2023 ESC Guidelines for the management of acute coronary syndromes

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(38), P. 3720 - 3826

Published: Aug. 25, 2023

Language: Английский

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2023 ESC Guidelines for the management of acute coronary syndromes

European Heart Journal Acute Cardiovascular Care, Journal Year: 2023, Volume and Issue: 13(1), P. 55 - 161

Published: Sept. 22, 2023

Journal Article Corrected proof Guidelines 2023 ESC for the management of acute coronary syndromes: Developed by task force on syndromes European Society Cardiology (ESC) Get access Robert A Byrne, Byrne (Ireland) Corresponding authors: A. Department and Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Ireland, School Pharmacy Biomolecular Sciences, RCSI University Medicine Health Ireland. Tel: +353-1-2483190, E-mail: [email protected] https://orcid.org/0000-0001-5224-6393 Search other works this author on: Oxford Academic Google Scholar Xavier Rossello, Rossello (Spain) https://orcid.org/0000-0001-6783-8463 J Coughlan, Coughlan https://orcid.org/0000-0001-6086-3279 Emanuele Barbato, Barbato (Italy) https://orcid.org/0000-0002-0050-5178 Colin Berry, Berry (United Kingdom) https://orcid.org/0000-0002-4547-8636 Alaide Chieffo, Chieffo https://orcid.org/0000-0002-3505-9112 Marc Claeys, Claeys (Belgium) https://orcid.org/0000-0002-6628-9543 Gheorghe-Andrei Dan, Dan (Romania) https://orcid.org/0000-0001-9867-2582 R Dweck, Dweck https://orcid.org/0000-0001-9847-5917 Mary Galbraith, Galbraith https://orcid.org/0000-0002-4196-1815 ... Show more Martine Gilard, Gilard (France) Lynne Hinterbuchner, Hinterbuchner (Austria) https://orcid.org/0000-0001-5369-7399 Ewa Jankowska, Jankowska (Poland) https://orcid.org/0000-0002-9202-432X Peter Jüni, Jüni Takeshi Kimura, Kimura (Japan) Vijay Kunadian, Kunadian https://orcid.org/0000-0003-2975-6971 Margret Leosdottir, Leosdottir (Sweden) https://orcid.org/0000-0003-1677-1566 Roberto Lorusso, Lorusso (Netherlands) https://orcid.org/0000-0002-1777-2045 F E Pedretti, Pedretti https://orcid.org/0000-0003-1789-8657 Angelos G Rigopoulos, Rigopoulos (Greece) https://orcid.org/0000-0003-0735-2319 Maria Rubini Gimenez, Gimenez (Germany) https://orcid.org/0000-0003-2384-8250 Holger Thiele, Thiele Pascal Vranckx, Vranckx Sven Wassmann, Wassmann Nanette Kass Wenger, Wenger States America) Borja Ibanez, Ibanez Clinical Department, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, IIS-Fundación Jiménez Díaz Hospital, CIBERCV, ISCIII, Spain. +3491 4531200, [email protected] https://orcid.org/0000-0002-5036-254X Scientific Document Group Heart Journal. Acute Care, zuad107, https://doi.org/10.1093/ehjacc/zuad107 Published: 22 September history typeset:

Language: Английский

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In-hospital cardiac arrest: the state of the art

Critical Care, Journal Year: 2022, Volume and Issue: 26(1)

Published: Dec. 6, 2022

Abstract In-hospital cardiac arrest (IHCA) is associated with a high risk of death, but mortality rates are decreasing. The latest epidemiological and outcome data from several registries helping to shape our understanding IHCA. introduction rapid response teams has been downward trend in hospital mortality. Technology access defibrillators continues progress. optimal method airway management during IHCA remains uncertain, there for decreasing use tracheal intubation increased supraglottic devices. first randomised clinical trial ongoing the UK. Retrospective observational studies have shown that pre-arrest factors strongly after IHCA, bias such makes prognostication individual cases potentially unreliable. Shared decision making advanced care planning will increase application appropriate DNACPR decisions decrease resuscitation attempts following

Language: Английский

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Duration of Device-Based Fever Prevention after Cardiac Arrest

New England Journal of Medicine, Journal Year: 2022, Volume and Issue: 388(10), P. 888 - 897

Published: Nov. 6, 2022

Guidelines recommend active fever prevention for 72 hours after cardiac arrest. Data from randomized clinical trials of this intervention have been lacking.

Language: Английский

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Hypothermia for neuroprotection in adults after cardiac arrest

Cochrane library, Journal Year: 2023, Volume and Issue: 2023(6)

Published: May 22, 2023

Language: Английский

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Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society

Circulation, Journal Year: 2023, Volume and Issue: 149(2)

Published: Nov. 28, 2023

The critical care management of patients after cardiac arrest is burdened by a lack high-quality clinical studies and the resultant high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty variability management. Critical crucial affects outcome. Although guidelines address some relevant topics (including temperature control neurological prognostication comatose survivors, 2 for there are more robust studies), many important subject areas have or nonexistent studies, leading absence low-certainty American Heart Association Emergency Cardiovascular Care Committee Neurocritical Society collaborated this gap organizing an expert consensus panel conference. Twenty-four experienced practitioners physicians, nurses, pharmacists, respiratory therapist) from multiple medical specialties, levels, institutions, countries made up panel. Topics were identified prioritized arranged organ system facilitate discussion, debate, building. Statements related postarrest generated, 80% agreement was required approve statement. Voting anonymous web based. addressed include neurological, cardiac, pulmonary, hematological, infectious, gastrointestinal, endocrine, general Areas uncertainty, no reached, future research directions also included. Until that inform these available, statements provided can advise clinicians on arrest.

