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Early computed tomography in victims of non-traumatic out-of-hospital cardiac arrest

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Abstract

Although early cranial and thoracic computed tomography (CT) is recommended in the early in-hospital treatment of victims of out-of-hospital cardiac arrest (OHCA), hardly anything is known regarding the proportions of therapy-relevant findings with this method. Victims of OHCA who were admitted to our hospital between January 1, 2008 and December 31, 2014 were studied. CT was classified as early if performed within the first 4 h following hospital admission. There were 32 (12.7 %) cranial, 31 (12.3 %) thoracic and 15 (6.0 %) abdominal CT. The major findings and associated number of patients were: intracranial bleeding in two patients (0.8 %), acute cerebral ischemia in two (0.8 %), cerebral oedema in four (1.6 %), pulmonary emboli in three (1.2 %), hemothorax in two (0.8 %), tracheal rupture in one (0.4 %), pneumonia in 11 (4.4 %), paralytic ileus in one (0.4 %), ascites in three (1.2 %), pneumoperitoneum in one (0.4 %), acute cholecystitis in two (0.8 %), mesenteric vascular occlusion in one (0.4 %) and ruptured abdominal aortic aneurysm in one (0.4 %). In victims of OHCA, early diagnostic CT provides therapy-relevant findings in a high proportion (42.3 %) of patients examined.

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References

  1. McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW, Sasson C, Crouch A, Perez AB, Merritt R, Kellermann A, Centers for Disease Control and Prevention (2011) Out-of-hospital cardiac arrest surveillance—Cardiac Arrest Registry to Enhance Survival (CARES), United States, 1 October 2005–31 December 2010. MMWR Surveill Summ 60:1–19

  2. Christ M, von Auenmüller KI, Grett M, Dierschke W, Trappe HJ (2014) Who observes out-of-hospital cardiac arrests in Germany? Dtsch Med Wochenschr 139:2225–2230. doi:10.1055/s-0034-1387296

    Article  CAS  PubMed  Google Scholar 

  3. Henry K, Murphy A, Willis D, Cusack S, Bury G, O`Sullivan I, Deasy C (2013) Out-of-hospital cardiac arrest in Cork, Ireland. Emerg Med J 30:496–500. doi:10.1136/emermed-2011-200888

    Article  PubMed  Google Scholar 

  4. Casella G, Carinci V, Cavallo P, Guastaroba P, Pavesi PC, Pallotti MG, Sangiorgio P, Barbato G, Coniglio C, Iarussi B, Gordini G, Di Pasquale G (2014) Combining therapeutic hypothermia and emergent coronary angiography in out-of-hospital cardiac arrest survivors: Optimal post-arrest care for the best patient. Eur Heart J Acute Cardiovasc Care. doi:10.1177/2048872614564080 [Epub ahead of print]

  5. Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VR, Deakin C, Bottiger B, Friberg H, Sunde K, Sandroni C (2015) European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. doi:10.1016/j.resuscitation.2015.07.018 [epub ahead of print]

  6. Arnaout M, Mongardon N, Deye N, Legriel S, Dumas F, Sauneuf B, Malissin I, Charpentier J, Pène F, Baud F, Chiche JD, Mira JP, Cariou A (2015) Out-of-hospital cardiac arrest from brain cause: epidemiology, clinical features, and outcome in a multicenter cohort*. Crit Care Med 43:453–460. doi:10.1097/CCM.0000000000000722

    Article  PubMed  Google Scholar 

  7. Chelly J, Mongardon N, Dumas F, Varenne O, Spaulding C, Vignaux O, Carli P, Charpentier J, Pène F, Chiche JD, Mira JP, Cariou A (2012) Benefit of an early and systematic imaging procedure after cardiac arrest: insights from the PROCAT (Parisian Region Out of Hospital Cardiac Arrest) registry. Resuscitation 83:1444–1450. doi:10.1016/j.resuscitation.2012.08.321

    Article  PubMed  Google Scholar 

  8. World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191–2194. doi:10.1001/jama.2013.281053

    Article  Google Scholar 

  9. Christ M, von Auenmueller K, Dierschke W, Noelke J, Butz T, Liebeton J, Trappe HJ (2014) Coronary Angiography in Patients with and without STEMI Following Out-of-Hospital Cardiac Arrest. Open J Intern Med 4:115–122. doi:10.4236/ojim.2014.44018

