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29 "cardiopulmonary resuscitation"
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Pediatrics
Development of a deep learning model for predicting critical events in a pediatric intensive care unit
In Kyung Lee, Bongjin Lee, June Dong Park
Acute Crit Care. 2024;39(1):186-191.   Published online February 20, 2024
DOI: https://doi.org/10.4266/acc.2023.01424
Correction in: https://doi.org/
  • 390 View
  • 43 Download
AbstractAbstract PDF
Background
Identifying critically ill patients at risk of cardiac arrest is important because it offers the opportunity for early intervention and increased survival. The aim of this study was to develop a deep learning model to predict critical events, such as cardiopulmonary resuscitation or mortality. Methods: This retrospective observational study was conducted at a tertiary university hospital. All patients younger than 18 years who were admitted to the pediatric intensive care unit from January 2010 to May 2023 were included. The main outcome was prediction performance of the deep learning model at forecasting critical events. Long short-term memory was used as a deep learning algorithm. The five-fold cross validation method was employed for model learning and testing. Results: Among the vital sign measurements collected during the study period, 11,660 measurements were used to develop the model after preprocessing; 1,060 of these data points were measurements that corresponded to critical events. The prediction performance of the model was the area under the receiver operating characteristic curve (95% confidence interval) of 0.988 (0.9751.000), and the area under the precision-recall curve was 0.862 (0.700–1.000). Conclusions: The performance of the developed model at predicting critical events was excellent. However, follow-up research is needed for external validation.
CPR/Resuscitation
Prognostic significance of respiratory quotient in patients undergoing extracorporeal cardiopulmonary resuscitation in Korea
Yun Im Lee, Ryoung-Eun Ko, Soo Jin Na, Jeong-Am Ryu, Yang Hyun Cho, Jeong Hoon Yang, Chi Ryang Chung, Gee Young Suh
Acute Crit Care. 2023;38(2):190-199.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01438
  • 1,538 View
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  • 2 Web of Science
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AbstractAbstract PDF
Background
Respiratory quotient (RQ) may be used as a tissue hypoxia marker in various clinical settings but its prognostic significance in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) is not known. Methods: Medical records of adult patients admitted to the intensive care units after ECPR in whom RQ could be calculated from May 2004 to April 2020 were retrospectively reviewed. Patients were divided into good neurologic outcome and poor neurologic outcome groups. Prognostic significance of RQ was compared to other clinical characteristics and markers of tissue hypoxia. Results: During the study period, 155 patients were eligible for analysis. Of them, 90 (58.1%) had a poor neurologic outcome. The group with poor neurologic outcome had a higher incidence of out-of-hospital cardiac arrest (25.6% vs. 9.2%, P=0.010) and longer cardiopulmonary resuscitation to pump-on time (33.0 vs. 25.2 minutes, P=0.001) than the group with good neurologic outcome. For tissue hypoxia markers, the group with poor neurologic outcome had higher RQ (2.2 vs. 1.7, P=0.021) and lactate levels (8.2 vs. 5.4 mmol/L, P=0.004) than the group with good neurologic outcome. On multivariable analysis, age, cardiopulmonary resuscitation to pump-on time, and lactate levels above 7.1 mmol/L were significant predictors for a poor neurologic outcome but not RQ. Conclusions: In patients who received ECPR, RQ was not independently associated with poor neurologic outcome.

Citations

Citations to this article as recorded by  
  • Risk factors for neurological disability outcomes in patients under extracorporeal membrane oxygenation following cardiac arrest: An observational study
    Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim, Ali Ait Hssain
    Intensive and Critical Care Nursing.2024; 83: 103674.     CrossRef
  • Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest and in-hospital cardiac arrest with return of spontaneous circulation: be careful when comparing apples to oranges
    Hwa Jin Cho, In Seok Jeong, Jan Bělohlávek
    Acute and Critical Care.2023; 38(2): 242.     CrossRef
CPR/Resuscitation
Cardiopulmonary resuscitation of infants at birth: predictable or unpredictable?
Mohammad Reza Zarkesh, Raheleh Moradi, Azam Orooji
Acute Crit Care. 2022;37(3):438-453.   Published online August 29, 2022
DOI: https://doi.org/10.4266/acc.2021.01501
  • 2,589 View
  • 156 Download
AbstractAbstract PDF
Background
Anticipating the need for at-birth cardiopulmonary resuscitation (CPR) in neonates is very important and complex. Timely identification and rapid CPR for neonates in the delivery room significantly reduce mortality and other neurological disabilities. The aim of this study was to create a prediction system for identifying the need for at-birth CPR in neonates based on Machine Learning (ML) algorithms.
Methods
In this study, 3,882 neonatal medical records were retrospectively reviewed. A total of 60 risk factors was extracted, and five ML algorithms of J48, Naïve Bayesian, multilayer perceptron, support vector machine (SVM), and random forest were compared to predict the need for at-birth CPR in neonates. Two types of resuscitation were considered: basic and advanced CPR. Using five feature selection algorithms, features were ranked based on importance, and important risk factors were identified using the ML algorithms.
Results
To predict the need for at-birth CPR in neonates, SVM using all risk factors reached 88.43% accuracy and F-measure of 88.4%, while J48 using only the four first important features reached 90.89% accuracy and F-measure of 90.9%. The most important risk factors were gestational age, delivery type, presentation, and mother’s addiction.
Conclusions
The proposed system can be useful in predicting the need for CPR in neonates in the delivery room.
Ethics
Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
Acute Crit Care. 2022;37(2):237-246.   Published online February 24, 2022
DOI: https://doi.org/10.4266/acc.2021.01095
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  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Background
The Life-Sustaining Treatment (LST) Decisions Act allows withholding and withdrawal of LST, including cardiopulmonary resuscitation (CPR). In the present study, the incidence of CPR before and after implementation of the Act was compared.
Methods
This was a retrospective review involving hospitalized patients who underwent CPR at a single center between February 2016 and January 2020 (pre-implementation period, February 2016 to January 2018; post-implementation period, February 2018 to January 2020). The primary outcome was monthly incidence of CPR per 1,000 admissions. The secondary outcomes were duration of CPR, return of spontaneous circulation (ROSC) rate, 24-hour survival rate, and survival-to-discharge rate. The study outcomes were compared before and after implementation of the Act.
Results
A total of 867 patients who underwent CPR was included in the analysis. The incidence of CPR per 1,000 admissions showed no significant difference before and after implementation of the Act (3.02±0.68 vs. 2.81±0.75, P=0.255). The ROSC rate (67.20±0.11 vs. 70.99±0.12, P=0.008) and survival to discharge rate (20.24±0.09 vs. 22.40±0.12, P=0.029) were higher after implementation of the Act than before implementation.
Conclusions
The incidence of CPR did not significantly change for 2 years after implementation of the Act. Further studies are needed to assess the changes in trends in the decisions of CPR and other LSTs in real-world practice.

