Resuscitation Group’s Post

This retrospective cohort study compared pulmonary valve-sparing and transannular patch techniques for correcting Tetralogy of Fallot (ToF) in 102 pediatric patients. The study found that the valve-sparing approach led to shorter durations of mechanical ventilation, ICU stays, and hospitalization, with fewer complications like arrhythmias. #MechanicalVentilation #PediatricCardiacSurgery #PostoperativeOutcomes #PulmonaryValveSparing #TetralogyofFallot #TransannularPatch

This retrospective cohort study compared pulmonary valve-sparing and transannular patch techniques for correcting Tetralogy of Fallot (ToF) in 102 pediatric patients. The study found that the valve-sparing approach led to shorter durations of mechanical ventilation, ICU stays, and hospitalization, with fewer complications like arrhythmias. #MechanicalVentilation #PediatricCardiacSurgery #PostoperativeOutcomes #PulmonaryValveSparing #TetralogyofFallot #TransannularPatch

⚠️ECPR⚠️ 🟡Extracorporeal cardiopulmonary resuscitation (ECPR) is a salvage procedure in which extracorporeal membrane oxygenation (ECMO) is initiated emergently on patients who have had cardiac arrest (CA) and on whom the conventional cardiopulmonary resuscitation (CCPR) has failed. 🟡The aim of ECPR is to provide adequate perfusion to the end-organs when the potentially “reversible” conditions were managed. 🟡ECPR is an emergency procedure. Well-defined criteria to help in selection of ideal patients for ECPR are mandatory to save the deserving CA patients and to differentiate from the patients on whom the ECPR’s outcome is unacceptably low. Unfortunately, there is no uniform consensus on those criteria. Selection criteria accepted by most of the centres are: Inclusion criteria 🟨Witnessed CA of cardiac origin or without any obvious cause. 🟨No sustained ROSC for the first 10 min (for a few centres, it is 20 min) of conventional CPR CPR duration less than 10 min. 🟨Ventricular fibrillation (VF), pulseless ventricular (pVT)on initial ECG. Exclusion criteria 🟨Known severe irreversible brain damage. 🟨Terminal malignancy. 🟨Traumatic origin with uncontrollable bleeding. 🟨Acute aortic dissection. 🟨Non-cardiac origin (asphyxia, submersion, primary cerebral disorder). 🟨Irreversible organ failure (like liver failure and late-stage advanced adult respiratory distress syndrome). 🟨Severe sepsis. 🟨Poor level of activities of daily living before CA. ECPR in children: 🟡Most of the ECPR managements are similar in paediatric and adult population. 🟡ECPR in the postoperative period following corrective or palliative surgery for congenital heart disease (CHD) is the most common indication for ECPR in the paediatric age group. This condition has better prognosis than other conditions. 🟡Cardiac arrhythmias, tamponade, pulmonary hypertension, hypoxemia due to pulmonary blood flow obstruction, myocardial dysfunction and residual lesions are the frequent causes for cardiac arrest in the postoperative period following surgery for CHD. Technique and Application: 🟡The mode of support for ECPR is VA since other modes (venovenous, arteriovenous) provide gas exchange but not circulatory support, whereas VA support provides both. 🟡VA support involves cannulation of the right atrium for venous drainage and the aorta or a large artery (femoral or carotid) for return to the arterial system. 🟡The heart and lungs are bypassed during ECPR, and the extracorporeal circuit provides full cardiopulmonary support. 🟡On ROSC, systemic blood flow is the sum of native cardiac output and extracorporeal flow. Complications: 🟡Bleeding is the most common complication associated with all forms of ECLS, including ECPR. The most common site of bleeding is cannulation site. #cardiology #perfusion #perfusionist #cardiacsurgery #cardiovascular #cpr #ecpr #health #medical

