282 results on '"Friberg H"'
Search Results
2. Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study
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Yates, E.J., Schmidbauer, S., Smyth, A.M., Ward, M., Dorrian, S., Siriwardena, A.N., Friberg, H., and Perkins, G.D.
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- 2018
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3. Time to epileptiform activity and EEG background recovery are independent predictors after cardiac arrest
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Westhall, E., Rosén, I., Rundgren, M., Bro-Jeppesen, J., Kjaergaard, J., Hassager, C., Lindehammar, H., Horn, J., Ullén, S., Nielsen, N., Friberg, H., and Cronberg, T.
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- 2018
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4. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest
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Dankiewicz J., Cronberg T., Lilja G., Jakobsen J. C., Levin H., Ullen S., Rylander C., Wise M. P., Oddo M., Cariou A., Belohlavek J., Hovdenes J., Saxena M., Kirkegaard H., Young P. J., Pelosi P., Storm C., Taccone F. S., Joannidis M., Callaway C., Eastwood G. M., Morgan M. P. G., Nordberg P., Erlinge D., Nichol A. D., Chew M. S., Hollenberg J., Thomas M., Bewley J., Sweet K., Grejs A. M., Christensen S., Haenggi M., Levis A., Lundin A., During J., Schmidbauer S., Keeble T. R., Karamasis G. V., Schrag C., Faessler E., Smid O., Otahal M., Maggiorini M., Wendel Garcia P. D., Jaubert P., Cole J. M., Solar M., Borgquist O., Leithner C., Abed-Maillard S., Navarra L., Annborn M., Unden J., Brunetti I., Awad A., McGuigan P., Olsen R. B., Cassina T., Vignon P., Langeland H., Lange T., Friberg H., Nielsen N. Collaborators, Erik Roman Pognuz, Umberto Lucangelo, Giorgio Berlot, Elisabetta Macchini., Dankiewicz, J., Cronberg, T., Lilja, G., Jakobsen, J. C., Levin, H., Ullen, S., Rylander, C., Wise, M. P., Oddo, M., Cariou, A., Belohlavek, J., Hovdenes, J., Saxena, M., Kirkegaard, H., Young, P. J., Pelosi, P., Storm, C., Taccone, F. S., Joannidis, M., Callaway, C., Eastwood, G. M., Morgan, M. P. G., Nordberg, P., Erlinge, D., Nichol, A. D., Chew, M. S., Hollenberg, J., Thomas, M., Bewley, J., Sweet, K., Grejs, A. M., Christensen, S., Haenggi, M., Levis, A., Lundin, A., During, J., Schmidbauer, S., Keeble, T. R., Karamasis, G. V., Schrag, C., Faessler, E., Smid, O., Otahal, M., Maggiorini, M., Wendel Garcia, P. D., Jaubert, P., Cole, J. M., Solar, M., Borgquist, O., Leithner, C., Abed-Maillard, S., Navarra, L., Annborn, M., Unden, J., Brunetti, I., Awad, A., Mcguigan, P., Olsen, R. B., Cassina, T., Vignon, P., Langeland, H., Lange, T., Friberg, H., Collaborators:, Nielsen N., ROMAN-POGNUZ, Erik, Lucangelo, Umberto, Berlot, Giorgio, and Macchini, Elisabetta
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Male ,Fever ,Heart disease ,medicine.medical_treatment ,Coma/etiology ,Hypothermia ,Kaplan-Meier Estimate ,Targeted temperature management ,GUIDELINES ,Out of hospital cardiac arrest ,Body Temperature ,law.invention ,TARGETED TEMPERATURE MANAGEMENT ,Randomized controlled trial ,Hypothermia, Induced ,law ,AMERICAN-HEART-ASSOCIATION ,EUROPEAN RESUSCITATION COUNCIL ,medicine ,Humans ,Single-Blind Method ,Cardiopulmonary resuscitation ,Coma ,610 Medicine & health ,Aged ,Cardiopulmonary Resuscitation ,Female ,Middle Aged ,Out-of-Hospital Cardiac Arrest ,Treatment Outcome ,business.industry ,Induced ,General Medicine ,medicine.disease ,Out-of-Hospital Cardiac Arrest/complications ,Fever/etiology ,Clinical research ,Hypothermia, Induced/adverse effects ,CARDIOPULMONARY-RESUSCITATION ,Anesthesia ,Cardiopulmonary Resuscitation/methods ,medicine.symptom ,business ,Human - Abstract
