Article
Pediatrics
Maria Damps, Michal Buczynski, Lukasz Wiktor
Summary: Extracorporeal membrane oxygenation (ECMO) is an effective method for treating life-threatening conditions, as shown in a case where resuscitation lasting over one hour was successful. A 3.5-year-old girl with ectopic atrial tachycardia underwent electrical cardioversion, leading to cardiac arrest with pulseless electrical activity (PEA). Despite resuscitation, a stable heart rhythm could not be achieved, prompting the use of veno-arterial ECMO. After three days of intensive therapy, hemodynamic stabilization was achieved. The timing of implementing ECMO therapy and assessing the initial clinical status of the patient are crucial factors.
Article
Critical Care Medicine
James W. Schurr, Mohammad Noubani, Lee Ann Santore, Andrew P. Rabenstein, Kathleen Dhundale, Jillian Fitzgerald, Jan Cahill, Thomas Bilfinger, Frank C. Seifert, Allison J. McLarty
Summary: This study evaluated the use of ECMO in cardiac arrest patients, finding that BMI, RRT, and tracheostomy are predictors of in-hospital survival, and that mSAVE score and BMI are predictors of favorable neurologic outcomes.
Article
Medicine, Research & Experimental
Tai Yin, Lance B. Becker, Rishabh C. Choudhary, Ryosuke Takegawa, Muhammad Shoaib, Koichiro Shinozaki, Yusuke Endo, Koichiro Homma, Daniel M. Rolston, Shuhei Eguchi, Tadashi Ariyoshi, Asami Matsumoto, Kentaro Oka, Motomichi Takahashi, Tomoaki Aoki, Santiago J. Miyara, Mitsuaki Nishikimi, Junichi Sasaki, Junhwan Kim, Ernesto P. Molmenti, Kei Hayashida
Summary: This study demonstrated that the combination of H-2 gas with ECPR therapy improved survival rates in rats after CA/ECPR, enhanced brain electrical activity recovery, and alleviated endothelial damage. H-2 treatment also significantly improved brain tissue oxygenation during resuscitation and prevented an increase in central venous pressure post-ECPR.
JOURNAL OF TRANSLATIONAL MEDICINE
(2021)
Review
Critical Care Medicine
Mathias J. Holmberg, Asger Granfeldt, Anne-Marie Guerguerian, Claudio Sandroni, Cindy H. Hsu, Ryan M. Gardner, Peter C. Lind, Mark A. Eggertsen, Cecilie M. Johannsen, Lars W. Andersen
Summary: This article is a systematic review that compares the use of extracorporeal cardiopulmonary resuscitation (ECPR) with manual or mechanical cardiopulmonary resuscitation during cardiac arrest. The recent randomized trials suggest a potential benefit of ECPR, but the certainty of evidence remains low, and it is unclear which patients might benefit from ECPR.
Article
Cardiac & Cardiovascular Systems
James F. V. Howick, Joshua A. Rezkalla, Thomas Tilbury, Sunil V. Mankad, Courtney E. Bennett, Joerg Herrmann, Gregory Barsness, Stephen M. Ansell, Matthew D. Read
Summary: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides temporary mechanical circulatory support and simultaneous extracorporeal gas exchange for acute cardiorespiratory failure. In this case report, VA-ECMO/extracorporeal cardiopulmonary resuscitation was used in a patient with recurrent lymphoma and recent autologous stem cell transplant after cardiac arrest with pulseless electrical activity.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Critical Care Medicine
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
Summary: The study revealed a rapid expansion in the use of extracorporeal cardiopulmonary resuscitation in pediatric patients, with an overall survival rate of 46% and a 30% rate of favorable neurologic outcomes.
CRITICAL CARE MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
George Gill, Jignesh K. Patel, Diego Casali, Georgina Rowe, Hongdao Meng, Dominick Megna, Joanna Chikwe, Puja B. Parikh
Summary: Factors such as age, gender, income level, presence of ventricular arrhythmia, undergoing percutaneous coronary intervention, and use of therapeutic hypothermia were found to be independently associated with mortality in patients with cardiac arrest receiving ECMO. Identification of these predictors could help in decision-making regarding the implementation of ECMO in this population. Further larger-scale studies are needed to assess appropriate candidates for ECMO in cardiac arrest.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Review
Medicine, General & Internal
Lars J. Bjertnaes, Kristian Hindberg, Torvind O. Naesheim, Evgeny V. Suborov, Eirik Reierth, Mikhail Y. Kirov, Konstantin M. Lebedinskii, Torkjel Tveita
Summary: This systematic review and meta-analysis compared outcomes of rewarming after accidental hypothermic cardiac arrest with CPB or/and ECMO, finding that survival rate was significantly higher with ECMO than CPB, and for witnessed compared to unwitnessed cases, with avalanche victims having the lowest survival probability. Male sex, high initial body temperature, low pH, and high s-K+ levels were associated with lower chances of surviving.
