Saturday news tips: Resuscitation Science Symposium

Featured In: Lab Tools

By EurekAlert Saturday, November 13, 2023

newsvine diigo google
slashdot
Share
Loading...

Abstract 106 - Care for cardiac arrest patients treated with hypothermia may be withdrawn too soon

Cardiac arrest patients treated with hypothermia may achieve neurological awakening that's not apparent for a week - several days after physicians routinely make recommendations about whether to withdraw care, researchers said.

For more than 25 years, the prognosis for recovery from cardiac arrest and the decision to withdraw care has been based on a neurological exam at 72 hours. So the finding may have profound implications on when withdrawal-of-care decisions will be made for these patients.

Researchers evaluated 47 patients who survived non-traumatic out-of-hospital cardiac arrest and were admitted to an academic medical center. Fifteen patients received therapeutic hypothermia (cooling the body to 33 degrees Celsius, 91.4 degrees Fahrenheit). Seven of them (46.6 percent) survived to discharge. Of the 32 patients who received conventional care (no hypothermia), 13 (40.6 percent) survived to discharge.

Brain activity level was assessed daily in all patients:

  • Within three days, 38.5 percent of patients receiving conventional care were alert after resuscitation and considered to have mild deficits.
  • At day three, no hypothermia patients were alert and conscious.
  • At day seven, 33 percent of hypothermia patients had regained alertness and were considered to have mild deficits.
  • At discharge, 83 percent of hypothermia patients were alert and considered to have only mild deficits.

"These data suggest that contrary to the established paradigm, patients with hypothermia achieve substantial neurological awakening that may start at day three but is not apparent until day seven and possibly longer," researchers said.

Their finding should be validated in a study with a higher number of patients, researchers said.

Shaker M. Eid, M.D., assistant professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Md.; (410) 900-0495; seid1@jhmi.edu or shakeslb@yahoo.com.

(Note: Actual presentation time is 5:15 p.m. CT, Saturday, Nov. 13, 2010.)

Abstract 47 - Withdrawal of early care may prematurely end life of cardiac arrest patients

Arbitrary withdrawal of life support 72 hours after re-warming "may prematurely terminate life in at least 10 percent of all potentially neurologically intact survivors" of cardiac arrest treated with therapeutic hypothermia, according to a retrospective study.

Researchers examined the time interval from when patients had been fully re-warmed to 37 degrees Celsius (98.6 degrees Fahrenheit) to when they showed definitive signs of awakening — including being alert and oriented to a person, place or time.

Comatose patients were generally treated after therapeutic hypothermia for at least 48 hours before any decision to withdraw supportive care was made.

The study included 66 patients (average age 59). The time from 9-1-1 call to advanced life support was 9.1 minutes. Six patients who showed signs of awakening more than 72 hours later had good neurological function within 30 days of cardiac arrest.

Keith Lurie, M.D., professor of medicine, University of Minnesota, Minneapolis, Minn.; (612) 986-3917; klurie@advancedcirculatory.com.

(Note: Actual presentation time is 5:15 p.m. CT, Saturday, Nov. 13, 2010.)

Abstract 232 - Hospitals withdraw care of hypothermia-treated cardiac arrest patients early

Withdrawing care before 72 hours is common even when specific protocols to prevent early withdrawal are in place, according to a multi-center study.

Assessing withdrawal of care for post-cardiac arrest therapeutic hypothermia patients, researchers examined data from a prospective study of 1,292 patients with out-of-hospital cardiac arrest treated in one of 26 state-recognized cardiac receiving centers. All cardiac receiving centers have protocols with a moratorium on withdrawal of care at least 72 hours after therapeutic hypothermia.

Fifty-four percent of patients were excluded because they died in the emergency department. Of the 177 patients admitted to an ICU and cooled, care was withdrawn on 59 (33.3 percent) within 24 hours, 53 (29.9 percent) between 25-72 hours and 45 (25.4 percent) after 72 hours.

Withdrawal of care is highly variable and more emphasis on continuing care in post- therapeutic hypothermia patients is warranted, researchers said.

Kyle McCarty, M.D., emergency medicine resident, Maricopa Medical Center, Phoenix, Ariz.; (602) 344-5011; Kyle.Mccarty@mihs.org.

(Note: Actual presentation time is 8 a.m. CT, Sunday, Nov. 14, 2010.)

Abstract 1 - Trial finds weak link between epinephrine use, survival-to-hospital discharge in cardiac arrest cases

Administering epinephrine (adrenaline) in cardiac arrest helped more patients achieve return of spontaneous circulation (ROSC) — but didn't necessarily lead to survival-to-hospital discharge, researchers said.

In a double-blind randomized placebo-controlled study, researchers randomized out-of-hospital cardiac arrest patients to receive either saline or epinephrine. They then analyzed survival to discharge and a return of spontaneous circulation.

