI following out-of-hospital cardiac arrest (OHCA). Material and Methods: All patients with OHCA who were admitted to our hospital between January 1st 2008 and December 31st 2013 were classified according to their initial laboratory and electrocardiographic findings into STEMI, NSTEMI or no ACS. Results: Overall, 147 patients [32 STEMI (21.8%), 28 NSTEMI (19.0%) and 87 no ACS (59.2%)] were included with a mean age of 63.7 ± 13.3 years;there were 84 men (57.1%) and 63 (42.9%) women. Of these, 63 patients (51.7%) received coronary angiography [29 STEMI (90.6%), 9 NSTEMI (32.1%) and 38 no ACS (43.7%)] showing a high prevalence of coronary artery disease (CAD) [28 STEMI (96.6%), 9 NSTEMI (100.0%) and 26 no ACS (68.4%)] requiring percutaneous coronary intervention (PCI) in 52 cases [28 STEMI (96.6%), 8 NSTEMI (88.9%) and 16 no ACS (42.1%)]. Discussion: Coronary angiography immediately after hospital admission is feasible if all are prepared for potential further resuscitation efforts during cardiac catheterization. Primary focus on haemodynamic stabilisation may reduce the rates of coronary angiographies in patients following OHCA. Altogether, our data support the call for immediate coronary angiography in all patients following OHCA irrespective of their initial laboratory or electrocardiographic findings.

关键词： out-of-hospital Cardiac Arrest OHCA Myocardial Infarction STEMI NSTEMI Coronary Angiography Resuscitation

Association between the Consumption of Carbonated Beverages and out-of-hospital Cardiac Arrests of Cardiac Origin in Japan

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World Journal of Cardiovascular Diseases 2015年第12期5卷 361-372页

作者： Masaki Tokunaga Yasunori Suematsu Shin-ichiro Miura Takashi Kuwano Atsushi Iwata Hiroaki Nishikawa Bo Zhang Naohiro Yonemoto Hiroshi Nonogi Ken Nagao Takeshi Kimura Keijiro Saku Department of Cardiology Fukuoka University School of Medicine Fukuoka Japan The AIG Collaborative Research Institute of Cardiovascular Medicine Fukuoka University Fukuoka Japan Department of Biochemistry Fukuoka University School of Medicine Fukuoka Japan Department of Epidemiology and Biostatistics National Center of Neurology and Psychiatry Tokyo Japan hospital Deputy Shizuoka General Hospital Shizuoka Japan Department of Cardiology Resuscitation and Emergency Cardiovascular Care Surugadai Nihon University Hospital Nihon University School of Medicine Tokyo Japan Department of Cardiovascular Medicine Graduate School of Medicine Kyoto University Kyoto Japan

Background: The consumption of carbonated beverages has been shown to increase the risk of developing metabolic syndrome. The associations between the consumption of carbonated beverages and left arterial dimension or left ventricular mass are believed to be likely related to the greater body weight of carbonated beverage drinkers relative to non-drinkers. Nonetheless, little is known about the association between the consumption of carbonated beverages and out-of-hospital cardiac arrests (OHCAs) in Japan. Methods: We compared the age-adjusted incidence of OHCAs to the expenditures on various beverages per person between 2005 and 2011 in the 47 prefectures of Japan. Patients who suffered from OHCAs of cardiac and non-cardiac origin were enrolled in All-Japan Utstein Registry of the Fire and Disaster Management Agency. The expenditures on various beverages per person in the 47 prefectures in Japan were obtained from data published by the Ministry of Health, Labour and Welfare of Japan. Results: There were 797,422 cases of OHCA in the All-Japan Utstein registry between 2005 and 2011, including 11,831 cases who did not receive resuscitation. Among these 785,591 cases of OHCA, 435,064 (55.4%) were classified as cardiac origin and 350,527 (44.6%) were non-cardiac origin. Non-cardiac origin included cerebrovascular disease, respiratory disease, malignant tumor, and exogenous disease (4.8%, 6.1%, 3.5%, and 18.9%, respectively). The expenditures on carbonated beverages were significantly associated with OHCAs of cardiac origin (r = 0.30, p = 0.04), but not non-cardiac origin (r = -0.03, p = 0.8). Expenditures on other beverages, including green tea, tea, coffee, cocoa, fruit or vegetable juice, fermented milk beverage, milk beverage, and mineral water, were not significantly associated with OHCAs of cardiac origin. Conclusion: Carbonated beverage consumption was significantly and positively associated with OHCAs of cardiac origin in Japan, indicating that beverage habits mi