    Article  Google Scholar 

  10. Kim SH, Choi SP, Park KN, Youn CS, Oh SH, Choi SM (2013) Early brain computed tomography findings are associated with outcome in patients treated with therapeutic hypothermia after out-of-hospital cardiac arrest. Scand J Trauma Resusc Emerg Med. 21:57. doi:10.1186/1757-7241-21-57

    Article  PubMed  PubMed Central  Google Scholar 

  11. Metter RB, Rittenberger JC, Guyette FX, Callaway CW (2011) Association between a quantitative CT scan measure of brain oedema and outcome after cardiac arrest. Resuscitation 82:1180–1185. doi:10.1016/j.resuscitation.2011.04.001

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lee BK, Jeung KW, Lee HY, Jung YH, Lee DH (2013) Combining brain computed tomography and serum neuron-specific enolase improves the prognostic performance compared to either alone in comatose cardiac arrest survivors treated with therapeutic hypothermia. Resuscitation 84:1387–1392. doi:10.1016/j.resuscitation.2013.05.026

    Article  CAS  PubMed  Google Scholar 

  13. Kashiwagi Y, Sasakawa T, Tampo A, Kawata D, Nishiura T, Kokita N, Iwasaki H, Fujita S (2015) Computed tomography findings of complications resulting from cardiopulmonary resuscitation. Resuscitation 88C:86–91. doi:10.1016/j.resuscitation.2014.12.022

    Article  Google Scholar 

  14. Italian Cooling Experience (ICE) Study Group (2012) Early- versus late initiation of therapeutic hypothermia after cardiac arrest: preliminary observations from the experience of 17 Italian intensive care units. Resuscitation 83:823–888. doi:10.1016/j.resuscitation.2011.12.002

    Article  Google Scholar 

  15. Debaty G, Maignan M, Savary D, Koch FX, Ruckly S, Durand M, Picard J, Escallier C, Chouquer R, Santre C, Minet C, Guergour D, Hammer L, Bouvaist H, Belle L, Adrie C, Payen JF, Carpentier F, Gueugniaud PY, Danel V, Timsit JF, Cariou A, Sunde K (2014) Impact of intra-arrest therapeutic hypothermia in outcomes of prehospital cardiac arrest: a randomized controlled trial. Intensive Care Med 40:1832–1842. doi:10.1007/s00134-014-3519-x

    Article  CAS  PubMed  Google Scholar 

  16. Peacock WF, Deal NS (2014) Is time to cooling target temperature important? Crit Pathw Cardiol 13:82–83. doi:10.1097/HPC.0000000000000013

    Article  PubMed  Google Scholar 

  17. Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556. doi:10.1056/NEJMoa012689

    Article  Google Scholar 

  18. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563. doi:10.1056/NEJMoa003289

    Article  PubMed  Google Scholar 

  19. Cocchi MN, Boone MD, Giberson B, Giberson T, Farrell E, Salciccioli JD, Talmor D, Williams D, Donnino MW (2014) Fever after rewarming: incidence of pyrexia in post-cardiac arrest patients who have undergone mild therapeutic hypothermia. J Intensive Care Med 29:365–369. doi:10.1177/0885066613491932

    Article  PubMed  PubMed Central  Google Scholar 

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Author contributions

Katharina Isabel von Auenmueller coordinated the acquisition of data. Jan Peter Nölke performed the statistical analysis, Benjamin Sasko and Scharbanu Amirie participated in the data acquisition and interpretation of the data and Hans-Joachim Trappe and Martin Christ participated in the study design and coordination. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Cardiology and Angiology, Marienhospital Herne, Ruhr–University Bochum, Hoelkeskampring 40, 44625, Herne, Germany

    Martin Christ, Katharina Isabel von Auenmueller, Jan Peter Noelke, Benjamin Sasko, Scharbanu Amirie & Hans-Joachim Trappe

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  1. Martin Christ
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  2. Katharina Isabel von Auenmueller
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  3. Jan Peter Noelke
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  4. Benjamin Sasko
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  6. Hans-Joachim Trappe
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Correspondence to Martin Christ.

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The authors declare that they have no conflicts of interest.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Christ, M., von Auenmueller, K.I., Noelke, J.P. et al. Early computed tomography in victims of non-traumatic out-of-hospital cardiac arrest. Intern Emerg Med 11, 237–243 (2016). https://doi.org/10.1007/s11739-015-1353-y

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  • DOI: https://doi.org/10.1007/s11739-015-1353-y

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