Hypothermia or Normothermia after Cardiac ArrestThis trial randomly assigned patients with coma after out-of-hospital cardiac arrest to undergo targeted hypothermia at 33 degrees C or normothermia with treatment of fever. At 6 months, there were no significant between-group differences regarding death or functional outcomes.BackgroundTargeted temperature management is recommended for patients after cardiac arrest, but the supporting evidence is of low certainty.MethodsIn an open-label trial with blinded assessment of outcomes, we randomly assigned 1900 adults with coma who had had an out-of-hospital cardiac arrest of presumed cardiac or unknown cause to undergo targeted hypothermia at 33 degrees C, followed by controlled rewarming, or targeted normothermia with early treatment of fever (body temperature, >= 37.8 degrees C). The primary outcome was death from any cause at 6 months. Secondary outcomes included functional outcome at 6 months as assessed with the modified Rankin scale. Prespecified subgroups were defined according to sex, age, initial cardiac rhythm, time to return of spontaneous circulation, and presence or absence of shock on admission. Prespecified adverse events were pneumonia, sepsis, bleeding, arrhythmia resulting in hemodynamic compromise, and skin complications related to the temperature management device.ResultsA total of 1850 patients were evaluated for the primary outcome. At 6 months, 465 of 925 patients (50%) in the hypothermia group had died, as compared with 446 of 925 (48%) in the normothermia group (relative risk with hypothermia, 1.04; 95% confidence interval [CI], 0.94 to 1.14; P=0.37). Of the 1747 patients in whom the functional outcome was assessed, 488 of 881 (55%) in the hypothermia group had moderately severe disability or worse (modified Rankin scale score >= 4), as compared with 479 of 866 (55%) in the normothermia group (relative risk with hypothermia, 1.00; 95% CI, 0.92 to 1.09). Outcomes were consistent in the prespecified subgroups. Arrhythmia resulting in hemodynamic compromise was more common in the hypothermia group than in the normothermia group (24% vs. 17%, PConclusionsIn patients with coma after out-of-hospital cardiac arrest, targeted hypothermia did not lead to a lower incidence of death by 6 months than targeted normothermia. (Funded by the Swedish Research Council and others; TTM2 ClinicalTrials.gov number, .)
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- 2021
5. Anxiety and depression among out-of-hospital cardiac arrest survivors
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Lilja, G., Nilsson, G., Nielsen, N., Friberg, H., Hassager, C., Koopmans, M., Kuiper, M., Martini, A., Mellinghoff, J., Pelosi, P., Wanscher, M., Wise, M.P., Östman, I., and Cronberg, T.
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- 2015
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6. Postreanimationsbehandlung: Kapitel 5 der Leitlinien zur Reanimation 2015 des European Resuscitation Council
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Nolan, J.P., Soar, J., Cariou, A., Cronberg, T., Moulaert, V.R.M., Deakin, C., Böttiger, B.W., Friberg, H., Sunde, K., and Sandroni, C.
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- 2017
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7. Postreanimationsbehandlung: Kapitel 5 der Leitlinien zur Reanimation 2015 des European Resuscitation Council
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Nolan, J.P., Soar, J., Cariou, A., Cronberg, T., Moulaert, V.R.M., Deakin, C., Böttiger, B.W., Friberg, H., Sunde, K., and Sandroni, C.
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- 2015
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8. Bioactive adrenomedullin in sepsis patients in the emergency department is associated with mortality, organ failure and admission to intensive care
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Lundberg OHM, Rosenqvist M, Bronton K, Schulte J, Friberg H, Melander O
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- 2022
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9. Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography: a post hoc analysis from the TTM trial
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Dankiewicz, J., Nielsen, N., Annborn, M., Cronberg, T., Erlinge, D., Gasche, Y., Hassager, C., Kjaergaard, J., Pellis, T., and Friberg, H.