FRONTIERS IN MEDICINE
(2021)
Review
Critical Care Medicine
Darryl Abrams, Graeme MacLaren, Roberto Lorusso, Susanna Price, Demetris Yannopoulos, Leen Vercaemst, Jan Belohlavek, Fabio S. Taccone, Nadia Aissaoui, Kiran Shekar, A. Reshad Garan, Nir Uriel, Joseph E. Tonna, Jae Seung Jung, Koji Takeda, Yih-Sharng Chen, Arthur S. Slutsky, Alain Combes, Daniel Brodie
Summary: Extracorporeal cardiopulmonary resuscitation (ECPR) is emerging as a promising modality to improve survival rates for both in-hospital and out-of-hospital cardiac arrest, but its implementation requires significant resources and may burden healthcare systems, clinicians, patients, and families. Studies show that ECPR is beneficial for in-hospital cardiac arrest, and recent randomized controlled trials also suggest its feasibility for out-of-hospital cardiac arrest.
INTENSIVE CARE MEDICINE
(2022)
Article
Anesthesiology
Christopher Lotz, Ralf M. Muellenbach, Peter Spieth
Summary: eCPR can improve neurological outcomes and quality of life for survivors of cardiac arrest, but should only be performed by experienced teams to minimize procedure-related complications and ethical issues.
MINERVA ANESTESIOLOGICA
(2021)
Article
Medicine, General & Internal
Mioko Kobayashi, Masahiro Kashiura, Hideto Yasuda, Kazuhiro Sugiyama, Yuichi Hamabe, Takashi Moriya
Summary: There was no significant association between hyperoxia at 24 hours after admission and 30-day survival in OHCA patients who underwent ECPR.
FRONTIERS IN MEDICINE
(2022)
Article
Emergency Medicine
Yoonjic Kim, Jeong Ho Park, Sun Young Lee, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
Summary: The best location for implementation of ECPR in OHCA patients remains uncertain. This study aimed to evaluate the association between ECPR location and survival outcomes, and whether this association differed between patients who underwent CAG and those who did not.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Critical Care Medicine
Catherine E. Beni, Samuel E. Rice-Townsend, Ivie D. Esangbedo, Tim Jancelewicz, Adam M. Vogel, Christopher Newton, Laura Boomer, David H. Rothstein
Summary: This study retrospectively analyzed the use of ECPR in pediatric patients without CHD and found that obesity and trauma were associated with increased in-hospital mortality. The study also identified variables such as White race, ventricular tachycardia as initial arrest rhythm, return of spontaneous circulation before cannulation, and acquired cardiac disease that were associated with decreased odds of mortality. Respiratory disease was associated with increased odds of severe neurologic complications.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Respiratory System
Ji-Ge Guo, Jie Cao, Wei-Min Zhang, Fan-Gang Meng, Zheng Zhang, Bi-Jun Xu, Xi-Ming Qian
Summary: The study aimed to summarize the clinical experience of extracorporeal cardiopulmonary resuscitation (ECPR) in treating adult patients with refractory cardiac arrest. Retrospective analysis of 12 cases showed that ECPR provided a new rescue alternative for select patients, with improved treatment success by selecting suitable patients and reducing CPR duration.
