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Weng X, Jiang L, Zhou M. Massive anterior mediastinal lipoma causing cardiac arrest in a middle-aged male: a case report and literature review. Future Cardiol 2023; 19:747-752. [PMID: 38112188 DOI: 10.2217/fca-2023-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/25/2023] [Indexed: 12/21/2023] Open
Abstract
Lipoma is a common benign soft tissue tumor, but its size and location can lead to serious issues. We report a case of a 48 year-old male patient who experienced sudden cardiac arrest outside the hospital. After resuscitation and examination, we determined that this was due to a massive mediastinal lipoma compressing the lungs, leading to respiratory failure and pulmonary encephalopathy, ultimately resulting in cardiac arrest. This case serves as a reminder to promptly identify and manage chest lipomas to avoid compression and functional impairment of the respiratory system. Early evaluation and treatment of massive lipomas are crucial for preventing complications.
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Affiliation(s)
- Xulin Weng
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Le Jiang
- Department of Emergency Intensive Care Unit, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Menglu Zhou
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
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Komori A, Iriyama H, Abe T. Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology. Resusc Plus 2023; 13:100363. [PMID: 36814461 PMCID: PMC9939706 DOI: 10.1016/j.resplu.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Aim of the study Although defibrillation using automated external defibrillator (AED) by bystander prior to emergency medical system (EMS) arrival was associated with favorable outcomes in out-of-hospital cardiac arrest (OHCA) of cardiac cause, whether it improves outcomes of OHCA due to non-cardiac cause is not clear. We aimed to investigate the impact of defibrillation with AED by bystander before defibrillation by EMS personnel on the outcomes of OHCA of presumed non-cardiac cause. Methods This was a retrospective cohort study using the All-Japan Utstein registry (reference period: 2013 to 2017). We included adult patients with OHCA of presumed non-cardiac cause, who had initial shockable rhythm, and who received witnessed arrest bystander cardiopulmonary resuscitation (CPR). Exposure variable was defibrillation with AED by bystander in comparison with initial defibrillation by EMS. Logistic regression analyses were conducted to assess the association between bystander AED shock and favorable neurological outcome (Cerebral Performance Category scale 1 or 2) at one month. Results Among the 1,053 patients included for analysis, 57 (5.4%) received bystander AED shock. There was no statistically significant difference in the rate of favorable neurological outcome at one month between groups [9 (15.8%) vs 109 (10.9%), p = 0.26]. Logistic regression analysis adjusted for characteristics, intervention, and time course of CPR showed no association between bystander AED shock and favorable neurological outcome [OR (95% CI): 1.63 (0.70-3.77), p = 0.25]. Conclusion In this study, defibrillation with AED by bystander before defibrillation by EMS personnel was not associated with the favorable outcomes of OHCA of presumed non-cardiac cause.
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Affiliation(s)
- Akira Komori
- Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan,Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan,Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan,Corresponding author at: Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki 300-2622, Japan.
| | - Hiroki Iriyama
- Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan,Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan,Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Toshikazu Abe
- Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan,Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
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Zhai Q, Duan J, Yu J, Zhang H, He X, Ma Q. Letter to the Editor: From Target Temperature Management Trial 1 to Trial 2: Therapeutic Hypothermia for Cardiac Arrest Discredited? Ther Hypothermia Temp Manag 2022. [PMID: 35231192 DOI: 10.1089/ther.2022.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Qiangrong Zhai
- Department of Emergency, Peking University Third Hospital, Beijing, China
| | - Jingwei Duan
- Department of Emergency, Peking University Third Hospital, Beijing, China
| | - Jie Yu
- The George Institute for Global Health, UNSW, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- The Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China
| | - Xiaojun He
- Department of Emergency Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Chinese Journal of Emergency Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingbian Ma
- Department of Emergency, Peking University Third Hospital, Beijing, China
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Wittwer MR, Zeitz C, Beltrame JF, Arstall MA. Aetiology of resuscitated out-of-hospital cardiac arrest treated at hospital. Resuscitation 2021; 170:178-183. [PMID: 34871757 DOI: 10.1016/j.resuscitation.2021.11.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Precipitating aetiology of out-of-hospital cardiac arrest (OHCA), as confirmed by diagnostic testing or autopsy, provides important insights into burden of OHCA and has potential implications for improving OHCA survivorship. This study aimed to describe the aetiology of non-traumatic resuscitated OHCAs treated at hospital within a local health network according to available documentation, and to investigate differences in outcome between aetiologies. METHODS Observational retrospective cohort study of consecutive OHCA treated at hospital within a local health network between 2011-2016. Cases without sustained ROSC (≥20 minutes), unverified cardiac arrest, and retrievals to external acute care facilities were excluded. A single aetiology was determined from the hospital medical record and available autopsy results. Survival to hospital discharge was compared between adjudicated aetiologies. RESULTS In the 314 included cases, distribution of precipitating aetiology was 53% cardiac, 18% respiratory, 3% neurological, 6% toxicological, 9% other, and 11% unknown. A presumed cardiac pre-hospital diagnosis was assigned in 235 (84%) cases, 20% of which were incorrect after exclusion of unknown cases. Rates of survival to hospital discharge varied significantly across aetiologies: cardiac 64%, respiratory 21%, neurological 0%, toxicological 58%, other 32% (p < 0.001). A two-fold difference in survival was observed between cardiac and non-cardiac aetiologies (64% versus 29%, excluding unknown, p < 0.001). CONCLUSIONS Non-cardiac aetiologies represented a substantial burden of resuscitated OHCA treated at hospital within a local health network and were associated with poor outcome. The results confirmed that true aetiology was not evident on initial examination in 1 in 5 cases with a pre-hospital cardiac diagnosis.