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- 2015
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10. Post-resuscitation care European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021
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Nolan, JP, Sandroni, C, Bottiger, BW, Cariou, A, Cronberg, T, Friberg, H, Genbrugge, C, Haywood, K, Lilja, G, Moulaert, VRM, Nikolaou, N, Olasveengen, TM, Skrifvars, MB, Taccone, F, Soar, J, Faculteit Medische Wetenschappen/UMCG, HUS Akuten, Diagnostisk-terapeutiska avdelningen, and Clinicum
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VENOUS THROMBOEMBOLISM PROPHYLAXIS ,Haemodynamic management ,33 DEGREES-C ,Post-cardiac arrest syndrome ,2015 INTERNATIONAL CONSENSUS ,NEURON-SPECIFIC ENOLASE ,education ,HOSPITAL CARDIAC-ARREST ,3126 Surgery, anesthesiology, intensive care, radiology ,CONTROLLED AUTOMATED REPERFUSION ,Settore MED/26 - NEUROLOGIA ,Ventilatory support ,TARGETED TEMPERATURE MANAGEMENT ,QUALITY-OF-LIFE ,Settore MED/41 - ANESTESIOLOGIA ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Intensive care medicine ,MULTIMODAL OUTCOME PREDICTION ,MEAN ARTERIAL-PRESSURE - Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation phase guidelines for adults, which are based on the 2020 International Liaison Committee on Resuscitation consensus on cardiopulmonary resuscitation. The topics covered include post-cardiac arrest syndrome, the differential diagnosis of the causes of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation and organ donation.
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- 2021
11. Corrigendum to 'European Resuscitation Council Guidelines 2021: Executive summary' [Resuscitation (2021) 1–60] (Resuscitation (2021) 161 (1–60), (S0300957221000551), (10.1016/j.resuscitation.2021.02.003))
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Perkins, Gavin D., Gräsner, Jan-Thortsen, Semeraro, Federico, Olasveengen, Theresa, Soar, Jasmeet, Lott, Carsten, Voorde, Patrick, Madar, John, Zideman, David, Mentzelopoulos, Spyridon, Bossaert, Leo, Greif, Robert, Monsieurs, Koen, Svavarsdóttir, Hildigunnur, Nolan, Jerry P., Ainsworth, S., Deakin, C. D., Lippert, F., Sandroni, C., Akin, S., Delchef, J., Lockey, A. S., Sari, F., Alfonzo, A., Dirks, B., Lott, C., Scapigliati, A., Andres, J., Djakow, J., Lulic, I., Schilder, S., Attard Montalto, S., Djarv, T., Maas, M., Schlieber, J., Barelli, A., Druwe, P., Maconochie, I., Schnaubelt, S., Baubin, M., Eldin, G., Madar, J., Semeraro, F., Behringer, W., Ersdal, H., Martinez-Mejias, A., Shammet, S., Bein, B., Friberg, H., Masterson, S., Singletary, E. M., Biarent, D., Genbrugge, C., Mentzelopoulos, S. D., Skåre, C., Bingham, R., Georgiou, M., Meyran, D., Skrifvars, M. B., Blom, M., Goemans, E., Monsieurs, K. G., Smyth, M., Boccuzzi, A., González-Salvado, V., Morley, C., Soar, J., Borra, V., Gradisek, P., Moulaert, V. R. M., Svavarsdóttir, H., Bossaert, L., Gräsner, J. T., Mpotos, N., Szczapa, T., Böttiger, B. W., Greif, R., Nikolaou, N., Taccone, F., Breckwoldt, J., Handley, A. J., Nolan, J. P., Tageldin Mustafa, M., Brissaud, O., Hassager, C., Olasveengen, T. M., Te Pas, A., Burkart, R., Haywood, K., Oliver, E., Karl-Christian Thies, Cariou, A., Heltne, J. K., Paal, P., Tjelmeland, I. B. M., Carli, P., Hendrickx, D., Pellis, T., Trevisanuto, D., Carmona, F., Herlitz, J., Perkins, G. D., Truhlár, A., Cassan, P., Hinkelbein, J., Pflanzl-Knizacek, L., Trummer, G., Castren, M., Hoffmann, F., Pitches, K., Turner, N. M., Christophides, T., Hunyadi Anticevic, S., Poole, K., Urlesberger, B., Cimpoesu, C. D., Johannesdottir, G. B., Raffay, V., Vaahersalo, J., Clarens, C., Khalifa, G., Renier, W., Voorde, P., Conaghan, P., Klaassen, B., Ristagno, G., Grootven, H., Couper, K., Koppl, J., Roehr, C. C., Wilkinson, D., Cronberg, T., Kreimeier, U., Rosell-Ortiz, F., Wnent, J., Buck, E., Kuzovlev, A., Rüdiger, M., Wyllie, J. P., Lucas, N., Lauritsen, T., Safri, A., Yeung, J., Roovere, A., Lilja, G., Sanchez Santos, L., Zideman, D. A., Radiology and Nuclear Medicine, AMS - Rehabilitation & Development, AMS - Sports, Amsterdam Gastroenterology Endocrinology Metabolism, Cardiology, ACS - Heart failure & arrhythmias, and APH - Health Behaviors & Chronic Diseases