关键词： out-of-hospital Cardiac Arrest Utstein Registry Carbonated Beverage Ecological Study

Effect of Airway Management and Impedance Threshold Device on Circulation, Survival and Neurological outcome in Adult out-of-hospital Cardiac Arrest

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Open Journal of Emergency Medicine 2014年第1期2卷 12-18页

作者： David Chase Angelo Salvucci Rafael Marino Robin Shedlosky Nancy Merman Katy Hadduck Ventura County Fire Department Camarillo CA USA

Purpose: This study was designed to study the effect of early use of the King Airway (KA) and impedance threshold device (ITD) in out-of-hospital cardiac arrest on ETCO2 as a surrogate measure of circulation, survival, and cerebral performance category (CPC) scores. After analysis of the first 9 month active period the KA was relegated to rescue airway status. Methods: This was a prospective pre-post study design. Patients >18 years with out-of-hospital cardiac caused arrest were included. Three periods were compared. In the first “non active” period conventional AHA 30/2 compression/ventilation ratio CPR was done with bag mask ventilation (BMV). No ITD was used. After advanced airway placement the compression/ventilation ratio was 10/1. In the second period continuous compressions were done. Primary airway management was a KA with an ITD. After placement of the KA the compression/ventilation ratio was 10/1. In the third period CPR reverted to 30/2 ratio with a two hand seal BMV with ITD. CPR ratio was 10/1 post endotracheal intubation (ETI) or KA. The KA was only recommended for failed BMV and ETI. Results: Survival to hospital discharge was similar in all three study periods. In Period 2 there was a strong trend to CPC scores >2. The study group hypothesized that the KA interfered with cerebral blood flow. For that reason the KA was abandoned as a primary airway. Comparing Period 1 to Period 3 there was a trend to improved survival in the bystander witnessed shockable rhythm (Utstein) subgroup, particularly if a metronome was used. ETCO2 was significantly increased in Period 2 and trended up in Period 3 when compared to Period 1. Advanced airway intervention had a highly significant negative association with survival. Conclusion: The introduction of an ITD into our system did not result in a statistically significant improvement in survival. The study groups were somewhat dissimilar. ETCO2 trended up. When comparing Period 1 to Period 3, the bundle of care was ass

关键词： Airway Management out-of-hospital Cardiac Arrest Cardiopulmonary Resuscitation Endotracheal Intubation Supraglottic Airways Emergency Medical Services

Benefits of using an endotracheal tube introducer as an adjunct to a Macintosh laryngoscope for endotracheal intubation performed by inexperienced doctors during mechanical CPR:A randomized prospective crossover study

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World Journal of Emergency Medicine 2019年第3期10卷 182-186页

作者： Hüseyin Cahit Halhalli As?m Enes ?zbek Emrah ?el?k Yavuz Y???t Serkan Yilmaz Müge ?ardak Department of Emergency Medicine University of Health SciencesKocaeli Derince Training and Research Hospital

Dear editor, out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for out-ofhospital cardiac arrests (OHCA). According to advanced cardiac life support (ACLS) guidelines, out-of-hospital cardiac arrest survival rates may be increased by performing cardiopulmonary resuscitation (CPR) with minimal interruptions.[3] According to the latest ACLS, does the patient need an advanced airway.

关键词： out-of-hospital cardiac inhospital cardiac advanced cardiac life support