Citations

Citations to this article as recorded by  
  • Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
    Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
    BMC Palliative Care.2024;[Epub]     CrossRef
  • For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
    Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Comparison of the end-of-life decisions of patients with hospital-acquired pneumonia after the enforcement of the life-sustaining treatment decision act in Korea
    Ae-Rin Baek, Sang-Bum Hong, Soohyun Bae, Hye Kyeong Park, Changhwan Kim, Hyun-Kyung Lee, Woo Hyun Cho, Jin Hyoung Kim, Youjin Chang, Heung Bum Lee, Hyun-Il Gil, Beomsu Shin, Kwang Ha Yoo, Jae Young Moon, Jee Youn Oh, Kyung Hoon Min, Kyeongman Jeon, Moon S
    BMC Medical Ethics.2023;[Epub]     CrossRef
  • Will implementation of the Life-sustaining Treatment Decisions Act reduce the incidence of cardiopulmonary resuscitation?
    In-Ae Song
    Acute and Critical Care.2022; 37(2): 256.     CrossRef
  • Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study
    Jaeyoung Choi, Ah Young Choi, Esther Park, Meong Hi Son, Joongbum Cho
    Resuscitation.2022; 180: 38.     CrossRef
Rapid response system
Analysis of avoidable cardiopulmonary resuscitation incidents with a part-time rapid response system in place
Jun Yeun Cho, Dong Seon Lee, Yun Young Choi, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Acute Crit Care. 2021;36(2):109-117.   Published online April 16, 2021
DOI: https://doi.org/10.4266/acc.2020.01095
  • 4,998 View
  • 148 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Although a rapid response system (RRS) can reduce the incidence of cardiopulmonary resuscitation (CPR) in general wards, avoidable CPR cases still occur. This study aimed to investigate the incidence and causes of avoidable CPR.
Methods
We retrospectively reviewed the medical records of all adult patients who received CPR between April 2013 and March 2016 (35 months) at a tertiary teaching hospital where a part-time RRS was introduced in October 2012. Four experts reviewed all of the CPR cases and determined whether each event was avoidable.
Results
A total of 192 CPR cases were identified, and the incidence of CPR was 0.190 per 1,000 patient admissions. Of these, 56 (29.2%) were considered potentially avoidable, with the most common cause being doctor error (n=32, 57.1%), followed by delayed do-not-resuscitate (DNR) placement (n=12, 21.4%) and procedural complications (n=5, 8.9%). The percentage of avoidable CPR was significantly lower in the RRS operating time group than in the RRS non-operating time group (20.7% vs. 35.5%; P=0.026). Among 44 avoidable CPR events (excluding cases related to DNR issues), the rapid response team intervened in only three cases (6.8%), and most of the avoidable CPR cases (65.9%) occurred during the non-operating time.
Conclusions
A significant number of avoidable CPR events occurred with a well-functioning, part-time RRS in place. However, RRS operation does appear to lower the occurrence of avoidable CPR. Thus, it is necessary to extend RRS operation time and modify RRS activation criteria. Moreover, policy and cultural changes are needed prior to implementing a full-time RRS.

Citations

Citations to this article as recorded by  
  • Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
    Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
    Acute and Critical Care.2022; 37(2): 237.     CrossRef
  • A Review of the Commercially Available ECG Detection and Transmission Systems—The Fuzzy Logic Approach in the Prevention of Sudden Cardiac Arrest
    Michał Lewandowski
    Micromachines.2021; 12(12): 1489.     CrossRef
Rapid response system
Effectiveness of a daytime rapid response system in hospitalized surgical ward patients
Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh
Acute Crit Care. 2020;35(2):77-86.   Published online May 13, 2020
DOI: https://doi.org/10.4266/acc.2019.00661
  • 6,171 View
  • 211 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients.
Methods
A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of “do not resuscitate” orders, and the survival of discharged CPA patients.
Results
The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001).
Conclusions
The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.

Citations

Citations to this article as recorded by  
  • Development and Validation of a Machine Learning Algorithm Using Clinical Pages to Predict Imminent Clinical Deterioration
    Bryan D. Steitz, Allison B. McCoy, Thomas J. Reese, Siru Liu, Liza Weavind, Kipp Shipley, Elise Russo, Adam Wright
    Journal of General Internal Medicine.2024; 39(1): 27.     CrossRef
  • Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review
    Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
    Heart & Lung.2024; 63: 51.     CrossRef
  • Clinical significance of acute care surgery system as a part of hospital medical emergency team for hospitalized patients
    Kyoung Won Yoon, Kyoungjin Choi, Keesang Yoo, Eunmi Gil, Chi-Min Park
    Annals of Surgical Treatment and Research.2023; 104(1): 43.     CrossRef
  • The associations between rapid response systems and their components with patient outcomes: A scoping review
    Rebecca J. Piasecki, Cheryl R. Dennison Himmelfarb, Kelly T. Gleason, Rachel M. Justice, Elizabeth A. Hunt
    International Journal of Nursing Studies Advances.2023; 5: 100134.     CrossRef
  • Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
    Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
    Acute and Critical Care.2022; 37(2): 237.     CrossRef
  • Estructura y función de los equipos de respuesta rápida para la atención de adultos en contextos hospitalarios de alta complejidad: Revisión sistemática de alcance
    Juliana Vanessa Rincón-López, Diego Larrotta-Castillo, Kelly Estrada-Orozco, Hernando Gaitán-Duarte
    Revista Colombiana de Obstetricia y Ginecología.2021; 72(2): 171.     CrossRef
  • Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
    Sang Hyuk Kim, Ji Young Hong, Youlim Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards
    Mi-Jung Yoon, Jin-Hee Park
    Journal of Korean Academy of Fundamentals of Nursing.2021; 28(4): 491.     CrossRef
Pediatric
Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit
Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim
Acute Crit Care. 2020;35(2):87-92.   Published online May 12, 2020
DOI: https://doi.org/10.4266/acc.2019.00752
  • 4,214 View
  • 96 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.
Methods
We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).
Results
Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.
Conclusions
Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

