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At least 415 records · Page 23Linked to original sources
PubMed1986

[Primary heart arrest during dynamic ECG in the myocardial infarct patient during convalescence. Contribution of 4 cases].

Four cases of cardiac arrest occurred during Holter monitoring are described. All patients had sustained an acute myocardial infarction thirteen-fourteen days prior to recording and were fully mobilized. In all of them the fatal arrhythmic event was ventricular fibrillation (VF). ECG analysis revealed an increase in heart rate before initiation of VF in one patient only. Warning ventricular arrhythmias were present in two patients. Transient ST segment changes during monitoring were noted in all patients. In three cases the arrhythmia was initiated by an ectopic ventricular beat (EVB) with R-on-T phenomenon; in two of them the EVB occurred after a sinus beat following a long post-ectopic pause. The different electrical events able to induce VF showed a variable and unpredictable pattern of occurrence and association in different patients and at different times in the same patient. Therefore, no specific "trigger" of the fatal arrhythmia could be identified.

Aged↗
PubMed1996

[Out-of-hospital buffer therapy in heart arrest].

The effects of infusing a buffer solution on resuscitability and outcome were tested in patients during out-of-hospital cardiac arrest. 502 adults with ventricular fibrillation or asystole with failure of first attempt at defibrillation were entered into a prospective, randomized, double-blind, controlled trial where one group received buffer and the other group placebo (saline). 87 of 245 (36%) patients who received a buffer were admitted to hospital and 24 (10%) were discharged alive, as against 92 of 257 (36%) admitted to hospital and 35 (14%) discharged alive for those who received placebo. Only 16 of the 502 patients had arterial alkalosis on arrival at hospital and no patient had a positive base excess. Patients resuscitated after out-of-hospital cardiac arrest had metabolic acidosis but buffer therapy did not improve outcome.

Adult↗
PubMed1990

[First aid in cases of out-of-hospital heart arrest].

In connection with participation of doctors in the emergency ambulance service in Odense, the number of cases of observed cardiac arrest outside hospital was registered during a period of six months. The object was to assess how often primary treatment for cardiac arrest was instituted by passers-by before arrival of the ambulance. Seventy-four cases of observed cardiac arrest occurred. In 11 of these (15%) primary resuscitation was attempted outside hospital. In only three (4%) cases the primary resuscitation was undertaken by lay persons. Treatment of cardiac arrest before arrival of the ambulance increases survival. It is therefore essential to increase the number of courses in the treatment of cardiac arrest for lay persons, if mortality is to be reduced.

Denmark↗
PubMed1993

[Heart arrest in outpatients resuscitated without neurologic sequelae].

BACKGROUND: Around 65% of the deaths by acute myocardial infarction are presented in the first hour of the attack when most patients are outside a hospital and it is almost always caused by ventricular fibrillation. Home defibrillation permits these patients to be saved if an integral emergency system is available. METHODS: The cases of ambulatory cardiac arrest resuscitated with no residual neurologic lesions in the province of Ciudad Real were reviewed. The hospital possesses an integral emergency department with an area of communication with one sole emergency telephone (006) and 7 mobile intensive care medical units. RESULTS: Five male patients with a mean age of 54 years were ambulatory defibrillated (4 at home and 1 at work) following cardiac arrest by ventricular fibrillation of acute myocardial infarction (4 inferior localization and 1 anterior). All the patients called for angina, except one for cardiorespiratory arrest. The mean time of delay between the call for help and the arrival of the doctor was 8.4 +/- 6.3 minutes; ventricular fibrillation was witnessed by a doctor in all the cases except for one. Ventricular fibrillation was recurrent in three patients and all required more than one defibrillation. Two patients required mechanical ventilation and vasoactive drugs due to cardiac failure. The complications secondary to resuscitation manoevers are commented upon but the absence of neurologic sequelae is of note. All the patients were discharged and returned to work with the exception of one patient who died due to rupture of the posteromedian muscle of the mitral valve. CONCLUSIONS: Cardiac arrest by ventricular fibrillation in the acute myocardial infarction may be successfully treated out of the hospital with an integral emergency system.

Ambulatory Care↗
PubMed1992

[Heart arrest as a sequela of clavicular fracture].

After a fracture of the medial part of the clavicle cardiac arrest occurred. This complication can be explained by vagus irritation because of fracture haematoma. The patient survived and was, six months later, of best health.

Clavicle↗
PubMedDate not supplied

[Early outcome assessment following heart arrest is currently impossible. Clinical parameters are easy to use but afflicted with uncertainty].

A critical review of a meta-analysis published in JAMA of early clinical neurological signs to detect "good" or "bad" outcome after cardiac arrest is presented. The review focuses on weaknesses of Glasgow Coma Scale, the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) and on individual differences in factors after arrest for study inclusion. It is suggested that the clinical assessments should be complemented with the assessment of neurochemical markers for brain damage.

Biomarkers↗
PubMed1995

[Diagnosis of heart arrest caused by CO2 embolism during laparoscopic surgery by monitoring of aortic blood flow and capnography].

