Patel KK, Spertus JA , Khariton Y et el published in Circulation a retrospective study of patients of in hospital cardiac arrest looking at timing of Epinephrine in PEA arrest and defibrillation in shockable rhythm. They looked at the data for 36,961 patients aged ≥65 years with an IHCA at 517 hospitals between 2000 and 2011. (National … Read more
The FDA approved angiotensin-II (Giapreza) as a new intravenous vasopressor for septic shock and other forms of distributive shock. The first new FDA-approved vasopressor in decades. This is based on recent trial, which was discussed here. https://wp.me/padfoC-7C
In a late breaking abstract in the CHEST meeting in Toronto, Matthew Semler, Wesley Self, Todd Rice et el presented finding of their SMART(The Isotonic Solutions and Major Adverse Renal Events Trial) trial. They reported that total of 1,139 patients (14.3%) in the balanced crystalloid group experienced the primary outcome of MAKE30(Major Adverse Kidney Events within 30 … Read more
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Traditional wisdom taught us to secure airway as soon as possible in case of cardiac arrest(at least in hospital arrest), though over the course of years, American hearth association have moved their focus from “ABC” (airway-breathing-circulation) to “CAB” (circulation-airway-breathing). AHA also suggested that if a trained individual is not present to secure airway, bag mask ventilation … Read more
Rohan Khera, Paul S. Chan published in circulation about timing of epinephrine in non-shockable cardiac arrest (in hospital) across 548 hospitals who participate in “get on with the guidelines” database. What they did They looked at 103,932 adult patients with non-shockable cardiac arrests from 2001 to 2014. 13,213 (12.7%) patients had delays to epinephrine (more than 5 … Read more
In first of its kind study, Mehrotra et el, compared 234 physicians (mostly residents and fellows) to Human Dx (a web and app based program to generate diagnosis). Overall, they compared diagnoses for 45 clinical vignettes( 15 high, 15 medium, and 15 low-acuity condition vignettes and 26 common and 19 uncommon condition vignettes). No physical exam details … Read more
Targeted temperature management (TTM, therapeutic hypothermia) after cardiac arrest first came to use in clinical setting since the publication of two landmark articles in 2002. Evidence was mainly for out of hsopital cardiac arrest patients. Recently, it was noted that there was no difference in outcome between temperatures of 33 and 36 Celsius. However, based … Read more
Latest AHA guidelines about adult CPR emphasize on high quality chest compression, currently at the rate of 100 to 120 per minute. In a prospective observational study, Kilgannon JH et al demonstrated that chest compression rate of 121–140 compressions/min had the highest odds ratio of ROSC. What they did 222 consecutive patients were enrolled in study, found … Read more