Citations

Citations to this article as recorded by  
  • The impact of pediatric intensivists on the management of pediatric diabetic ketoacidosis in pediatric intensive care units
    Ah Young Choi, Esther Park
    BMC Pediatrics.2023;[Epub]     CrossRef
  • Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
    Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
    PLOS ONE.2021; 16(10): e0259092.     CrossRef
  • Intensivists in the pediatric intensive care unit: conductors for better operational efficiency
    June Dong Park
    Acute and Critical Care.2020; 35(2): 115.     CrossRef
Review Article
CPR/Resuscitation
Role of extracorporeal cardiopulmonary resuscitation in adults
Hongsun Kim, Yang Hyun Cho
Acute Crit Care. 2020;35(1):1-9.   Published online February 29, 2020
DOI: https://doi.org/10.4266/acc.2020.00080
  • 9,600 View
  • 365 Download
  • 20 Web of Science
  • 22 Crossref
AbstractAbstract PDF
Extracorporeal cardiopulmonary resuscitation (ECPR) has been performed with increasing frequency worldwide to improve the low survival rate of conventional cardiopulmonary resuscitation (CCPR). Several studies have shown that among patients who experience in-hospital cardiac arrest, better survival outcomes and neurological outcomes can be expected after ECPR than after CCPR. However, studies have not clearly shown a short-term survival benefit of ECPR for patients who experience out-of-hospital cardiac arrest. Favorable outcomes are associated with a shorter low-flow time, an initial shockable rhythm, lower serum lactate levels, higher blood pH, and a lower Sequential Organ Failure Assessment score. Indications for ECPR include young age, witnessed arrest with bystander cardiopulmonary resuscitation, an initial shockable rhythm, correctable causes such as a cardiac etiology, and no return of spontaneous circulation within 10–20 minutes of CCPR. ECPR is a complex intervention that requires a highly trained team, specialized equipment, and multidisciplinary support within a healthcare system, and it has the risk of several life-threatening complications. Therefore, physicians should carefully select patients for ECPR who can gain the most benefit, instead of applying ECPR indiscriminately.