- Abstract
The authors regret that the list of the ERC 2021 Guidelines Collaborators which were included in Appendix A was incomplete. The complete list of collaborators is provided below: [Table presented] The authors would like to apologise for any inconvenience caused.
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- 2021
12. European Resuscitation Council Guidelines 2021: Executive summary
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Perkins, Gavin D., primary, Gräsner, Jan-Thorsen, additional, Semeraro, Federico, additional, Olasveengen, Theresa, additional, Soar, Jasmeet, additional, Lott, Carsten, additional, Van de Voorde, Patrick, additional, Madar, John, additional, Zideman, David, additional, Mentzelopoulos, Spyridon, additional, Bossaert, Leo, additional, Greif, Robert, additional, Monsieurs, Koen, additional, Svavarsdóttir, Hildigunnur, additional, Nolan, Jerry P., additional, Ainsworth, S., additional, Akin, S., additional, Alfonzo, A., additional, Andres, J., additional, Attard Montalto, S., additional, Barelli, A., additional, Baubin, M., additional, Behringer, W., additional, Bein, B., additional, Biarent, D., additional, Bingham, R., additional, Blom, M., additional, Boccuzzi, A., additional, Borra, V., additional, Bossaert, L., additional, Böttiger, B.W., additional, Breckwoldt, J., additional, Brissaud, O., additional, Burkart, R., additional, Cariou, A., additional, Carli, P., additional, Carmona, F., additional, Cassan, P., additional, Castren, M., additional, Christophides, T., additional, Cimpoesu, C.D., additional, Clarens, C., additional, Conaghan, P., additional, Couper, K., additional, Cronberg, T., additional, De Buck, E., additional, de Lucas, N., additional, De Roovere, A., additional, Deakin, C.D., additional, Delchef, J., additional, Dirks, B., additional, Djakow, J., additional, Djarv, T., additional, Druwe, P., additional, Eldin, G., additional, Ersdal, H., additional, Friberg, H., additional, Genbrugge, C., additional, Georgiou, M., additional, Goemans, E., additional, Gonzalez-Salvado, V., additional, Gradisek, P., additional, Graesner, J.T., additional, Greif, R., additional, Handley, A.J., additional, Hassager, C., additional, Haywood, K., additional, Heltne, J.K., additional, Hendrickx, D., additional, Herlitz, J., additional, Hinkelbein, J., additional, Hoffmann, F., additional, Hunyadi Anticevic, S., additional, Johannesdottir, G.B., additional, Khalifa, G., additional, Klaassen, B., additional, Koppl, J., additional, Kreimeier, U., additional, Kuzovlev, A., additional, Lauritsen, T., additional, Lilja, G., additional, Lippert, F., additional, Lockey, A., additional, Lott, C., additional, Lulic, I., additional, Maas, M., additional, Maconochie, I., additional, Madar, J., additional, Martinez-Mejias, A., additional, Masterson, S., additional, Mentzelopoulos, S.D., additional, Meyran, D., additional, Monsieurs, K.G., additional, Morley, C., additional, Moulaert, V.R.M., additional, Mpotos, N., additional, Nikolaou, N., additional, Nolan, J.P., additional, Olasveengen, T.M., additional, Oliver, E., additional, Paal, P., additional, Pellis, T., additional, Perkins, G.D., additional, Pflanzl-Knizacek, L., additional, Pitches, K., additional, Poole, K., additional, Raffay, V., additional, Renier, W., additional, Ristagno, G., additional, Roehr, C.C., additional, Rosell-Ortiz, F., additional, Rudiger, M., additional, Safri, A., additional, Sanchez