We report the case of a 25-year-old woman undergoing a laparoscopic cholecystectomy, who suffered, one min after the beginning of intraperitoneal insufflation of CO2 (2.5 L at a pressure of 10 mmHg), a sudden decrease to 0.8 L.min-1 of the aortic blood flow (ABF), monitored in the descending aorta by an oesophageal echo-Doppler probe, associated with a decrease of PetCO2 to 15 mmHg and of SpO2 readings to 88%. Despite the lack of simultaneous changes in heart rate and arterial pressure, pulmonary gas embolism (GE) was suspected. The pneumoperitoneum was exsufflated and CPR was started because of circulatory inefficiency. Ten min later, efficient spontaneous cardiac activity restarted, whereas PetCO2 and ABF returned rapidly to normal values. At this time, a typical gas noise was clearly obtained through the oesophageal Doppler transducer. The patient remained in deep coma (GCS:6) with a left sided hemiplegia. However, she fully recovered after four sessions of hyperbaric oxygenation. Simultaneous continuous monitoring of ABF and PetCO2 allows an undelayed recognition of major circulatory disturbances, before significant changes in heart rate and arterial pressure occur.

Adult↗
PubMed1990

[Heart arrest during spinal anesthesia for transurethral resection of the prostate. Apropos of a case].

We report a cardiac arrest in a 66 years healthy patient during a spinal anesthesia for a transurethral resection of prostate. The accident occurred one hour and fifteen minutes after the subarachnoidal injection of hyperbaric lidocaine 80 mg, at the end of surgery, but before any postural change. We attempt to elucidate the surgical or anesthesiologic precipitating factors that lead to the cardiac arrest in this patient. However, there was no real etiology that formally explained the genesis of the accident. This case is to add to a series of recently published accidents that occurred during spinal anesthesia in healthy patients.

Aged↗
PubMed1994

[Efforts of general practitioners in the treatment of heart arrest in a rural area. A prospective pilot study].

During a two year period, general practitioners in a local area were called to all 112 alarms (the number dialled in Denmark in emergencies) in order to improve the prognosis of patients with cardiac arrest. In 55% of the calls, the practitioners arrived within five minutes, whereas the ambulance arrived within five minutes in only 16% of the cases (p < 0.01). Three of ten patients with cardiac arrest survived without cerebral damage. In 23% of the cases final treatment was completed by the local practitioner.

Adolescent↗
PubMed1993

[Resuscitation in heart arrest due to severe hypothermia].

Two patients were resuscitated after cardiopulmonary arrest due to severe hypothermia. The first patient, a 76-year-old man, had ventricular fibrillation resistant to conventional therapy; he was rapidly rewarmed by means of cardiopulmonary bypass. In the second patient, a 77-year-old woman, classical resuscitation led to restoration of spontaneous circulation. The patient was subsequently rapidly rewarmed with hemodialysis with fluid of 40 degrees C. We conclude that rapid rewarming with cardiopulmonary bypass is the treatment of choice in severely hypothermic patients presenting with cardiac arrest that is resistant to conventional therapy. Hemodialysis seems a suitable technique in patients who remain deeply hypothermic after resuscitation. However, it is difficult to assess its value because of the lack of clinical studies comparing this technique with other procedures.

Aged↗
PubMed1982

[Analysis of the population of Purkinje's cells in the cerebellar cortex of dogs subjected to heart arrest].

The population of Purkinje's cells (PC) was studied in the cerebellum cortex of 5 mongrel dogs that suffered 12-minute circulatory arrest caused by electric trauma followed by complete external recovery of the neurological status. Morphometric analysis revealed that 2 weeks after resuscitation the total number of PC per mm of their layer length remains unchanged, while the composition of the population drastically changes. In all the zones of the cerebellum studied, the number of PC having different morphological changes increases, whereas the number of light PC was significantly decreased. The result of the changes was that 2 weeks after clinical death, dark cells constituted half the normal (morphologically unchanged) population of PC. Meanwhile in the control group, dark PC constituted 1/3 of the population. Cytophotometry revealed that in both groups of animals (the intact and with a history of clinical death) the dark PC are characterized by the increased content of nucleic acid, as compared to that of the light PC. It is suggested that the increase in the relative number of the dark PC in the cerebellum cortex of dogs after systemic circulation arrest is related to the transition of intracellular physiological regeneration to the reparative one. Therefore, both pathological and compensatory processes are seen in the dog cerebellum cortex 2 weeks after resuscitation. It was disclosed that PC of the lateral zone of the cerebellum hemisphere are most vulnerable, while those of the medial zone (vermis cerebelli) are most viable.

Animals↗
PubMed1979

[Myocardial metabolic status in various methods of inducing a reversible heart arrest].

In experiments with dogs, three different methods of inducing a reversible cardiac arrest were compared: (A) the ischemic arrest for 45 min, (B) the cardiac arrest for 90 min due to injection of Cardioplegin according to KIRSCH, and (C) the cardiac arrest for 90 min due to infusion of solution LK 352 according to BRETSCHNEIDER. The body temperature was reduced to 30 degrees C during the period of cardiac arrest. From the alterations in the adenylic acid system of the left ventricular myocardium at the end of the period of myocardial standstill and after 60 min of recovery, it can be deduced that the best myocardial protection is given by method C. Method A has the least effect.

Adenine Nucleotides↗