Citations

Citations to this article as recorded by  
  • Impact of independent early stage extracorporeal cardiopulmonary resuscitation in the emergency department following the establishment of an extracorporeal life support team
    Zhan-Xiao Liu, Ya Yang, Huan-Huan Song, Wei Liu, Peng Sun, Cai-Wei Lin
    Heliyon.2024; 10(1): e23411.     CrossRef
  • Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomized controlled trials and propensity score-matched studies
    Christopher Jer Wei Low, Ryan Ruiyang Ling, Michele Petrova Xin Ling Lau, Nigel Sheng Hui Liu, Melissa Tan, Chuen Seng Tan, Shir Lynn Lim, Bram Rochwerg, Alain Combes, Daniel Brodie, Kiran Shekar, Susanna Price, Graeme MacLaren, Kollengode Ramanathan
    Intensive Care Medicine.2024; 50(2): 209.     CrossRef
  • Clinician Perspectives on Cannulation for Extracorporeal Cardiopulmonary Resuscitation: A Mixed Methods Analysis
    Devindi Wanigasekara, Vincent A. Pellegrino, Aidan JC. Burrell, Nyein Aung, Shaun D. Gregory
    ASAIO Journal.2023; 69(3): 332.     CrossRef
  • Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with cardiac arrest: a comparative meta-analysis and trial sequential analysis
    Christopher Jer Wei Low, Kollengode Ramanathan, Ryan Ruiyang Ling, Maxz Jian Chen Ho, Ying Chen, Roberto Lorusso, Graeme MacLaren, Kiran Shekar, Daniel Brodie
    The Lancet Respiratory Medicine.2023; 11(10): 883.     CrossRef
  • Anticoagulation strategies in patients with extracorporeal membrane oxygenation: A network meta‐analysis and systematic review
    Jiale Chen, Guoquan Chen, Wenyi Zhao, Wenxing Peng
    Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2023; 43(10): 1084.     CrossRef
  • Prophylactic antibiotic treatment for preventing nosocomial infection in extracorporeal membrane oxygenation–resuscitated circulatory arrest patients
    Lan-Pin Kuo, Yi-Chen Wang, Po-Lin Chen, Wei-Hung Lin, Wei-Ming Wang, Chao-Jung Shih, Pei-Ni Yang, Yu-Ning Hu, Chih-Hsin Hsu, Jun-Neng Roan, Meng-Ta Tsai
    JTCVS Open.2023; 16: 582.     CrossRef
  • Lethal abdominal compartment syndrome after extracorporeal cardiopulmonary resuscitation in a patient with out-of-hospital cardiac arrest: a case report
    Gun Jik Kim, Kyoung Hoon Lim, Tak-hyuk Oh, Hyun-Joo Lee, Deokbi Hwang, Hanna Jung
    International Journal of Emergency Medicine.2023;[Epub]     CrossRef
  • How effective is extracorporeal life support for patients with out-of-hospital cardiac arrest initiated at the emergency department? A systematic review and meta-analysis
    Wachira Wongtanasarasin, Sarunsorn Krintratun, Witina Techasatian, Daniel K. Nishijima, Gaetano Santulli
    PLOS ONE.2023; 18(11): e0289054.     CrossRef
  • Treatment of Refractory Cardiac Arrest by Controlled Reperfusion of the Whole Body: A Multicenter, Prospective Observational Study
    Georg Trummer, Christoph Benk, Jan-Steffen Pooth, Tobias Wengenmayer, Alexander Supady, Dawid L. Staudacher, Domagoj Damjanovic, Dirk Lunz, Clemens Wiest, Hug Aubin, Artur Lichtenberg, Martin W. Dünser, Johannes Szasz, Dinis Dos Reis Miranda, Robert J. va
    Journal of Clinical Medicine.2023; 13(1): 56.     CrossRef
  • Extended cardiopulmonary resuscitation: from high fidelity simulation scenario to the first clinical applications in Poznan out-of-hospital cardiac arrest program
    Maciej Sip, Mateusz Puslecki, Marek Dabrowski, Tomasz Klosiewicz, Radoslaw Zalewski, Marcin Ligowski, Ewa Goszczynska, Christopher Paprocki, Marek Grygier, Maciej Lesiak, Marek Jemielity, Bartłomiej Perek
    Perfusion.2022; 37(1): 46.     CrossRef
  • Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: first results and outcomes of a newly established ECPR program in a large population area
    Ilija Djordjevic, Christopher Gaisendrees, Christoph Adler, Kaveh Eghbalzadeh, Simon Braumann, Borko Ivanov, Julia Merkle, Antje-Christin Deppe, Elmar Kuhn, Robert Stangl, Alex Lechleuthner, Christian Miller, Roman Pfister, Navid Mader, Stephan Baldus, An
    Perfusion.2022; 37(3): 249.     CrossRef
  • Impact of left ventricular unloading using a peripheral Impella®‐pump in eCPR patients
    Christopher Gaisendrees, Ilija Djordjevic, Anton Sabashnikov, Christopher Adler, Kaveh Eghbalzadeh, Borko Ivanov, Sebastian Walter, Georg Schlachtenberger, Julia Merkle‐Storms, Stephen Gerfer, Henning Carstens, Antje‐Christin Deppe, Elmar Kuhn, Thorsten W
    Artificial Organs.2022; 46(3): 451.     CrossRef
  • Vascular complications based on mode of extracorporeal membrane oxygenation
    Juliet Blakeslee-Carter, Connie Shao, Ryan LaGrone, Irina Gonzalez-Sigler, Danielle C. Sutzko, Benjamin Pearce, Kyle Eudailey, Emily Spangler, Adam W. Beck, Graeme E. McFarland
    Journal of Vascular Surgery.2022; 75(6): 2037.     CrossRef
  • Efficacy of a temporary CentriMag ventricular assist device in acute fulminant myocarditis patients revived with extracorporeal cardiopulmonary resuscitation
    Ying-Hsiang Wang, Chien-Sung Tsai, Jia-Lin Chen, Yi-Ting Tsai, Chih-Yuan Lin, Hsiang-Yu Yang, Po-Shun Hsu
    Journal of the Formosan Medical Association.2022; 121(10): 1917.     CrossRef
  • Anticoagulation Strategies during Extracorporeal Membrane Oxygenation: A Narrative Review
    Sasa Rajsic, Robert Breitkopf, Dragana Jadzic, Marina Popovic Krneta, Helmuth Tauber, Benedikt Treml
    Journal of Clinical Medicine.2022; 11(17): 5147.     CrossRef
  • Outcomes of Pediatric Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis
    Abdelaziz Farhat, Ryan Ruiyang Ling, Christopher L. Jenks, Wynne Hsing Poon, Isabelle Xiaorui Yang, Xilong Li, Yulun Liu, Cindy Darnell-Bowens, Kollengode Ramanathan, Ravi R. Thiagarajan, Lakshmi Raman
    Critical Care Medicine.2021; 49(4): 682.     CrossRef
  • Prediction of successful weaning off ECMO support after ECPR: Is pulse pressure crucial for success?
    Ilija Djordjevic, Thorsten Wahlers
    Journal of Cardiac Surgery.2021; 36(8): 2751.     CrossRef
  • Impact of age on the outcomes of extracorporeal cardiopulmonary resuscitation: analysis using inverse probability of treatment weighting
    Young Su Kim, Yang Hyun Cho, Jeong Hoon Yang, Ji-Hyuk Yang, Suryeun Chung, Gee Young Suh, Kiick Sung
    European Journal of Cardio-Thoracic Surgery.2021; 60(6): 1318.     CrossRef
  • Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
    Dong-Geum Shin, Sang-Deock Shin, Donghoon Han, Min-Kyung Kang, Seung-Hun Lee, Jihoon Kim, Jung-Rae Cho, Kunil Kim, Seonghoon Choi, Namho Lee
    Medicina.2021; 57(9): 886.     CrossRef
  • Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages
    Vorakamol Phoophiboon, Monvasi Pachinburavan, Nicha Ruamsap, Natthawan Sanguanwong, Nattapong Jaimchariyatam
    Acute and Critical Care.2021; 36(4): 286.     CrossRef
  • Brain natriuretic peptide levels predict 6-month mortality in patients with cardiogenic shock who were weaned off extracorporeal membrane oxygenation
    Hyoung Soo Kim, Kyu Jin Lee, Sang Ook Ha, Sang Jin Han, Kyoung-Ha Park, Sun Hee Lee, Yong Il Hwang, Seung Hun Jang, Sunghoon Park
    Medicine.2020; 99(29): e21272.     CrossRef
  • Role and Prognosis of Extracorporeal Life Support in Patients Who Develop Cardiac Arrest during or after Office-Based Cosmetic Surgery
    Seong Soon Kwon, Byoung-Won Park, Min-Ho Lee, Duk Won Bang, Min-Su Hyon, Won-Ho Chang, Hong Chul Oh, Young Woo Park
    The Korean Journal of Thoracic and Cardiovascular Surgery.2020; 53(5): 277.     CrossRef
Original Article
Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards
Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
Acute Crit Care. 2019;34(4):246-254.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00668
  • 5,961 View
  • 196 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