Santos, L., additional, Sandroni, C., additional, Sari, F., additional, Scapigliati, A., additional, Schilder, S., additional, Schlieber, J., additional, Schnaubelt, S., additional, Semeraro, F., additional, Shammet, S., additional, Singletary, E.M., additional, Skare, C., additional, Skrifvars, M.B., additional, Smyth, M., additional, Soar, J., additional, Svavarsdottir, H., additional, Szczapa, T., additional, Taccone, F., additional, Tageldin Mustafa, M., additional, Te Pas, A., additional, Thies, K.C., additional, Tjelmeland, I.B.M., additional, Trevisanuto, D., additional, Truhlar, A., additional, Trummer, G., additional, Turner, N.M., additional, Urlesberger, B., additional, Vaahersalo, J., additional, Van de Voorde, P., additional, Van Grootven, H., additional, Wilkinson, D., additional, Wnent, J., additional, Wyllie, J.P., additional, Yeung, J., additional, and Zideman, D.A., additional
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- 2021
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13. Erratum zu: Postreanimationsbehandlung: Kapitel 5 der Leitlinien zur Reanimation 2015 des European Resuscitation Council
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Nolan, J. P., Soar, J., Cariou, A., Cronberg, T., Moulaert, V. R. M., Deakin, C., Böttiger, B. W., Friberg, H., Sunde, K., and Sandroni, C.
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- 2016
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14. Dysglycemia, glycemic variability and outcome after cardiac arrest and temperature management at 33 °C and 36 °C (a post-hoc analysis of the target temperature management trial)
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Borgquist, O, Wise, MP, Nielsen, N, Al-Subaie, N, Cranshaw, J, Cronberg, T, Glover, G, Hassager, C, Kjaergaard, J, Walden, A, and Friberg, H
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- 2015
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15. Time to start of cardiopulmonary resuscitation and the effect of target temperature management at 33°C and 36°C
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Dankiewicz, J, Cronberg, T, Erlinge, D, Friberg, H, Hassager, C, Horn, J, Hovdenes, J, Kjaergaard, J, Kuiper, M, Gasche, Y, Pellis, T, Stammet, P, Wanscher, M, Wetterslev, J, Wise, MP, Åneman, A, and Nielsen, N
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- 2015
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16. Corrigendum to “Highly malignant routine EEG predicts poor prognosis after cardiac arrest in the Target Temperature Management trial” [Resuscitation 131 (2019) 24–28]
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Backman, S., primary, Cronberg, T., additional, Friberg, H., additional, Ullén, S., additional, Horn, J., additional, Kjaergaard, J., additional, Hassager, C., additional, Wanscher, M., additional, Nielsen, N., additional, and Westhall, E., additional
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- 2019
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17. Highly malignant routine EEG predicts poor prognosis after cardiac arrest in the Target Temperature Management trial
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Backman, S., Cronberg, T., Friberg, H., Ullén, S., Horn, J., Kjaergaard, J., Hassager, C., Wanscher, M., Nielsen, N., and Westhall, E.
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- 2018
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18. Erratum to: Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography: a post hoc analysis from the TTM trial
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Dankiewicz, J., Nielsen, N., Annborn, M., Cronberg, T., Erlinge, D., Gasche, Y., Hassager, C., Kjaergaard, J., Pellis, T., and Friberg, H.