Language: Английский

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Hypothermic versus Normothermic Temperature Control after Cardiac Arrest

NEJM Evidence, Journal Year: 2022, Volume and Issue: 1(11)

Published: June 15, 2022

BACKGROUND: The evidence for temperature control comatose survivors of cardiac arrest is inconclusive. Controversy exists as to whether the effects hypothermia differ per circumstances or patient characteristics. METHODS: An individual data meta-analysis Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest (TTM) and Hypothermia Normothermia Out-of-Hospital (TTM2) trials was conducted. intervention comparator normothermia. primary outcome all-cause mortality 6 months. Secondary outcomes included poor functional (modified Rankin scale score 4 6) Predefined subgroups based on design variables in original were tested interaction with follows: age (older younger than median), sex (female male), initial rhythm (shockable nonshockable), time return spontaneous circulation (above below circulatory shock admission (presence absence). RESULTS: analyses 2800 patients, 1403 assigned 1397 Death occurred 691 1398 participants (49.4%) group 666 1391 (47.9%) normothermia (relative risk hypothermia, 1.03; 95% confidence interval [CI], 0.96 1.11; P=0.41). A 733 1350 (54.3%) 718 1330 (54.0%) 1.01; CI, 0.94 1.08; P=0.88). Outcomes consistent predefined subgroups. CONCLUSIONS: did not decrease 6-month compared out-of-hospital arrest. (Funded by Vetenskapsrådet; ClinicalTrials.gov numbers NCT02908308 NCT01020916.)

Language: Английский

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Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society

Neurocritical Care, Journal Year: 2023, Volume and Issue: 40(1), P. 1 - 37

Published: Dec. 1, 2023

The critical care management of patients after cardiac arrest is burdened by a lack high-quality clinical studies and the resultant high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty variability management. Critical crucial affects outcome. Although guidelines address some relevant topics (including temperature control neurological prognostication comatose survivors, 2 for there are more robust studies), many important subject areas have or nonexistent studies, leading absence low-certainty American Heart Association Emergency Cardiovascular Care Committee Neurocritical Society collaborated this gap organizing an expert consensus panel conference. Twenty-four experienced practitioners physicians, nurses, pharmacists, respiratory therapist) from multiple medical specialties, levels, institutions, countries made up panel. Topics were identified prioritized arranged organ system facilitate discussion, debate, building. Statements related postarrest generated, 80% agreement was required approve statement. Voting anonymous web based. addressed include neurological, cardiac, pulmonary, hematological, infectious, gastrointestinal, endocrine, general Areas uncertainty, no reached, future research directions also included. Until that inform these available, statements provided can advise clinicians on arrest.

Language: Английский

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Temperature control after cardiac arrest

Critical Care, Journal Year: 2022, Volume and Issue: 26(1)

Published: Nov. 24, 2022

Abstract Most of the patients who die after cardiac arrest do so because hypoxic-ischemic brain injury (HIBI). Experimental evidence shows that temperature control targeted at hypothermia mitigates HIBI. In 2002, one randomized trial and quasi-randomized showed 32–34 °C improved neurological outcome mortality in are comatose arrest. However, following publication these trials, other studies have questioned neuroprotective effects hypothermia. 2021, largest study conducted far on (the TTM-2 trial) including 1900 adults resuscitation no effect 33 compared with normothermia or fever control. A systematic review 32 trials published between 2001 2021 concluded a target prevention did not result an improvement survival (RR 1.08; 95% CI 0.89–1.30) favorable functional 1.21; 0.91–1.61) 90–180 days resuscitation. There was substantial heterogeneity across certainty low. Based results, International Liaison Committee Resuscitation currently recommends monitoring core actively preventing (37.7 °C) for least 72 h from Future needed to identify potential patient subgroups may benefit aimed comparing

Language: Английский

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Hypoxic-Ischemic Brain Injury in ECMO: Pathophysiology, Neuromonitoring, and Therapeutic Opportunities

Cells, Journal Year: 2023, Volume and Issue: 12(11), P. 1546 - 1546

Published: June 5, 2023

Extracorporeal membrane oxygenation (ECMO), in conjunction with its life-saving benefits, carries a significant risk of acute brain injury (ABI). Hypoxic-ischemic (HIBI) is one the most common types ABI ECMO patients. Various factors, such as history hypertension, high day 1 lactate level, low pH, cannulation technique, large peri-cannulation PaCO2 drop (∆PaCO2), and early pulse pressure, have been associated development HIBI The pathogenic mechanisms are complex multifactorial, attributing to underlying pathology requiring initiation itself. likely occur or peri-decannulation time secondary refractory cardiopulmonary failure before after ECMO. Current therapeutics target pathological mechanisms, cerebral hypoxia ischemia, by employing targeted temperature management case extracorporeal resuscitation (eCPR), optimizing O2 saturations perfusion. This review describes pathophysiology, neuromonitoring, therapeutic techniques improve neurological outcomes patients order prevent minimize morbidity HIBI. Further studies aimed at standardizing relevant neuromonitoring techniques, perfusion, minimizing severity once it occurs will long-term

Language: Английский

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