- CPR/Resuscitation
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Lower limb muscle matters in patients with hypoxic brain injury following out-of-hospital cardiac arrest
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Dong-Hyun Jang, Seung Min Park, Dong Keon Lee, Dong Won Kim, Chang Woo Im, You Hwan Jo, Kui Ja Lee
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Acute Crit Care. 2023;38(1):104-112. Published online February 27, 2023
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DOI: https://doi.org/10.4266/acc.2022.01389
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 Abstract
 PDF Supplementary Material
- Background
There are conflicting results regarding the association between body mass index and the prognosis of cardiac arrest patients. We investigated the association of the composition and distribution of muscle and fat with neurologic outcomes at hospital discharge in successfully resuscitated out-of-hospital cardiac arrest (OHCA) patients. Methods: This prospective, single-centre, observational study involved adult OHCA patients, conducted between April 2019 and June 2021. The ratio of total skeletal muscle, upper limb muscle, lower limb muscle, and total fat to body weight was measured using InBody S10, a bioimpedance analyser, after achieving the return of spontaneous circulation. Restricted cubic spline curves with four knots were used to examine the relationship between total skeletal muscle, upper limb muscle, and lower limb muscle relative to total body weight and neurologic outcome at discharge. Multivariable logistic regression analysis was performed to assess an independent association. Results: A total of 66 patients were enrolled in the study. The proportion of total muscle and lower limb muscle positively correlated with the possibility of having a good neurologic outcome. The proportion of lower limb muscle showed an independent association in the multivariable analysis (adjusted odds ratio, 2.29; 95% confidence interval, 1.06–13.98), and its optimal cut-off value calculated through receiver operating characteristic curve analysis was 23.1%, which can predict a good neurological outcome. Conclusions: A higher proportion of lower limb muscle to body weight was independently associated with the probability of having a good neurologic outcome in OHCA patients.
- CPR/Resuscitation
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Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury
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Dong Keon Lee, Kyung Sik Kang, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
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Acute Crit Care. 2019;34(3):228-231. Published online April 26, 2018
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DOI: https://doi.org/10.4266/acc.2015.00633
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Abstract
PDFSupplementary Material
- There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.
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Citations
Citations to this article as recorded by  - Thoracic Aortic Rupture Post Cardiopulmonary Resuscitation in a Patient With Previous Thoracic Aneurysm Repair
Aniekeme S Etuk, Olanrewaju F Adeniran , Bernard I Nkwocha, Nformbuh Asangmbeng, Mina Jacob
Cureus.2023;[Epub] CrossRef - Cardiac Arrest as an Uncommon Manifestation of Late Type A Aortic Dissection Associated with Transcatheter Aortic Valve Replacement
Jan Naar, Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Iva Zemanova, Martin Syrucek, Petr Neuzil, Petr Ostadal
Journal of Clinical Medicine.2023; 12(16): 5318. CrossRef - Blunt Thoracic Aortic Injury and Contemporary Management Strategy
Ranjan Dahal, Yogesh Acharya, Alan H. Tyroch, Debabrata Mukherjee
Angiology.2022; 73(6): 497. CrossRef - Resuscitative endovascular occlusion of the aorta (REBOA) as a mechanical method for increasing the coronary perfusion pressure in non-traumatic out-of-hospital cardiac arrest patients
Dong-Hyun Jang, Dong Keon Lee, You Hwan Jo, Seung Min Park, Young Taeck Oh, Chang Woo Im
Resuscitation.2022; 179: 277. CrossRef - Blunt traumatic aortic dissection death by falling: an autopsy case report
Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano
Forensic Science, Medicine and Pathology.2022; 19(3): 388. CrossRef - Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation
Sung Oh Hwang, Woo Jin Jung, Young-Il Roh, Kyoung-Chul Cha
Clinical and Experimental Emergency Medicine.2022; 9(4): 271. CrossRef - Intra-arrest transoesophageal echocardiographic findings and resuscitation outcomes
Woo Jin Jung, Kyoung-Chul Cha, Yong Won Kim, Yoon Seop Kim, Young-Il Roh, Sun Ju Kim, Hye Sim Kim, Sung Oh Hwang
Resuscitation.2020; 154: 31. CrossRef - Aortic Rupture as a Complication of Cardiopulmonary Resuscitation
Prashanth Venkatesh, Edward J. Schenck
JACC: Case Reports.2020; 2(8): 1150. CrossRef
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