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- 2015
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19. Lactate, lactate clearance and outcome after cardiac arrest: A post‐hoc analysis of the TTM ‐Trial
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Düring, J., primary, Dankiewicz, J., additional, Cronberg, T., additional, Hassager, C., additional, Hovdenes, J., additional, Kjaergaard, J., additional, Kuiper, M., additional, Nielsen, N., additional, Pellis, T., additional, Stammet, P., additional, Vulto, J., additional, Wanscher, M., additional, Wise, M., additional, Åneman, A., additional, and Friberg, H., additional
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- 2018
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20. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels
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Michalopoulos, A., Groeneveld, J., Lev, A., Sprung, C., Vakalos, A., Kotanidou, A., Zakynthinos, E., Filos, K., Pneumatikos, I., Moraiti, A., Clouva-molyvdas, P., Mandragos, K., Kyriazopoulos, G., Karampela, I., Koulenti, D., Myrianthefs, P., Ioannidou, E., Mouloudi, E., Chalkiadaki, A., Bitzani, M., Routsi, C., Armaganidis, A., Sofianos, E., Harjola, V., Berezowicz, P., Jacobsen, K., Espersen, K., Fogh, B., Betsch, H., Vincent, Jean-Louis, Vanhems, Philippe, Walther, Sten M., Sakr, Yasser, Rello, Jordi, Leone, Marc, Pickkers, P., Lipman, Jeffrey, Holmbom, Martin, Antonelli, Massimo, Hanberger, Håkan, Kocak, S., Ulger, F., Guven, H., Turkmen, A., Dogruer, K., Adanir, T., Demirkiran, O., Tugrul, S., Cakar, N., Akinci, I., Uzel, N., Togal, T., Topeli, A., Turkoglu, M., Guven, M., Akan, M., Bodur, H., Bosnak, M., Kizilkaya, M., Ozgencil, E., Kaya, A., Fistikci, H., Ates, C., Atalan, K., Jacobson, S., Owall, A., Kokinsky, E., Rudenstam, J., Häggqvist, J., Hulting, J., Sellgren, J., Arvidsson, S., Schindele, M., Hammarskjöld, F., Friberg, H., Petersson, J., Paulsson, A., Lindström, I., Stiernstrom, H., Peterzén, B., Blomqvist, H., Petersen, P., Soto Ibáñez, J., González, J., Izura, J., Corcobado Márquez, C., Rico-Feijoo, J., Sierra, R., Rello, J., Posada, P., Briones Lopez, M., Jara, R., Luis, V., Maria Jesus, H., de la Torre-Prados, M., Felices, F., Sanchez Garcia, M., Macias Pingarrón, J., Garcia-Fuentes, C., Cerdá, E., Serrano, N., Barcenilla-Gaite, F., Sirvent, J., Montejo González, J., Guerrero Gomez, F., Amador Amerigo, J., Borges, M., Sánchez-Olmedo, J., López Ciudad, V., Moreno, M., Esteban, E., Vallés, J., De Rojas Román, J., Yuste, I., Ugarte Peña, P., Sole-violán, J., Bustinza, A., Albaya, A., Latour-Perez, J., Navarro, J., Garcia, F., Martin Delgado, M., Rovira, A., Ramos-gómez, L., Garro, P., Silva, J., Iglesias, L., María Jesús, L., Pueyo, L., Lorente, C., Martinon-Torres, F., Aguilar, G., Martinez-Sagasti, F., Blesa Malpica, A., Valencia, M., Zavala, E., Bustamante Munguira, E., Arribas, M., Insausti, J., Vegas Pinto, R., Bocero, L., Estella, A., Esteban-Reboll, F., Lopez Camps, V., Antón Caraballo, E., Muñoz, E., Olaechea, P., Escriba, A., Santos, I., Campiñez, Burgueño., Moreira, P., Pizzamiglio, M., Conti, V., Kahveci, A., Nydahl, A., Lind, D., Caballero Zirena, A., Guerrero, F., Palomar, M., Einar, V., Agvald-Ohman, C., Wyon, N., Johansson, L., Gil, B., Mariscal, F., Galvan, B., Espinosa, E., Lesmes Serrano, A., Mesalles Sanjuan, E., Manzano Ramirez, A., Quintana Tort-Martorell, E., Monton Dito, J., Ibañez, A., Garcia del Valle, S., Alemparte-Pardavila, E., Monedero, P., Naveira-Abeigón, E., Jorda, R., Alvarez, M., Rubio, O., Bouw, M., Afonso, Susana, Matos, Ricardo, Carneiro, A., Amaro, P., Ribeiro, R., Paiva, J., Galdos-Anuncibay, P., Nieto, M., Ruiz, J., Perez Calvo, C., Mañez, R., França, C., Moreno, R., Dias, C., Sousa, A., Rezende, A., Mourão, L., Ponce, P., Oliveira, T., Esteves, F., Den Boer, S., Bakker, J., Van