❤️October is vEDS Action Month. vEDS Awareness saves lives.⁠ ⁠ vEDS can cause life-threatening complications, such as aneurysm, dissection, and rupture of the arteries and rupture of organs, mainly the bowel. All medical professionals involved in a person’s care should be aware of their vEDS diagnosis and the risks associated with it.⁠ ⁠ 🏥vEDS can affect all areas of medical care. It’s important to consider tissue fragility & potential for sudden, severe, & life-threatening complications during any interventions. Conservative approaches should be considered when possible. Elective procedures should be avoided due to the higher surgical risks associated with vEDS.⁠ ⁠ 🚑Emergency providers must be made aware that a person has vEDS in order to provide appropriate care. People with vEDS are encouraged to carry emergency information with them to help them get the right emergency care.⁠ ⁠ People with vEDS require tailored medical care, and conservative management options should be considered before surgery due to the higher surgical risks associated with vEDS.⁠ ⁠ 💊High blood pressure puts stress on the blood vessel walls, which are very fragile in vEDS. Medications are often used to keep blood pressure at a normal or low level and prevent large changes in blood pressure. Beta-blockers and angiotensin II receptor blockers (ARBs) have been shown to improve clinical outcomes for those with vEDS when combined with specialist care and advice.⁠ ⁠ Most people with vEDS should have regular vascular imaging to screen for potential complications. This helps them be addressed in a planned procedure rather than an emergency. It’s important to investigate suspected vascular events— symptoms can be subtle.⁠ Find information and support groups and resources on vEDS at: https://lnkd.in/eZd7hDC2

#Cardiopulmonary_Resuscitation(CPR) and Associated Chest Injuries: A Clinical Overview CPR is a pivotal intervention in emergency medicine designed to maintain circulation and breathing when cardiac arrest occurs. The procedure involves performing chest compressions and, when indicated, providing rescue breaths. Despite its life-saving potential, CPR is not devoid of complications, particularly chest injuries. This review explores the prevalence, types, and clinical management of these injuries to better inform clinical practice and patient care. 🔴 Incidence and Prevalence Chest injuries following CPR are a well-documented phenomenon, with studies indicating that rib fractures occur in approximately 30% to 40% of patients undergoing the procedure. The likelihood of injury can be influenced by factors such as the patient's age, bone density, and overall health. Older adults and individuals with compromised bone strength are at higher risk for sustaining chest injuries during resuscitation. 🔴#Types_of_Chest_Injuries 1- Rib Fractures: they are the most frequent chest injury resulting from CPR. The mechanical force applied during chest compressions can lead to fracture or rib contusions. These injuries can cause significant pain, reduce mobility, and complicate post-resuscitation recovery. Management typically involves analgesics and supportive care to alleviate discomfort and promote healing. 2- Sternal Fractures: Fractures of the sternum, though less common than rib fractures, can occur due to the force exerted during compressions. Sternal fractures are associated with more severe complications and may require additional imaging and intervention. The presence of sternal fractures necessitates careful monitoring for potential underlying injuries and complications. 3- Internal Organ Damage: In rare cases, the force of chest compressions may cause damage to internal organs, such as the lungs, liver, or spleen. This can result in pneumothorax, hemothorax, or intra-abdominal hemorrhage. Such injuries require prompt identification and management, often involving advanced imaging and surgical intervention if necessary. 🔴Management of Chest Injuries Effective management of chest injuries post-CPR is crucial to minimize complications and support recovery: 1-Pain Management: Adequate analgesia is essential to manage pain associated with rib and sternal fractures. Nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids may be used, depending on the severity of the pain and patient-specific factors. 2-Monitoring and Evaluation: Continuous monitoring for potential complications such as pneumothorax or internal bleeding is necessary. 3- Supportive Care: include respiratory support, physical therapy, and follow-up evaluations. Figure 1. Representative computed tomographic images of lung injuries following cardiopulmonary resuscitation from : mdpi.com

Listening to the patient and understanding what’s important to them is the biggest miss in healthcare.