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  • The role of emergency medical services in the management of in-hospital emergencies: Causes and outcomes of emergency calls – A descriptive retrospective register-based study
    Henna Myrskykari, Timo Iirola, Hilla Nordquist
    Australasian Emergency Care.2024; 27(1): 42.     CrossRef
  • Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review
    Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
    Heart & Lung.2024; 63: 51.     CrossRef
  • Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
    Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
    Critical Care Medicine.2024; 52(2): 314.     CrossRef
  • Improving sepsis recognition and management
    Merrilee I Cox, Hillary Voss
    Current Problems in Pediatric and Adolescent Health Care.2021; 51(4): 101001.     CrossRef
  • A Somogy Megyei Kaposi Mór Oktató Kórház által bevezetett gyors reagálású rendszer hatása a kórházi mortalitásra
    János Fogas, Rita Koroseczné Pavlin, Krisztina Szabó, Eszter Héra, Imre Repa, Mariann Moizs
    Orvosi Hetilap.2021; 162(20): 782.     CrossRef
  • Evidence revealed the effects of rapid response system
    Jae Hwa Cho
    Acute and Critical Care.2019; 34(4): 282.     CrossRef
Review Article
CPR/Resuscitation
Management of post-cardiac arrest syndrome
Youngjoon Kang
Acute Crit Care. 2019;34(3):173-178.   Published online August 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00654
  • 33,177 View
  • 2,129 Download
  • 30 Web of Science
  • 33 Crossref
AbstractAbstract PDF
Post-cardiac arrest syndrome is a complex and critical issue in resuscitated patients undergone cardiac arrest. Ischemic-reperfusion injury occurs in multiple organs due to the return of spontaneous circulation. Bundle of management practicies are required for post-cardiac arrest care. Early invasive coronary angiography should be considered to identify and treat coronary artery obstructive disease. Vasopressors such as norepinephrine and dobutamine are the first-line treatment for shock. Maintainance of oxyhemoglobin saturation greater than 94% but less than 100% is recommended to avoid fatality. Target temperature therapeutic hypothermia helps to resuscitated patients. Strict temperature control is required and is maintained with the help of cooling devices and monitoring the core temperature. Montorings include electrocardiogram, oxymetry, capnography, and electroencephalography (EEG) along with blood pressue, temprature, and vital signs. Seizure should be treated if EEG shows evidence of seizure or epileptiform activity. Clinical neurologic examination and magnetic resonance imaging are considered to predict neurological outcome. Glycemic control and metabolic management are favorable for a good neurological outcome. Recovery from acute kidney injury is essential for survival and a good neurological outcome.