Berkel, G., Borg, M., Gullo, A., Gianesello, L., Martinelli, L., Antonelli, M., Bassetti, M., Telo, L., Alves, M., Almeida, E., Leite, A., Pádua, F., Costa, H., Póvoa, P., Lopes, V., Carmo, E., Febra, C., Martins, A., Castelo-Branco Sousa, M., Bártolo, A., Junker, A., Erno, P., Klepstad, P., Loevstad, R., Bergmans, D., Rodgers, M., Pham, C., Speelberg, B., Wesselink, R., Ammann, J., Vet, J., Gille, A., Kuiper, M., Kieft, H., Blom, H., Vogelaar, J., Corsten, S., Ten Cate, J., Rosseel, P., De Pont, A., Della Rocca, G., Biancofiore, G., Morelli, A., Ranieri, MV., Cotogni, P., Alessandro, D., Clementi, S., Ferraro, F., Giuseppe, N., Sforza, D., Castiglione, G., Marino, G., Fumagalli, R., Santagostino, G., De Negri, P., De Gasperi, A., Oggioni, R., Conte, V., Sicignano, A., Marri, I., Locicero, M., Guadagnucci, A., Chieregato, A., Fiore, G., Sorbara, C., Munch, C., Ruatti, H., Lorella, P., Borrelli, F., Panella, L., De Blasi, R., Ceriani, R., Colonna, S., Abbruzzese, C., Rosano, A., Caspani, M., Emmi, V., Stelian, E., Scolz, S., Guberti, A., Margarit, O., Giarratano, A., Rosi, R., Marzorati, S., De blasio, E., Minerva, M., Petrucci, N., Mangani, V., Lazzero, A., Sapuppo, M., Cecilia, P., Borelli, M., Greco, S., Vesconi, S., Sofer, S., Cohen, J., Kishinevsky, E., Selçuk Üniversitesi, Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, İç Hastalıkları, and OMÜ
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Male ,Pediatrics ,Cross-sectional study ,health care facilities, manpower, and services ,Antibiotics ,Resistance ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Prevalence ,Drug Resistance ,law.invention ,Medical microbiology ,law ,Pathologie maladies infectieuses ,Antibiotic ,Critically ill ,Infection ,Aged ,Anti-Bacterial Agents ,Bacteria ,Bacterial Infections ,Cross-Sectional Studies ,Europe ,Female ,Hospitalization ,Humans ,Middle Aged ,Treatment Outcome ,Drug Resistance, Bacterial ,Intensive Care Units ,Infectious Diseases ,Critically ill -- Care ,Mortality rate ,Bacterial ,Intensive care unit ,SAPS II ,Beta lactam antibiotics ,Research Article ,Human ,medicine.medical_specialty ,medicine.drug_class ,Intensive Care Unit ,Bacterial Infection ,Antibiotic resistance ,Internal medicine ,Settore MED/41 - ANESTESIOLOGIA ,Anti-Bacterial Agent ,medicine ,Cross-Sectional Studie ,business.industry ,Aminopeptidases -- Analysis ,Klinisk medicin ,Polypeptides ,Bacterial diseases -- Diagnosis ,Antibiotics -- Therapeutic use ,Clinical Medicine ,business - Abstract
Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome., 0, SCOPUS: ar.j, info:eu-repo/semantics/published
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- 2014
21. Protocol for meta-analysis of temperature reduction in animal models of cardiac arrest
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Olai H, Thornéus G, Watson H, Malcolm Robert Macleod, Friberg H, Rhodes J, Nielsen N, Cronberg T, and Deierborg T
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Methods Articles ,animals ,meta‐analysis ,Methods Article ,cardiac arrest ,hypothermia ,global ischaemia ,temperature management - Abstract
Targeted temperature management (TTM) of 32–34 °C has been the standard treatment for out‐of‐hospital cardiac arrest since clinical trials in 2002 showed benefits to survival and neurological outcome. Recently, this treatment has been challenged by another clinical trial showing no difference in outcome between TTM of 33 °C and 36 °C. This protocol describes the methodology for a meta‐analysis detailing temperature‐reducing interventions to treat global ischaemia in animal models. By combining relevant data sets in the literature, we will explore the experimental evidence for TTM. Our aims are to explain possible translational gaps and provide methodological considerations for future experimental research and clinical trials.