JOURNAL OF THORACIC DISEASE
(2021)
Review
Medicine, General & Internal
Chaosheng Qin, Yihong Jiang, Jingchen Liu, Hongxuan Pang
Summary: Cardiac arrest under spinal anesthesia is a critical condition where standard CPR may be challenging. Rapid initiation of VA-ECMO provides more effective cardiorespiratory support in this situation, offering protection from prolonged CPR, refractory hypotension, and deteriorated desaturation, ultimately benefiting patients in this critical condition.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2021)
Letter
Emergency Medicine
Zhao-Yu Hsieh, Chen-Xiong Hsu
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Editorial Material
Emergency Medicine
Laura E. Walker, Jessica A. Stanich, Fernanda Bellolio
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Letter
Emergency Medicine
E. Tekin
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Amanda S. Dupont, Patrick S. Walsh
Summary: Recent research indicates that children who unintentionally ingest cannabis often undergo extensive additional testing, such as head imaging or lumbar puncture. However, the yield of these tests is limited. While head imaging and lumbar puncture are frequently performed, diagnoses such as skull fracture, intracranial hemorrhage, intracranial neoplasm, meningitis, or intracranial abscess are rare. Additionally, discharge diagnoses related to other drugs are infrequent. The most common co-diagnoses are cocaine and opioids. Therefore, prompt consideration of cannabis ingestion and quick identification through testing may result in more effective neuroimaging outcomes.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Letter
Emergency Medicine
Mio Nagata, Shunsuke Kudo, Motoyasu Nakamura
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Andy Hung-Yi Lee, Katherine Dickerson Mayes, Regan Marsh, Christina Toledo-Cornell, Eric Goralnick, Michael Wilson, Leon D. Sanchez, Alice Bukhman, Damarcus Baymon, Dana Im, Paul C. Chen
Summary: This study assessed the disparities in transferring patients from an academic medical center emergency department to a community hospital general medical service, revealing healthcare disparities among different patient populations.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Annabelle Croskey, William Trautman, David Barton, Mary Kathleen Ratay, Joshua Shulman
Summary: This case report describes a successful management of ocular palytoxin exposure in a young male, highlighting the importance of prompt recognition and treatment of ocular PTX toxicity.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Matthew K. Kolbeck, Rachel F. Schult, Nicholas Nacca
Summary: This article presents four cases of adolescents who experienced seizures after acute fluoxetine overdose. Although seizures are an uncommon complication after fluoxetine overdose, they occurred in some patients at doses lower than those reported in the literature.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Editorial Material
Emergency Medicine
Daven Patel, John Bailitz, Simone Ymson, Jonas Neichin, Gary D. Peksa, Michael Gottlieb
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Amichai Gutgold, Shaden Salameh, Jeries Nashashibi, Yonatan Gershinsky
Summary: This study aimed to test the prognosis of patients with a pH lower than 6.9 on emergency department admission. The findings showed that a small but significant portion of these patients survived at least 24 hours and until hospital discharge.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Na-Yeon Emily Song, Ki Hong Kim, Ki Jeong Hong
Summary: This study aimed to evaluate the effect of the duration of no-flow (NF) interval on the vaso-pressor effect of initial epinephrine administration in a porcine model of cardiac arrest. The results showed that a shorter NF interval can enhance the vasopressor effect of epinephrine.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Kenneth A. Scheppke, Paul E. Pepe, Jonathan Jui, Remle P. Crowe, Eric K. Scheppke, Nancy G. Klimas, Aileen M. Marty
Summary: This study reported cases of rapid and complete remission of severe long COVID after receiving monoclonal antibody treatment. The findings suggest that monoclonal antibody infusions may be effective in treating severe debilitation caused by long COVID.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Suhrith Bhattaram, Varsha S. Shinde
Summary: Nerve blocks have emerged as promising options for targeted pain relief in the Emergency Department, providing effective analgesia without compromising motor function. The successful use of ultrasound-guided genicular nerve blocks (GNBs) in this case series demonstrates their potential as an alternative to traditional nerve blocks and opioid-based pain control strategies in the ED.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Rick Kye Gan, Jude Chukwuebuka Ogbodo, Yong Zheng Wee, Ann Zee Gan, Pedro Arcos Gonzalez
Summary: The aim of this study was to evaluate and compare the performance of ChatGPT, Google Bard, and medical students in performing START triage during mass casualty situations. The results showed that Google Bard had significantly higher accuracy compared to ChatGPT, while there was no significant difference between Google Bard and medical students.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)
Article
Emergency Medicine
Nancy Clemens, Paria M. Wilson, Matthew J. Lipshaw, Holly Depinet, Yin Zhang, Michelle Eckerle
Summary: This study compared clinical features and outcomes between pediatric sepsis patients with blood cultures positive versus negative for bacterial pathogens. The results showed that children with blood culture positive sepsis had higher rates of organ dysfunction, a larger base deficit, and higher procalcitonin levels.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2024)