Today’s topic is sudden cardiac death, or SCD. The silent and often unexpected killer affects countless lives every year, and is imperative that we shed light on its causes, prevention, and critical steps we can take to save lives. Sudden cardiac death is a condition in which the heart abruptly stop beating, leading to a cessation a blood flow to the brain and other vital organs. It can happen without warning and within minutes. Despite advancements in medical technology and treatment, SCD remains the leading cause of mortality, worldwide, claiming hundreds of thousands of lives annually. To combat this silent threat, we must take a multifaceted approach. First and foremost, awareness and education are paramount. Understanding the risk factors, and recognizing the early signs of heart problems can make a significant difference. Symptoms like chest pain, shortness of breath, palpitations, and unexplained fainting should never be ignored. Regular health check ups and screenings play a crucial role in early detection and prevention. Simple test, such as an electrocardiogram (ECG), can identify potential issues before they become life-threatening. For those with a known risk, wearing portable heart monitors can provide continuous monitoring and early intervention. Lifestyle changes are equally vital. Adopting a heart, healthy diet, engaging in regular physical activity, avoid smoking, and moderate alcohol intake can significantly reduce the risk of heart disease, and, consequently, SCD. For those diagnosed with heart conditions, adhering to prescribe medication’s, and following medical advice can help manage the disease and prevent complications. Furthermore, the availability and accessibility of automated external defibrillators (AEDs) in public places can save lives. AEDs our design to be user-friendly, allowing even untrained individuals to provide life-saving defibrillation to someone experiencing sudden cardiac death. Encouraging the installation of AED’s in schools, workplaces, and community centers, along with CPR training, empowers more people to act swiftly in an emergency. Medical research and innovation are also paving the way for better prevention and treatment of SCD. Advances and genetic testing can identify individuals at high risk, enabling personalized prevention strategies. Implantable cardioverter-defibrillators (ICDs) offer continuous heart, monitoring and automatic shock delivery in case of dangerous arrhythmias, providing a safety net for those at risk. In conclusion, addressing sudden cardiac death, requires a concerted effort from healthcare professionals, policy, makers, communities, and individuals. By increasing awareness, promoting healthy lifestyles, ensuring regular medical check ups, and making lifesaving technologies accessible, we can reduce the incident of SCD and protect countless lives. let’s make a difference!❤️

Cresilon Receives FDA Clearance for TRAUMAGEL: A New Algae-Based Gel Treats Severe Bleeding in Seconds Cresilon Inc's Traumagel has been cleared by the FDA as an emergency treatment to control moderate to severe bleeding. The product uses a proprietary algae-derived hydrogel technology developed by the Brooklyn-based company. This is the second gel-based treatment successfully pushed through by Cresilon, following the FDA’s clearance of its Hemostatic Gel in June 2023. While that gel was cleared to patch up small nicks and cuts, Traumagel is intended to mend bleeding from much more serious injuries like gunshot wounds, stabbings, and car crashes. The FDA cleared Traumagel based on preclinical data showing that it performed similarly to standard wound care treatments in use today. However, the company argues that their product has several advantages over existing interventions, such as taking only seconds to start working. The gel is also purportedly easy to deploy, with a pre-filled syringe that requires no added pressure on the wound, and can be used to treat all types of bleeding. Severe blood loss can kill in a matter of minutes, whether from a gunshot wound or a massive injury-related hemorrhage. A person dies from injury nearly every 3 minutes, and 40% of these deaths are due to major hemorrhage or its consequences. Death from hemorrhage is early, with up to 60% of deaths occurring within the first 3 hours of injury. “The ability to rapidly stop bleeding at the point of care and halt a life-threatening hemorrhage can be the difference between life and death for people with traumatic wounds,” said Cresilon CEO, co-founder, and inventor Joe Landolina in a statement from the company. “The FDA clearance for Traumagel is a monumental milestone for Cresilon and brings us another step forward in our mission to save lives and transform the standard of care in wound treatment. Our proprietary hemostatic gel technology is a game-changer and unlike any other hemostatic agent currently being used.” The company expects to start launching the gel in late 2024 and will market its product to the U.S. military, government health agencies, emergency medical services systems, and other medical professionals who regularly treat trauma patients. The company is also researching and developing a new product in conjunction with the U.S. Defense Department as a potential field and prehospital treatment to help manage life-threatening brain hemorrhages and traumatic brain injuries. According to the company, early results have been promising. Scientists elsewhere have been working on their own gel-based technologies intended to improve medical care. Researchers have developed bandages infused with gel to speed up healing, for instance, while others are using gels as a form of male birth control or help treat conditions like Parkinson’s disease or back pain. https://lnkd.in/ei48PQFK