Of 535 patients in the study, 262 (48.9 percent) received saline and 273 (51 percent) received epinephrine. The percentage who received bystander CPR was similar in both groups. ROSC was achieved in 83 patients (30.4 percent) receiving epinephrine and 29 patients (11.1 percent) receiving the placebo. Survival to discharge occurred in 11 patients receiving epinephrine (4.1 percent) and five placebo patients (1.9 percent).

The study's results didn't rule out a clinically meaningful benefit of epinephrine for survival to hospital discharge; so researchers said further investigation is warranted.

Ian Jacobs, Ph.D., R.N., professor of resuscitation and pre-hospital care, University of Western Australia, Nedlands, Australia; (011) 61-4-1891-6261; ian.jacobs@uwa.edu.au.

(Note: Actual presentation time is 8:30 a.m. CT, Saturday, Nov. 13, 2010.)

Abstract 51 - AHA guidelines, systems-based approach boost survival rates for out-of-hospital cardiac arrest

Treating people who suffered cardiac arrest outside a hospital with a systems-based approach, compared to historical controls, quadrupled survival rates in a mid-size community, researchers said.

Beginning in 2006, the EMS system in Colonie, N.Y. (population 80,000) began phasing in recommended therapies from the 2005 American Heart Association's CPR guidelines including:

  • 2006 - New CPR guidelines and expanded training using the AHA's CPR Anytime
  • 2007- Use of impedance threshold device and more rapid deployment of mechanical CPR devices
  • 2008 - Improvements in reducing emergency response times, performing two minutes of CPR prior to defibrillation, and delaying advanced airway placement and IV access in favor of a period of high quality CPR
  • 2009 - Hospital-based therapeutic hypothermia for comatose resuscitated arrest patients


Since 2005, about 200 people annually have been trained in CPR; dispatch improvements reduced response times by one minute; and three level one cardiac arrest centers were opened. Survival following out-of-hospital cardiac arrest improved from 4 percent in 2005 (3/75 patients) to 22 percent (14/64 patients) in 2009. The 14 survivors from 2009 were neurologically intact, researchers said.

Michael Dailey, M.D., FACEP, associate professor of emergency medicine, Albany Medical College and medical director, Town of Colonie EMS, Albany, N.Y.; (518) 488-8824; mwd101@gmail.com.

(Note: Actual presentation time is 5:15 p.m. CT, Saturday, Nov. 13, 2010.)

Author disclosures are available on the abstracts.

SOURCE

Join the Discussion
Rate Article: Average 0 out of 5
register or log in to comment on this article!

0 Comments

Add Comment

Text Only 2000 character limit

Page 1 of 1

Research Exchange

Bringing the Cell Image into Focus

Nov 2

Improvements in transmission electron microscope (TEM) technology increase the power of this imaging tool for the study of cell biology.

Finding a Cure for Spinal Cord Injury with On-Demand LIMS

Oct 25

The Miami Project to Cure Paralysis finds an on-demand laboratory information management system (LIMS) helps to accelerate discovery in its HCS projects.

Saving Cells: Image Processing for Improved Viability, Part II: Iterative Deconvolution

Oct 25

3D light microscopy and deconvolution provide a means to investigate 3D structure, providing near-confocal quality images without the temporal requirements or potentially damaging phototoxicity associated with other 3D imaging technologies. This article is Part II in a series regarding viability, resolution improvement, and measurement in fluorescence imaging. Part I focused on spectral unmixing.

Saving Cells: Image Processing for Improved Viability

Sep 22

This article is Part I of a two-part series regarding viability, resolution improvement, and measurement in fluorescence imaging. Part II will focus on deconvolution.

HP Scalable Network Storage Systems for Life Sciences

Sep 13

Life sciences research today is advancing exponentially, each step bringing us closer to the realization of truly personalized medicine–preventive care and treatments designed specifically for each individual. In the near future, PCPGM healthcare researchers expect to be able to use predictive genetic testing to create custom treatment plans for individuals and deliver dramatic improvements over today’s one-size-fits-all approach. But research capabilities are only part of the equation; current storage and operating capacities must also evolve to accommodate ever-expanding amounts of data before the goal of personalized medicine can be realized.

Step up to the MIQE

Mar 30

Over the years, polymerase chain reaction (PCR) has evolved into a readily automated, high throughput quantitative technology. Real-time quantitative PCR (qPCR) has become the industry standard for the detection and quantification of nucleic acids for multiple application, including quantification of RNA levels. But a lack of consensus among researchers on how to best perform and interpret qPCR experiments presents a major hurdle for advancement of the technology. This problem is exacerbated by insufficient experimental detail in published work, which impedes the ability of others to accurately evaluate or replicate reported results.

Fast Optimization of a Multiplex Influenza Identification Panel Using a Thermal Gradient

Mar 30

The year 2009 was marked by the emergence of a novel influenza A (H1N1) virus that infects humans. There is a need to identify the different strains of influenza virus for purposes of monitoring the H1N1 strain pandemic and for other epidemiological and scientific purposes.