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  • Nursing core competencies for postresuscitation care in Iran: a qualitative study
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani
    BMJ Open.2024; 14(1): e074614.     CrossRef
  • Critical care nurses’ experiences of caring challenges during post-resuscitation period: a qualitative content analysis
    Mahnaz Zali, Azad Rahmani, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani, Arman Azadi, Mansour Ghafourifard
    BMC Nursing.2024;[Epub]     CrossRef
  • Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit
    Ayman El-Menyar, Bianca M Wahlen
    World Journal of Cardiology.2024; 16(3): 126.     CrossRef
  • Nurses’ experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani
    Nursing Ethics.2023; 30(2): 245.     CrossRef
  • Nurses' experiences of provision family‐centred care in the postresuscitation period: A qualitative study
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar‐Areshtanab, Neda Gilani
    Nursing Open.2023; 10(11): 7215.     CrossRef
  • Revisión del Síndrome Post Parada Cardíaca
    Juan Antonio Coyago Iñiguez , Erika Pamela Abad Molina, John Paul Castillo Hernández, Martín Alexander Chamorro Romero, Sonia Azucena Ortiz Reinoso, Chrisy Esthephanye Sarmiento Sarmiento
    LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades.2023; 4(1): 475.     CrossRef
  • Pathophysiological Roles of Transient Receptor Potential (Trp) Channels and Zinc Toxicity in Brain Disease
    Dae Ki Hong, A Ra Kho, Song Hee Lee, Beom Seok Kang, Min Kyu Park, Bo Young Choi, Sang Won Suh
    International Journal of Molecular Sciences.2023; 24(7): 6665.     CrossRef
  • The role of targeted temperature management in 30-day hospital readmissions in cardiac arrest survivors: A national population-based study
    Justin Mark, Jose Lopez, Waseem Wahood, Joshua Dodge, Miguel Belaunzaran, Fergie Losiniecki, Yelixa Santos-Roman, Mauricio Danckers
    IJC Heart & Vasculature.2023; 46: 101207.     CrossRef
  • Microvascular Leakage as Therapeutic Target for Ischemia and Reperfusion Injury
    Jan Andreas Kloka, Benjamin Friedrichson, Petra Wülfroth, Rainer Henning, Kai Zacharowski
    Cells.2023; 12(10): 1345.     CrossRef
  • Mid-regional pro-adrenomedullin and lactate levels for risk stratification in patients with out-of-hospital cardiac arrest
    Thomas A Zelniker, Dominik Schwall, Fardin Hamidi, Simone Steinbach, Pascal Scheller, Sebastian Spaich, Guido Michels, Evangelos Giannitsis, Hugo A Katus, Norbert Frey, Michael R Preusch
    European Heart Journal: Acute Cardiovascular Care.2023; 12(6): 364.     CrossRef
  • Non‐trauma uses of viscoelastic hemostatic assays in critical care: A narrative review and primer for pharmacists
    Susan E. Smith, Brooke Barlow, Liana Ha, SeongEun Emily Park, Trisha N. Branan
    JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2023; 6(11): 1265.     CrossRef
  • Prognostic Value of the Ratio of Hemoglobin to Red Blood Cell Distribution Width in Patients with Out-of-Hospital Cardiac Arrest: A Retrospective Study
    Hong Wang, Yao Luo, Tangjuan Zhang, Qing Lv, Liu Yang, Xinya Jia, Yan Zhou, Renjie Li, Xingqiang Zhu, Ruyi Lei, Chao Lan
    Intensive Care Research.2023; 3(3): 229.     CrossRef
  • Effectiveness of Induced Hypothermia on the Prognosis of Post-cardiac Arrest Patients: A Scoping Literature Review
    Ralph Kingsford Rohit, Charu Tibrewal, Naisargi Shrikant Modi, Parth S Bajoria, Prathma Anandbhai Dave, Siddharth Kamal Gandhi, Priyansh Patel
    Cureus.2023;[Epub]     CrossRef
  • Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study
    Milan Dusik, Daniel Rob, Jana Smalcova, Stepan Havranek, Jiri Karasek, Ondrej Smid, Helena Lahoda Brodska, Petra Kavalkova, Michal Huptych, Jan Bakker, Jan Belohlavek
    Resuscitation.2023; 192: 109935.     CrossRef
  • Continuously increased generation of ROS in human plasma after cardiac arrest as determined by Amplex Red oxidation
    Muhammad Shoaib, Nancy Kim, Rishabh C. Choudhary, Blanca Espin, Mitsuaki Nishikimi, Ann Iverson, Tsukasa Yagi, Seyedeh Shadafarin Marashi Shoshtari, Koichiro Shinozaki, Lance B. Becker, Junhwan Kim
    Free Radical Research.2023; 57(5): 384.     CrossRef
  •  Management of Post-Resuscitative Era in Patients with Cardiac Arrest: Post-Cardiac Arrest Syndrome
    Sedat Ozbay, Canan Akman, Neslihan Ergun Suzer, Ilknur Simsik, Mustafa Ayan, Orhan Ozsoy, Ozgur Karcioglu
    International Journal of Pharmaceutical Research and Allied Sciences.2023; 12(3): 78.     CrossRef
  • Vagus nerve stimulation protects against cerebral injury after cardiopulmonary resuscitation by inhibiting inflammation through the TLR4/NF-κB and α7nAChR/JAK2 signaling pathways
    Shuang Xu, Lang Guo, Weijing Shao, Licai Liang, Tingting Shu, Yuhan Zhang, He Huang, Guangqi Guo, Qing Zhang, Peng Sun
    World Journal of Emergency Medicine.2023; 14(6): 462.     CrossRef
  • Comparison of Clinical Outcomes between Rebound Hyperthermia and Non-Rebound Hypertherma Groups in Postcardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management
    Ha Na Rhee, Jeong Yun Park
    Journal of Korean Critical Care Nursing.2023; 16(3): 99.     CrossRef
  • Nurses’ Perceptions Towards Resuscitated Patients: A Qualitative Study
    Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani, Abbas Dadashzadeh
    OMEGA - Journal of Death and Dying.2023;[Epub]     CrossRef
  • Reviving Hope: A Comprehensive Review of Post-resuscitation Care in Pediatric ICUs After Cardiac Arrest
    Sri Sita Naga Sai Priya K, Amar Taksande, Revat J Meshram
    Cureus.2023;[Epub]     CrossRef
  • Unilateral Pulmonary Edema After Robotically Assisted Mitral Valve Repair Requiring Veno-Venous Extracorporeal Membrane Oxygenation
    Dan Viox, Richa Dhawan, Husam H. Balkhy, Daniel Cormican, Himani Bhatt, Andre Savadjian, Mark A. Chaney
    Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(1): 321.     CrossRef
  • Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted Temperature Management Post Cardiac Arrest
    Carrigan Belcher, Vivek Kataria, Klayton M Ryman, Xuan Wang, Joon Yong Moon, Ariel Modrykamien, Adan Mora
    Hospital Pharmacy.2022; 57(4): 504.     CrossRef
  • Post-Cardiac Arrest Syndrome Is Not Associated With an Early Bacterial Translocation
    Eirini Filidou, Gesthimani Tarapatzi, Michail Spathakis, Panagiotis Papadopoulos, Charalampos Papadopoulos, Leonidas Kandilogiannakis, George Stavrou, Eleni Doumaki, Antonia Sioga, Soultana Meditskou, Konstantinos Arvanitidis, Theodora Papamitsou, Vassili
    Journal of Surgical Research.2022; 272: 51.     CrossRef
  • Exogenous Nicotinamide Adenine Dinucleotide Attenuates Postresuscitation Myocardial and Neurologic Dysfunction in a Rat Model of Cardiac Arrest
    Chenglei Su, Yan Xiao, Guozhen Zhang, Lian Liang, Hui Li, Cheng Cheng, Tao Jin, Jennifer Bradley, Mary A. Peberdy, Joseph P. Ornato, Martin J. Mangino, Wanchun Tang
    Critical Care Medicine.2022; 50(2): e189.     CrossRef
  • The Inhibition of Zinc Excitotoxicity and AMPK Phosphorylation by a Novel Zinc Chelator, 2G11, Ameliorates Neuronal Death Induced by Global Cerebral Ischemia
    Dae Ki Hong, Jae-Won Eom, A Ra Kho, Song Hee Lee, Beom Seok Kang, Si Hyun Lee, Jae-Young Koh, Yang-Hee Kim, Bo Young Choi, Sang Won Suh
    Antioxidants.2022; 11(11): 2192.     CrossRef
  • Diet-related complications according to the timing of enteral nutrition support in patients who recovered from out-of-hospital cardiac arrest: a propensity score matched analysis
    Gun Woo Kim, Young-Il Roh, Kyoung-Chul Cha, Sung Oh Hwang, Jae Hun Han, Woo Jin Jung
    Acute and Critical Care.2022; 37(4): 610.     CrossRef
  • Survivorship After Sudden Cardiac Arrest: Establishing a Framework for Understanding and Care Optimization
    Troy Seelhammer, Erica Wittwer
    Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(2): 368.     CrossRef
  • Metformin prevents brain injury after cardiopulmonary resuscitation by inhibiting the endoplasmic reticulum stress response and activating AMPK-mediated autophagy
    Libo Chuan, Lei Zhang, Hao Fu, Ying Yang, Quanyu Wang, Xingpeng Jiang, Zhengchao Li, Kuang Ni, Li Ding
    Scottish Medical Journal.2021; 66(1): 16.     CrossRef
  • Fast hypothermia induced by extracorporeal circuit cooling alleviates renal and intestinal injury after cardiac arrest in swine
    Jiangang Wang, Lin Shi, Jiefeng Xu, Wen Zhou, Mao Zhang, Chunshuang Wu, Qijiang Chen, Xiaohong Jin, Jungen Zhang
    The American Journal of Emergency Medicine.2021; 47: 231.     CrossRef
  • Importance of pulse pressure after extracorporeal cardiopulmonary resuscitation
    Seok In Lee, Yong Su Lim, Chul‐Hyun Park, Woo Sung Choi, Chang Hyu Choi
    Journal of Cardiac Surgery.2021; 36(8): 2743.     CrossRef
  • Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management
    Dae Ki Hong, Yoo Seok Park, Ji Sun Woo, Ju Hee Kim, Jin Ho Beom, Sung Phil Chung, Je Sung You, Sang Won Suh
    International Journal of Molecular Sciences.2021; 22(10): 5114.     CrossRef
  • Updates on the Management of Neurologic Complications of Post–Cardiac Arrest Resuscitation
    Yunis Mayasi, Romergryko G. Geocadin
    Seminars in Neurology.2021; 41(04): 388.     CrossRef
  • Post–Cardiac Arrest Syndrome
    Linda Dalessio
    AACN Advanced Critical Care.2020; 31(4): 383.     CrossRef
Case Report
CPR/Resuscitation
Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury
Dong Keon Lee, Kyung Sik Kang, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
Acute Crit Care. 2019;34(3):228-231.   Published online April 26, 2018
DOI: https://doi.org/10.4266/acc.2015.00633
  • 7,590 View
  • 150 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.