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Affiliation(s)
- M R Wittwer
- School of Medicine, University of Adelaide, Australia; Department of Cardiology, Northern Adelaide Local Health Network, Australia.
| | - C Zeitz
- School of Medicine, University of Adelaide, Australia; Department of Cardiology, Central Adelaide Local Health Network, Australia
| | - J F Beltrame
- School of Medicine, University of Adelaide, Australia; Department of Cardiology, Central Adelaide Local Health Network, Australia
| | - M A Arstall
- School of Medicine, University of Adelaide, Australia; Department of Cardiology, Northern Adelaide Local Health Network, Australia
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Afferent limb failure revisited – A retrospective, international, multicentre, cohort study of delayed rapid response team calls. Resuscitation 2020; 156:6-14. [DOI: 10.1016/j.resuscitation.2020.08.117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/25/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022]
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Ota I, Kubota Y, Uejima T, Shigeoka H, Hiraide A. Outcomes after out-of-hospital cardiac arrests by anaphylaxis: A nationwide population-based observational study. Acute Med Surg 2020; 7:e458. [PMID: 31988770 PMCID: PMC6971466 DOI: 10.1002/ams2.458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022] Open
Abstract
AIM The objective of this study was to focus on outcomes of anaphylaxis-associated out-of hospital cardiac arrest (OHCA) in non-cardiac cases. METHODS All residents with OHCA due to non-cardiac cause in Japan from 2013 to 2015 were included for analysis. Propensity score matching and logistic regression analyses were used to assess outcome-related factors in anaphylaxis cases and non-anaphylaxis cases. The comparison group was comprised of non-anaphylaxis cases, which consisted of other cases of non-cardiac etiology. RESULTS A total of 375,874 OHCA cases were included, of which 148,598 were due to non-cardiac cause. In these non-cardiac OHCA cases, 147 were due to anaphylaxis, with an annual incidence of 0.04 per 100,000. In the patients' characteristics, witnessed ratio, shockable rhythm, defibrillation by emergency medical services (EMS), and treatment with adrenaline by EMS were significantly greater in the anaphylaxis cases compared with the non-anaphylaxis cases. In anaphylaxis cases, the crude 1-month survival rate (32.7% versus 5.3%) and crude favorable neurological outcomes rate (24.5% versus 2.2%) were higher compared with non-anaphylaxis cases (P < 0.001). The differences in outcomes between the two types of cases were also marked after we adjusted these variables by propensity score matching. By logistic regression analyses, administration of a drug by EMS was negatively associated with good neurological outcomes (odds ratio, 0.27; 95% confidence interval, 0.09-0.87), but bystander cardiopulmonary resuscitation was positively associated with good neurological outcomes (odds ratio, 2.33; 95% confidence interval, 0.99-5.52). CONCLUSION Neurological outcome was markedly more favorable in cases with anaphylaxis than non-anaphylaxis cases. Further studies are needed to explain this result.
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Affiliation(s)
- Ikuo Ota
- Department of Emergency MedicineNagayama HospitalSennanJapan
| | - Yoshie Kubota
- Institutional Research CenterKindai UniversityHigashiosakaJapan
| | - Toshifumi Uejima
- Department of Acute MedicineKindai UniversityOsakasayamaOsakaJapan
| | | | - Atsushi Hiraide
- Institutional Research CenterKindai UniversityHigashiosakaJapan
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Association between shockable rhythm conversion and outcomes in patients with out-of-hospital cardiac arrest and initial non-shockable rhythm, according to the cause of cardiac arrest. Resuscitation 2019; 142:144-152. [DOI: 10.1016/j.resuscitation.2019.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/29/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022]
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Comment on ‘Comparison of presumed cardiac and respiratory causes of out-of-hospital cardiac arrest’. Resuscitation 2019; 140:211. [DOI: 10.1016/j.resuscitation.2019.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 11/30/2018] [Accepted: 01/04/2019] [Indexed: 11/19/2022]
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Orban JC, Kerever S, Mongardon N, Ichai C. Reply to: Comment on 'Comparison of presumed cardiac and respiratory causes of out-of-hospital cardiac arrest'. Resuscitation 2019; 140:212-213. [PMID: 31078495 DOI: 10.1016/j.resuscitation.2019.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 04/27/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Jean-Christophe Orban
- Medical Surgical ICU, Pasteur 2 Hospital, Nice University Hospital, 30 Voie Romaine, 06001 Nice, France.
| | - Sébastien Kerever
- Departments of Anesthesiology and Critical Care, Lariboisière University Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Nicolas Mongardon
- Anesthesia and Surgical ICU, Henri Mondor University Hospital, 31 rue du Parc, 94000 Créteil, France; School of Medicine, Paris Est University, 61 Avenue du Général De Gaulle, 94000 Créteil, France; Inserm U955, Équipe 3, "Stratégies Pharmacologiques et Thérapeutiques Expérimentales des Insuffisances Cardiaques et Coronaires", 8 rue du Général Sarrail, 94010 Créteil, France
| | - Carole Ichai
- Medical Surgical ICU, Pasteur 2 Hospital, Nice University Hospital, 30 Voie Romaine, 06001 Nice, France
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Outcome after pre-hospital cardiac arrest in accordance with underlying cause. Resuscitation 2019; 138:36-41. [PMID: 30831217 DOI: 10.1016/j.resuscitation.2019.02.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/22/2019] [Accepted: 02/24/2019] [Indexed: 01/01/2023]
Abstract
AIM In terms of treatment options, the underlying cause of out-of-hospital cardiac arrest (OHCA) has an impact on survival. This study aimed to examine the frequencies of different causes of OHCA and their outcomes using data from a national resuscitation registry. METHODS All pre-hospital cardiopulmonary resuscitations (CPR) documented in the German Resuscitation Registry between 2007 and 2017 were retrospectively investigated with regard to cause of cardiac arrest, return of spontaneous circulation (ROSC), and hospital discharge rate with good neurological outcome. To avoid selection bias, only rescue services with a return rate in the form 'further clinical treatment' of >30% were included, this resulted in a total return rate of 84% of the included data. RESULTS In total, 33,772 patients were included. The most common causes of OHCA were cardiac events (62.2%), hypoxia (11.1%) and trauma (3.2%), in 17.2% no or unknown cause were documented. Overall, 44.8% of patients achieved ROSC, 13.1% of patients were discharged alive from hospital and 68.3% of these were in good neurological condition (9.0% of all patients). ROSC rates differed between 8.9% (sudden infant death syndrome) and 64.4% (intracranial bleeding), while discharge rates with good neurological outcome ranged between 0.9% (sepsis) and 14.0% (intoxication). CONCLUSION The most common causes of OHCA are cardiac events and hypoxia. Depending on the underlying cause, outcome after pre-hospital CPR varies widely with a survival rate with good neurological outcome ranging from 0.9 to 14%.
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Gupta A, Ladejobi A, Munir MB, Pasupula DK, Bhonsale A, Kancharla K, Wang NC, Jain S, Saba S. Derivation and validation of a new score to predict long-term survival after sudden cardiac arrest. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:1585-1590. [DOI: 10.1111/pace.13528] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Aman Gupta
- Department of Internal Medicine; UPMC; University of Pittsburgh; Pittsburgh PA USA
| | - Adetola Ladejobi
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Mohammad Bilal Munir
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | | | - Aditya Bhonsale
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Krishna Kancharla
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Norman C. Wang
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Sandeep Jain
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Samir Saba
- Division of Cardiovascular Diseases, Department of Internal Medicine, UPMC, Heart & Vascular Institute; University of Pittsburgh; Pittsburgh PA USA
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Kendall MC. Cardiac and respiratory causes of out-of-hospital cardiac arrest. Resuscitation 2018; 132:e2. [DOI: 10.1016/j.resuscitation.2018.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
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