JIM│ Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis Author: Huaiwu He, Yun Long et al. Link: https://buff.ly/4hUNr5o #PerfusionIndex #AcuteKidneyInjury #Perioperative Background The relationship between perfusion index (PI) and organ dysfunction in patients in the intensive care unit (ICU) is not clear. This study aimed to explore the relationship between PI and renal function in the perioperative critical care setting and evaluate the predictive efficiency of PI on patients with acute kidney injury (AKI) in the ICU. Methods This retrospective analysis involved 12,979 patients who had undergone an operation and were admitted to the ICU in Peking Union Medical College Hospital from January 2014 to December 2019. The distribution of average PI in the first 24 h after ICU admission and its correlation with AKI was calculated by Cox regression. Receiver operating characteristic (ROC) curves were generated to compare the ability of PI, mean arterial pressure (MAP), creatinine, blood urea nitrogen (BUN), and central venous pressure (CVP) to discriminate AKI in the first 48 h in all perioperative critically ill patients. Results Average PI in the first 24 h served as an independent protective factor of AKI (Odds ratio [OR]=0.786, 95% confidence interval [CI]: 0.704–0.873, P <0.0001). With a decrease in PI by one unit, the incidence of AKI increased 1.74 times. Among the variables explored for the prediction of AKI (PI, MAP, creatine, BUN, and CVP), PI yielded the highest area under the ROC curve, with a sensitivity of 64.34% and specificity of 70.14%. A cut-off value of PI ≤2.12 could be used to predict AKI according to the Youden index. Moreover, patients in the low PI group (PI ≤2.12) exhibited a marked creatine elevation at 24–48 h with a slower decrease compared with those in the high PI group (PI >2.12). Conclusions As a local blood flow indicator, the initial 24-h average PI for perioperative critically ill patients can predict AKI during their first 120 h in the ICU.

#icu #Intensive_Care_Unit_(ICU) An Intensive Care Unit (ICU) is a specialized hospital department providing close monitoring and life-sustaining treatment for critically ill patients who require: 1. Continuous, comprehensive care. 2. Advanced life-support therapies. 3. Intensive monitoring by specialized healthcare professionals. #Characteristics : 1. High nurse-to-patient ratio. 2. Advanced medical equipment (e.g., ventilators, dialysis machines). 3. Continuous monitoring of vital signs and organ function. 4. Availability of specialized healthcare professionals (e.g., intensivists, respiratory therapists). 5. Collaborative, multidisciplinary care. #Types_of_ICU : 1. Medical ICU - MICU 2. Surgical ICU - SICU 3. Cardiovascular ICU - CVICU 4. Neurological ICU - Neuro ICU 5. Pediatric ICU - PICU 6. Neontal ICU - NICU 7. Burn ICU 8. Trauma ICU 9. Cardiothoracic ICU - CTICU 10. Neurosurgical ICU - NSICU #Importance_of_ICU : 1. Improves patient outcomes 2. Reduces mortality rates 3. Enhances quality of life 4. Supports families during critical illness 5. Advances medical research and education. #Types_of_Patients : 1. Critically ill patients 2. Post-operative patients 3. Trauma patients 4. Patients with life-threatening conditions (e.g., sepsis, cardiac arrest) 5. Patients requiring advanced life-support therapies. ● MedicalPatients : 1. Sepsis patients 2. Respiratory failure patients 3. Cardiac patients 4. Neurological patients 5. Gastrointestinal patients 6. Renal patients 7. Endocrine patients 8. Infectious disease patients ● Surgical Patients : 1. Post-operative patients 2. Trauma patients 3. Burn patients 4. Transplant patients 5. Vascular surgery patients ● Cardiovascular Patients : 1. Myocardial infarction patients 2. Heart failure patients 3. Cardiac arrest patients 4. Arrhythmia patients 5. Hypertensive crisis patients ● Neurological Patients : 1. Stroke patients 2. Traumatic brain injury patients 3. Spinal cord injury patients 4. Seizure patients 5. Neurodegenerative disease patients ● Pediatric Patients : 1. Neonates 2. Pediatric trauma patients 3. Respiratory distress patients 4. Cardiac patients 5. Neurological patients #Uses_of_physiotherapist_in_icu ● Respiratory Management : 1. Lung expansion exercises 2. Chest physiotherapy 3. Airway clearance techniques ● Mobility and Strengthening : 1. Early mobilization 2. Passive range of motion exercises 3. Resistance band exercises 4. Bed cycling or leg press ● Neurological Rehabilitation : 1. Neurodevelopmental techniques 2. PNF 3. Cognitive rehabilitation 4. Balance and vestibular rehabilitation 5. Swallowing rehabilitation ● Cardiovascular Stability : 1. Monitoring cardiovascular function 2. Blood pressure management 3. Cardiac rehabilitation