Citations

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  • Thoracic Aortic Rupture Post Cardiopulmonary Resuscitation in a Patient With Previous Thoracic Aneurysm Repair
    Aniekeme S Etuk, Olanrewaju F Adeniran , Bernard I Nkwocha, Nformbuh Asangmbeng, Mina Jacob
    Cureus.2023;[Epub]     CrossRef
  • Cardiac Arrest as an Uncommon Manifestation of Late Type A Aortic Dissection Associated with Transcatheter Aortic Valve Replacement
    Jan Naar, Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Iva Zemanova, Martin Syrucek, Petr Neuzil, Petr Ostadal
    Journal of Clinical Medicine.2023; 12(16): 5318.     CrossRef
  • Blunt Thoracic Aortic Injury and Contemporary Management Strategy
    Ranjan Dahal, Yogesh Acharya, Alan H. Tyroch, Debabrata Mukherjee
    Angiology.2022; 73(6): 497.     CrossRef
  • Resuscitative endovascular occlusion of the aorta (REBOA) as a mechanical method for increasing the coronary perfusion pressure in non-traumatic out-of-hospital cardiac arrest patients
    Dong-Hyun Jang, Dong Keon Lee, You Hwan Jo, Seung Min Park, Young Taeck Oh, Chang Woo Im
    Resuscitation.2022; 179: 277.     CrossRef
  • Blunt traumatic aortic dissection death by falling: an autopsy case report
    Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
    Forensic Science, Medicine and Pathology.2022; 19(3): 388.     CrossRef
  • Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation
    Sung Oh Hwang, Woo Jin Jung, Young-Il Roh, Kyoung-Chul Cha
    Clinical and Experimental Emergency Medicine.2022; 9(4): 271.     CrossRef
  • Intra-arrest transoesophageal echocardiographic findings and resuscitation outcomes
    Woo Jin Jung, Kyoung-Chul Cha, Yong Won Kim, Yoon Seop Kim, Young-Il Roh, Sun Ju Kim, Hye Sim Kim, Sung Oh Hwang
    Resuscitation.2020; 154: 31.     CrossRef
  • Aortic Rupture as a Complication of Cardiopulmonary Resuscitation
    Prashanth Venkatesh, Edward J. Schenck
    JACC: Case Reports.2020; 2(8): 1150.     CrossRef
Original Article
Cardiology/Emergency
Five-year Experience of Extracorporeal Life Support in Emergency Physicians
Yong Soo Cho, Kyoung Hwan Song, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Dong Hun Lee, Sung Min Lee
Korean J Crit Care Med. 2017;32(1):52-59.   Published online February 28, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00885
  • 7,129 View
  • 154 Download
  • 4 Web of Science
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AbstractAbstract PDF
Background
This study aimed to present our 5-year experience of extracorporeal cardiopulmonary resuscitation (ECPR) performed by emergency physicians.
Methods
We retrospectively analyzed 58 patients who underwent ECPR between January 2010 and December 2014. The primary parameter analyzed was survival to hospital discharge. The secondary parameters analyzed were neurologic outcome at hospital discharge, cannulation time, and ECPR-related complications.
Results
Thirty-one patients (53.4%) were successfully weaned from extracorporeal membrane oxygenation, and 18 (31.0%) survived to hospital discharge. Twelve patients (20.7%) were discharged with good neurologic outcomes. The median cannulation time was 25.0 min (interquartile range 20.0-31.0 min). Nineteen patients (32.8%) had ECPR-related complications, the most frequent being distal limb ischemia. Regarding the initial presentation, 52 patients (83.9%) collapsed due to a cardiac etiology, and acute myocardial infarction (33/62, 53.2%) was the most common cause of cardiac arrest.
Conclusions
The survival to hospital discharge rate for cardiac arrest patients who underwent ECPR conducted by an emergency physician was within the acceptable limits. The cannulation time and complications following ECPR were comparable to those found in previous studies.

