A5079976045- Cardiac Arrest and Resuscitation
- Thermal Regulation in Medicine
- Traumatic Brain Injury and Neurovascular Disturbances
- Respiratory Support and Mechanisms
- Heart Rate Variability and Autonomic Control
- Disaster Response and Management
- Infection Control and Ventilation
- Traumatic Brain Injury Research
- Intensive Care Unit Cognitive Disorders
- Stroke Rehabilitation and Recovery
- Airway Management and Intubation Techniques
Karolinska Institutet
2011-2024
Stockholm South General Hospital
2011-2024
<h3>Importance</h3> Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). <h3>Objective</h3> To determine whether prehospital trans-nasal intra-arrest improves compared initiated hospital arrival. <h3>Design, Setting, and Participants</h3> The PRINCESS trial was an investigator-initiated, randomized,...
Delayed hypothermia, initiated after hospital arrival, several hours cardiac arrest with 8-10 to reach the target temperature, is likely have limited impact on overall survival. However, effect of ultrafast i.e. delivered intra-arrest or immediately return spontaneous circulation (ROSC), functional neurologic outcome out-of-hospital (OHCA) unclear. In two prior trials, prehospital trans-nasal evaporative cooling was safe, feasible and reduced time temperature compared delayed cooling. Both...
Abstract Background Randomized trials have shown that trans-nasal evaporative cooling initiated during CPR (i.e. intra-arrest) effectively lower core body temperature in out-of-hospital cardiac arrest patients. However, these may been underpowered to detect significant differences neurologic outcome, especially patients with initial shockable rhythm. Methods We conducted a post hoc pooled analysis of individual data from two randomized including 851 who eventually received the allocated...
Importance Brain injury is the leading cause of death following cardiac arrest and associated with severe neurologic disabilities among survivors, profound implications for patients their families, as well broader societal impacts. How these affect long-term survival largely unknown. Objective To investigate whether complete recovery at hospital discharge after better compared moderate or disabilities. Design, Setting, Participants This cohort study used data from 4 mandatory national...
Trans-nasal evaporative cooling is an effective method to induce intra-arrest therapeutic hypothermia in out-of-hospital cardiac arrest (OHCA). The use of supraglottic airway devices (SGA) instead endotracheal intubation may enable shorter time intervals cooling. We aimed study the outcomes OHCA patients receiving (ETI) or a SGA during trans-nasal This pre-specified sub-study PRINCESS trial (NCT01400373) that included witnessed randomized resuscitation vs. standard care followed by...
Background: In animal models, early initiation of therapeutic cooling, intra-arrest, or restored circulation has been shown to be neuroprotective shortly after cardiac arrest. We aimed assess the feasibility and cooling efficacy transnasal evaporative initiated as possible hospital arrival in patients randomized TTM2 trial. Methods: This study took form a single-center (Södersjukhuset, Stockholm) substudy trial (NCT02908308) comparing target temperature management (TTM) 33 °C versus...
Background: Despite promising results, the role of intra-arrest hypothermia in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim this study was to assess effects trans-nasal evaporative cooling (TNEC) during resuscitation on neurological recovery OHCA patients admitted alive hospital. Methods: A post hoc analysis PRINCESS trial, including only hospital, either assigned TNEC or standard care resuscitation. primary endpoint favorable outcome (FO) defined as a Cerebral...
Background: The impact of ultrafast hypothermia, i.e. delivered intra-arrest or immediately after return spontaneous circulation (ROSC), on functional neurologic outcome out-of-hospital cardiac arrest (OHCA) is unclear. In two prior trials, prehospital transnasal evaporative cooling was safe, feasible and reduced time to target temperature. Both studies showed trends towards improved recovery in patients with shockable rhythms. aim the PRINCESS2-study assess whether cooling, initiated either...
Introduction: Out-of-hospital cardiac arrest (OHCA) afflicts around 275,000 victims per year across Europe and is accountable for more than 60% of deaths from coronary heart disease. In 2005, a dual dispatch system in OHCA was implemented Stockholm, Sweden, using CPR-trained fire fighters with automatic external defibrillators as first responders addition to the emergency medical services (EMS). The pilot study 2006 showed promising results on improving time intervals survival rates....