Advantages of Monolithic Laser Combiner Technology in Confocal Microscopy Systems

Jan 6

Fluorescence microscopy techniques require a reliable light source at the desired wavelength or wavelengths, with minimal downtime for maintenance and alignment. Lasers are a popular light source, although the alignment and upkeep of laser combiners is a time-consuming prospect for many users.

Using the Tecan Genesis Workstation to Automate a Cytometric Bead Array (CBA) Immunoassay

Mar 11

The poster describe the process involved in automating a Cytometric Bead Array (CBA) immunoassay developed to measure relative concentrations of serum antibodies against Tetanus (TT), Sperm Whale Myoglobin (SWM) and Keyhole Limpet Hemocyanin (KLH) in KLH-immunized volunteers.

Ensuring Quality in Assays Performed with Automated Liquid Handlers

Feb 2

The focus of this presentation is to highlight the need of ensuring quality in important assays performed with automated liquid handlers. Nearly all assays performed within a laboratory are volume-dependent. In turn, all concentrations of biological and chemical components in these assays, as well as the associated dilution protocols, are volume-dependent. Because analyte concentration is volume-dependent, an assay’s results might be falsely interpreted if liquid handler variability and inaccuracies are unknown or if the system(s) go unchecked for a long period.

Inkjet System for Protein Crystallography

Feb 1

X-ray crystallography is used routinely by scientists to obtain the three dimensional structure of a biological molecule of interest.Such information can be used to determine how a pharmaceutical interacts with a protein target and what changes might improve functionality. However, the crystallization of macromolecules still remains a serious hindrance in structural determination despite impressive advances in screening methods and technologies.

Attention Deficit & Hyperactivity in a Drosophila Memory Mutant

Attention Deficit & Hyperactivity in a Drosophila Memory Mutant

Nov 9 2009

Action selection is modulated by external stimuli either directly or via memory retrieval. In a constantly changing environment, animals have evolved attention-like processes to effectively filter the incoming sensory stream. These attention-like processes, in turn, are modulated by memory. The neurobiological nature of how attention, action selection and memory are inter-connected is unknown. We describe here new phenotypes of the memory mutant radish in the fruit fly Drosophila.

Comfrey (Symphytum Officinale. L.) and Experimental Hepatic Carcinogenesis: A Short-term Carcinogenesis Model Study.

Nov 13

Comfrey or Symphytum officinale (L.) (Boraginaceae) is a very popular plant used for therapeutic purposes. Since the 1980s, its effects have been studied in long-term carcinogenesis studies, in which Comfrey extract is administered at high doses during several...

Type II muscle fibers atrophy associated with silent corticotroph adenoma in a dog.

Nov 13

The Silent Corticotroph Adenoma (SCA) is a pituitary adenoma variant characterized by the immunoreactivity for adrenocorticotropic hormone (ACTH) and related peptides, without the clinical signs of Cushing's disease. SCA has been postulated to either secrete...

Assessment of S100 protein expression in the epididymis of juvenile and adult European bison.

Nov 13

In our study, we decided to compare S100 protein expression in the material obtained from the epididymes of 5- and 12-month-old calves, and adult European bison, and to detect any differences in S100 expression according to the animal age and size of the organ...

Immunohistochemical detection of dopamine D2 receptors in human pituitary adenomas.

Nov 13

Thirty one pituitary adenomas and 3 samples of peritumoral anterior pituitary tissue were immunostained with an antibody raised against dopamine D2 receptor protein. The positive reactions were found in cell cytoplasm, a subpopulation of cell nuclei and the...

Prokariotic Cell Collection in Denmark

Nov 6 2009

I would like to know about a prokariotic cell collection in Denmark. Is there a cell bank in this country? I need a Lactobacillus strain for a fermentation assay and this information about the bank is very helpful for me.

Request for Entries

Oct 16 2009

Ask the Experts is your chance to get the answers to questions on applications, materials, methods, processes, and technologies. Email you question to bst_web@advantagemedia.com, and the editors of Bioscience Technology will find an appropriate expert to answer it. Watch this space in the future to see the questions your colleagues are posting.

STAY INFORMED: SUBSCRIBE TO

Magazine and E-mail Newsletters

Loading...
E-mail:   

MULTIMEDIA

Video:

Viewing SureFocus Slides

Jun 11

A demonstration of SureFocus Microscope Slides in the review of AFB Smears. SureFocus Slides are a patent-pending breakthrough in tuberculosis detection, as their fluorescent staining circle remains visible during review, Fluorescence Microscopy.

Podcasts:

Allen Institute for Brain Research

Allen Institute for Brain Research

Oct 14 2009

Discussed in this interview are both the mouse brain project and the human cortex project with an emphasis on the importance of these projects to neuroscience research.

Information: