12 results on '"Dillenbeck, Emelie"'
Search Results
2. Abstract 151: The PRINCESS 2 Trial: A Randomized Study to Assess the Impact of Ultrafast Hypothermia on Neurologic Function in Out-of-Hospital Cardiac Arrest With Initial Shockable Rhythm
- Author
-
Dillenbeck, Emelie, Hollenberg, Jacob, Holzer, Michael, Busch, Hans-Joerg, Nichol, Graham, Radsel, Peter, Belohavek, Jan, Forsberg, Sune, Annoni, Filippo, Svensson, Leif, Jonsson, Martin, Bäckström, Denise, Gellerfors, Mikael, Awad, Akil, Taccone, Fabio S, and Nordberg, Per
- Published
- 2023
- Full Text
- View/download PDF
3. Transnasal Evaporative Cooling in Out-of-Hospital Cardiac Arrest Patients to Initiate Hypothermia—A Substudy of the Target Temperature Management 2 (TTM2) Randomized Trial.
- Author
-
Awad, Akil, Dillenbeck, Emelie, Dankiewicz, Josef, Ringh, Mattias, Forsberg, Sune, Svensson, Leif, Claesson, Andreas, Hollenberg, Jacob, and Nordberg, Per
- Subjects
- *
EVAPORATIVE cooling , *INDUCED hypothermia , *CARDIAC arrest , *CARDIAC patients , *HYPOTHERMIA , *INTENSIVE care units - Abstract
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 to assess the feasibility and cooling efficacy of transnasal evaporative cooling, initiated as early as possible after hospital arrival in patients randomized to cooling in the TTM2 trial. Methods: This study took the form of a single-center (Södersjukhuset, Stockholm) substudy of the TTM2 trial (NCT02908308) comparing target temperature management (TTM) to 33 °C versus normothermia in OHCA. In patients randomized to TTM33 °C, transnasal evaporative cooling was applied as fast as possible. The primary objectives were the feasibility aspects of initiating cooling in different hospital locations (i.e., in the emergency department, coronary cathlab, intensive care unit (ICU), and during intrahospital transport) and its effectiveness (i.e., time to reach target temperature). Transnasal cooling was continued for two hours or until patients reached a core temperature of <34 °C. Cooling intervals were compared to participants at the same site who were randomized to hypothermia and treated at 33 °C but who for different reasons did not receive transnasal evaporative cooling. Results: From October 2018 to January 2020, 32 patients were recruited, of which 17 were randomized to the TTM33. Among them, 10 patients (8 men, median age 69 years) received transnasal evaporative cooling prior to surface systemic cooling in the ICU. In three patients, cooling was started in the emergency department; in two patients, it was started in the coronary cathlab, and in five patients, it was started in the ICU, of which three patients were subsequently transported to the coronary cathlab or to perform a CT scan. The median time to initiate transnasal cooling from randomization was 9 min (range: 5 to 39 min). The median time from randomization to a core body temperature of 34 °C was 120 min (range 60 to 334) compared to 178 min among those in the TTM33 group that did not receive TNEC and to 33 °C 230 min (range: 152 to 351) vs. 276 min (range: 150 to 546). No feasibility or technical issues were reported. No adverse events occurred besides minor nosebleeds. Conclusions: The early induction of transnasal cooling in out-of-hospital cardiac arrest patients was feasible to initiate in the emergency department, coronary cathlab, ICU, and during intrahospital transport. Time to target temperature was shortened compared to standard cooling. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. Effect of intra-arrest trans-nasal evaporative cooling in out-of-hospital cardiac arrest: a pooled individual participant data analysis
- Author
-
Taccone, Fabio, Hollenberg, Jacob, Forsberg, Sune, Truhlar, Anatolij, Jonsson, Martin, Annoni, Filippo, Gryth, Dan, Ringh, Mattias, Cuny, Jerome, Busch, Hans Jörg, Vincent, Jean Louis, Svensson, Leif, Nordberg, Per, Castren, Maaret, Eichwede, Frank, Mols, Pierre, Schwab, Tilmann, Vergnion, Michel, Storm, Christian, Pesenti, Antonio, Pachl, Jan, Guerisse, Fabien, Elste, Thomas, Roessler, Markus, Fritz, Harald, Durnez, Pieterjan, Goldstein, Patrick, Vermeersch, Nick, Higuet, Adeline, Jiménes, Francisco Carmona, Ortiz, Fernando Rosell, Williams, Julia, Desruelles, Didier, Creteur, Jacques, Dillenbeck, Emelie, Busche, Caroline, Konrad, David, Peterson, Johan, Clinicum, Department of Diagnostics and Therapeutics, and HUS Emergency Medicine and Services
- Subjects
medicine.medical_specialty ,Soins intensifs réanimation ,Hypothermia ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Out of hospital cardiac arrest ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Hospital discharge ,medicine ,Humans ,Administration, Intranasal ,Outcome ,Entire population ,business.industry ,RC86-88.9 ,Individual participant data ,Research ,030208 emergency & critical care medicine ,Medical emergencies. Critical care. Intensive care. First aid ,Hyperthermia, Induced ,3126 Surgery, anesthesiology, intensive care, radiology ,Cardiac arrest ,Confidence interval ,3. Good health ,Cold Temperature ,Intra-arrest ,Pooled analysis ,Treatment Outcome ,Randomized clinical trial ,medicine.symptom ,business ,Out-of-Hospital Cardiac Arrest - 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 trials may have been underpowered to detect significant differences in neurologic outcome, especially in patients with initial shockable rhythm. Methods: We conducted a post hoc pooled analysis of individual data from two randomized trials including 851 patients who eventually received the allocated intervention and with available outcome (“as-treated” analysis). Primary outcome was survival with favourable neurological outcome at hospital discharge (Cerebral Performance Category [CPC] of 1–2) according to the initial rhythm (shockable vs. non-shockable). Secondary outcomes included complete neurological recovery (CPC 1) at hospital discharge. Results: Among the 325 patients with initial shockable rhythms, favourable neurological outcome was observed in 54/158 (34.2%) patients in the intervention and 40/167 (24.0%) in the control group (RR 1.43 [confidence intervals, CIs 1.01–2.02]). Complete neurological recovery was observed in 40/158 (25.3%) in the intervention and 27/167 (16.2%) in the control group (RR 1.57 [CIs 1.01–2.42]). Among the 526 patients with initial non-shockable rhythms, favourable neurological outcome was in 10/259 (3.8%) in the intervention and 13/267 (4.9%) in the control group (RR 0.88 [CIs 0.52–1.29]; p = 0.67); survival and complete neurological recovery were also similar between groups. No significant benefit was observed for the intervention in the entire population. Conclusions: In this pooled analysis of individual data, intra-arrest cooling was associated with a significant increase in favourable neurological outcome in out-of-hospital cardiac arrest patients with initial shockable rhythms. Future studies are needed to confirm the potential benefits of this intervention in this subgroup of patients., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2021
5. Strategies of Advanced Airway Management in Out-of-Hospital Cardiac Arrest during Intra-Arrest Hypothermia: Insights from the PRINCESS Trial.
- Author
-
Tjerkaski, Jonathan, Hermansson, Thomas, Dillenbeck, Emelie, Taccone, Fabio Silvio, Truhlar, Anatolij, Forsberg, Sune, Hollenberg, Jacob, Ringh, Mattias, Jonsson, Martin, Svensson, Leif, and Nordberg, Per
- Subjects
ADVANCED cardiac life support ,INDUCED hypothermia ,EVAPORATIVE cooling ,CARDIAC arrest ,RETURN of spontaneous circulation ,PROPENSITY score matching ,HYPOTHERMIA - Abstract
Background: 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 of endotracheal intubation may enable shorter time intervals to induce cooling. We aimed to study the outcomes in OHCA patients receiving endotracheal intubation (ETI) or a SGA during intra-arrest trans-nasal evaporative cooling. Methods: This is a pre-specified sub-study of the PRINCESS trial (NCT01400373) that included witnessed OHCA patients randomized during resuscitation to trans-nasal intra-arrest cooling vs. standard care followed by temperature control at 33 °C for 24 h. For this study, patients randomized to intra-arrest cooling were stratified according to the use of ETI vs. SGA prior to the induction of cooling. SGA was placed by paramedics in the first-tier ambulance or by physicians or anesthetic nurses in the second tier while ETI was performed only after the arrival of the second tier. Propensity score matching was used to adjust for differences at the baseline between the two groups. The primary outcome was survival with good neurological outcome, defined as cerebral performance category (CPC) 1–2 at 90 days. Secondary outcomes included time to place airway, overall survival at 90 days, survival with complete neurologic recovery (CPC 1) at 90 days and sustained return of spontaneous circulation (ROSC). Results: Of the 343 patients randomized to the intervention arm (median age 64 years, 24% were women), 328 received intra-arrest cooling and had data on the airway method (n = 259 with ETI vs. n = 69 with SGA). Median time from the arrival of the first-tier ambulance to successful airway management was 8 min for ETI performed by second tier and 4 min for SGA performed by the first or second tier (p = 0.001). No significant differences in the probability of good neurological outcome (OR 1.43, 95% CI 0.64–3.01), overall survival (OR 1.26, 95% CI 0.57–2.55), full neurological recovery (OR 1.17, 95% CI 0.52–2.73) or sustained ROSC (OR 0.88, 95% CI 0.50–1.52) were observed between ETI and SGA. Conclusions: Among the OHCA patients treated with trans-nasal evaporative intra-arrest cooling, the use of SGA was associated with a significantly shorter time to airway management and with similar outcomes compared to ETI. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
6. Neurologic Recovery at Discharge and Long-Term Survival After Cardiac Arrest.
- Author
-
Dillenbeck, Emelie, Svensson, Leif, Rawshani, Araz, Hollenberg, Jacob, Ringh, Mattias, Claesson, Andreas, Awad, Akil, Jonsson, Martin, and Nordberg, Per
- Published
- 2024
- Full Text
- View/download PDF
7. 425 The PRINCESS 2 trial: A randomized study to asses the impact of ultrafast hypothermia on neurologic function in out-of-hospital cardiac arrest with initial shockable rhythm
- Author
-
Dillenbeck, Emelie, Hollenberg, Jacob, Holzer, Michael, Busch, Hans-Jörg, Nichol, Graham, Radsel, Peter, Belohlavek, Jan, Forsberg, Sune, Annoni, Filippo, Svensson, Leif, Jonsson, Martin, Backström, Denise, Gellerfors, Mikael, Awad, Akil, Taccone, Fabio, and Nordberg, Per
- Published
- 2023
- Full Text
- View/download PDF
8. 403 The association between functional neurologic outcome and longterm survival after cardiac arrest
- Author
-
Dillenbeck, Emelie, Jonsson, Martin, Svensson, Leif, Rawshani, Araz, Ringh, Mattias, Hollenberg, Jacob, Awad, Akil, and Nordberg, Per
- Published
- 2023
- Full Text
- View/download PDF
9. Intra-Arrest Therapeutic Hypothermia and Neurologic Outcome in Patients Admitted after Out-of-Hospital Cardiac Arrest: A Post Hoc Analysis of the Princess Trial.
- Author
-
MACCHINI, Elisabetta, DILLENBECK, Emelie, JONSSON, Martin, ANNONI, Filippo, FORSBERG, Sune, HOLLENBERG, Jacob, TRUHLAR, Anatolij, SVENSSON, Leif, NORDBERG, Per, and TACCONE, Fabio Silvio
- Subjects
- *
THERAPEUTIC hypothermia , *CARDIAC arrest , *EVAPORATIVE cooling , *TREATMENT effectiveness , *ADVANCED cardiac life support , *PRINCESSES - Abstract
Background: Despite promising results, the role of intra-arrest hypothermia in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim of this study was to assess the effects of trans-nasal evaporative cooling (TNEC) during resuscitation on neurological recovery in OHCA patients admitted alive to the hospital. Methods: A post hoc analysis of the PRINCESS trial, including only patients admitted alive to the hospital, either assigned to TNEC or standard of care during resuscitation. The primary endpoint was favorable neurological outcome (FO) defined as a Cerebral Performance Category (CPC) of 1–2 at 90 days. The secondary outcomes were overall survival at 90 days and CPC 1 at 90 days. Subgroup analyses were performed according to the initial cardiac rhythm. Results: A total of 149 patients in the TNEC and 142 in the control group were included. The number of patients with CPC 1–2 at 90 days was 56/149 (37.6%) in the intervention group and 45/142 (31.7%) in the control group (p = 0.29). Survival and CPC 1 at 90 days was observed in 60/149 patients (40.3%) vs. 52/142 (36.6%; p = 0.09) and 50/149 (33.6%) vs. 35/142 (24.6%; p = 0.11) in the two groups. In the subgroup of patients with an initial shockable rhythm, the number of patients with CPC 1 at 90 days was 45/83 (54.2%) in the intervention group and 27/78 (34.6%) in the control group (p = 0.01). Conclusions: In this post hoc analysis of admitted OHCA patients, no statistically significant benefits of TNEC on neurological outcome at 90 days was found. In patients with initial shockable rhythm, TNEC was associated with increased full neurological recovery. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
10. Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial.
- Author
-
Nordberg, Per, Taccone, Fabio Silvio, Truhlar, Anatolij, Forsberg, Sune, Hollenberg, Jacob, Jonsson, Martin, Cuny, Jerome, Goldstein, Patrick, Vermeersch, Nick, Higuet, Adeline, Jiménes, Francisco Carmona, Ortiz, Fernando Rosell, Williams, Julia, Desruelles, Didier, Creteur, Jacques, Dillenbeck, Emelie, Busche, Caroline, Busch, Hans-Jörg, Ringh, Mattias, and Konrad, David
- Subjects
ADVANCED cardiac life support ,BYSTANDER CPR ,EVAPORATIVE cooling ,CARDIAC arrest ,CLINICAL trials ,THERAPEUTIC hypothermia ,EMERGENCY medical services ,BRAIN ,BRAIN injuries ,COMPARATIVE studies ,CARDIOPULMONARY resuscitation ,INDUCED hypothermia ,RESEARCH methodology ,MEDICAL care ,MEDICAL cooperation ,NOSEBLEED ,PATIENTS ,RESEARCH ,STATISTICAL sampling ,SAMPLE size (Statistics) ,EVALUATION research ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment - Abstract
Importance: 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).Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival.Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled.Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours.Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C.Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups.Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days.Trial Registration: ClinicalTrials.gov Identifier: NCT01400373. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
11. Transnasal evaporative cooling in healthy awake persons
- Author
-
Nordberg, Per, Hermansson, Thomas, Backman, Anders, Svensson, Leif, Jonsson, Martin, Hollenberg, Jacob, Ringh, Mattias, Dillenbeck, Emelie, and Forsberg, Sune
- Published
- 2015
- Full Text
- View/download PDF
12. Pre-hospital Resuscitation INtra-arrest Cooling Effectiveness Survival – The PRINCESS Study
- Author
-
Nordberg, Per, Taccone, Fabio, Truhlar, Anatolij, Ortiz, Fernando Rosell, Vermeersch, Nick, Goldstein, Patrick, Cuny, Jerome, Vrankx, Marc, Jiménez, Francesco Carmona, Lyon, Richard, Williams, Julia, Vincent, Jean-Louis, Hollenberg, Jacob, Forsberg, Sune, Dillenbeck, Emelie, Hermansson, Thomas, and Svensson, Leif
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.