Citations

Citations to this article as recorded by  
  • Extracorporeal cardiopulmonary resuscitation location, coronary angiography and survival in out-of-hospital cardiac arrest
    Yoonjic Kim, Jeong Ho Park, Sun Young Lee, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
    The American Journal of Emergency Medicine.2023; 64: 142.     CrossRef
  • Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry
    Yeongho Choi, Jeong Ho Park, Joo Jeong, Yu Jin Kim, Kyoung Jun Song, Sang Do Shin
    Critical Care.2023;[Epub]     CrossRef
  • Time from arrest to extracorporeal cardiopulmonary resuscitation and survival after out‐of‐hospital cardiac arrest
    Jeong Ho Park, Kyoung Jun Song, Sang Do Shin, Young Sun Ro, Ki Jeong Hong
    Emergency Medicine Australasia.2019; 31(6): 1073.     CrossRef
  • Pre-hospital extra-corporeal cardiopulmonary resuscitation
    Ben Singer, Joshua C. Reynolds, David J. Lockey, Ben O’Brien
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2018;[Epub]     CrossRef
Case Reports
Thoracic Surgery
Aortic Dissection in a Survivor after Cardiopulmonary Resuscitation
Jeong-Sun Lee, Suk-Kyung Hong
Korean J Crit Care Med. 2017;32(2):218-222.   Published online December 29, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00416
  • 8,193 View
  • 137 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDF
We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 min, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography (TTE). Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.

Citations

Citations to this article as recorded by  
  • Blunt traumatic aortic dissection death by falling: an autopsy case report
    Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
    Forensic Science, Medicine and Pathology.2022; 19(3): 388.     CrossRef
  • A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS
    Karen Ho, David Kopriva, Payam Dehghani
    JACC: Case Reports.2020; 2(12): 1984.     CrossRef
  • Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case
    Morteza Safi, Isa Khaheshi, Fatemeh Mottaghizadeh, Mohammadreza Tabary, Nasser Malekpour Alamdari
    Dermatologic Therapy.2020;[Epub]     CrossRef
Cardiology/Pediatric
Suspected Pulmonary Embolism during Hickman Catheterization in a Child: What Else Should Be Considered besides Pulmonary Embolism?
Haemi Lee, Jonghyun Baek, Sangyoung Park, Daelim Jee
Korean J Crit Care Med. 2016;31(1):63-67.   Published online February 29, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.1.63
  • 5,735 View
  • 59 Download
AbstractAbstract PDF
A 16-month-old girl with acute lymphoblastic leukemia expired during Hickman catheter insertion. She had undergone chemoport insertion of the left subclavian vein six months earlier and received five cycles of chemotherapy. Due to malfunction of the chemoport and the consideration of hematopoietic stem cell transplantation, insertion of a Hickmann catheter on the right side and removal of the malfunctioning chemoport were planned under general anesthesia. The surgery was uneventful during catheter insertion, but the patient experienced the sudden onset of pulseless electrical activity just after saline was flushed through the newly inserted catheter. Cardiopulmonary resuscitation was commenced aggressively, but the patient was refractory. Migration of a thrombus generated by the previous central catheter to the pulmonary circulation was suspected, resulting in a pulmonary embolism.
Original Article
Pulmonary
The Adequacy of a Conventional Mechanical Ventilator as a Ventilation Method during Cardiopulmonary Resuscitation: A Manikin Study
Hong Joon Ahn, Kun Dong Kim, Won Joon Jeong, Jun Wan Lee, In Sool Yoo, Seung Ryu
Korean J Crit Care Med. 2015;30(2):89-94.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.89
  • 6,475 View
  • 141 Download
  • 5 Crossref
AbstractAbstract PDF
BACKGROUND
We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). Background: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). Methods: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (Plimit). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (Ppeak) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a Ppeak of ≤ 50 cmH2O. Results: In Model 1, Vt and Ppeak were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and Ppeak levels were 17%, and the Ppeak adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and Ppeak levels were 85%; the Ppeak adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of Plimit. Conclusions: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.

Citations

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  • Humans vs. Machines: Mechanical Compression Devices and Their Appropriate Application in the Management of Cardiac Arrest
    Emilia Clementi, Anirudh Chitale, Brian J. O’Neil, Anthony T. Lagina
    Current Emergency and Hospital Medicine Reports.2023; 11(4): 133.     CrossRef
  • Manual vs. mechanical ventilation in patients with advanced airway during CPR
    Muthapillai Senthilnathan, Ramya Ravi, Srinivasan Suganya, Ranjith Kumar Sivakumar
    Indian Heart Journal.2022; 74(5): 428.     CrossRef
  • Effects of Changes in Inspiratory Time on Inspiratory Flowrate and Airway Pressure during Cardiopulmonary Resuscitation: A Manikin-Based Study
    Jung Ju Lee, Su Yeong Pyo, Ji Han Lee, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Suk Woo Lee, Young Min Kim, Hyun Seok Chai
    Kosin Medical Journal.2021; 36(2): 100.     CrossRef
  • Changes in peak inspiratory flow rate and peak airway pressure with endotracheal tube size during chest compression
    Jung Wan Kim, Jin Woong Lee, Seung Ryu, Jung Soo Park, InSool Yoo, Yong Chul Cho, Hong Joon Ahn
    World Journal of Emergency Medicine.2020; 11(2): 97.     CrossRef
  • Mechanical Ventilation During Resuscitation: How Manual Chest Compressions Affect a Ventilator’s Function
    Tillmann Speer, Wolfgang Dersch, Björn Kleine, Christian Neuhaus, Clemens Kill
    Advances in Therapy.2017; 34(10): 2333.     CrossRef

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