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- 2016
22. Postreanimationsbehandlung
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Nolan, J.P., primary, Soar, J., additional, Cariou, A., additional, Cronberg, T., additional, Moulaert, V.R.M., additional, Deakin, C., additional, Böttiger, B.W., additional, Friberg, H., additional, Sunde, K., additional, and Sandroni, C., additional
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- 2017
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23. Impact of organic N on corky root in organically cultivated greenhouse tomatoes
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Mårtensson, A., primary and Friberg, H., additional
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- 2017
- Full Text
- View/download PDF
24. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)
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Rob, D., primary, Špunda, R., additional, Lindner, J., additional, Šmalcová, J., additional, Šmíd, O., additional, Kovárník, T., additional, Linhart, A., additional, Bìlohlávek, J., additional, Marinoni, M. M., additional, Cianchi, G., additional, Trapani, S., additional, Migliaccio, M. L., additional, Gucci, L., additional, Bonizzoli, M., additional, Cramaro, A., additional, Cozzolino, M., additional, Valente, S., additional, Peris, A., additional, Grins, E., additional, Kort, E., additional, Weiland, M., additional, Shresta, N. Manandhar, additional, Davidson, P., additional, Algotsson, L., additional, Fitch, S., additional, Marco, G., additional, Sturgill, J., additional, Lee, S., additional, Dickinson, M., additional, Boeve, T., additional, Khaghani, A., additional, Wilton, P., additional, Jovinge, S., additional, Ahmad, A. N., additional, Loveridge, R., additional, Vlachos, S., additional, Patel, S., additional, Gelandt, E., additional, Morgan, L., additional, Butt, S., additional, Whitehorne, M., additional, Kakar, V., additional, Park, C., additional, Hayes, M., additional, Willars, C., additional, Hurst, T., additional, Best, T., additional, Vercueil, A., additional, Auzinger, G., additional, Adibelli, B., additional, Akovali, N., additional, Torgay, A., additional, Zeyneloglu, P., additional, Pirat, A., additional, Kayhan, Z., additional, Schmidbauer, S. S., additional, Herlitz, J., additional, Karlsson, T., additional, Friberg, H., additional, Knafelj, R., additional, Radsel, P., additional, Duprez, F., additional, Bonus, T., additional, Cuvelier, G., additional, Mashayekhi, S., additional, Maka, M., additional, Ollieuz, S., additional, Reychler, G., additional, Mosaddegh, R., additional, Abbasi, S., additional, Talaee, S., additional, Zotzmann, V. Z., additional, Staudacher, D. S., additional, Wengenmayer, T. W., additional, Dürschmied, D. D., additional, Bode, C. B., additional, Nelskylä, A., additional, Nurmi, J., additional, Jousi, M., additional, Schramko, A., additional, Mervaala, E., additional, Ristagno, G., additional, Skrifvars, M., additional, Ozsoy, G., additional, Kendirli, T., additional, Azapagasi, E., additional, Perk, O., additional, Gadirova, U., additional, Ozcinar, E., additional, Cakici, M., additional, Baran, C., additional, Durdu, S., additional, Uysalel, A., additional, Dogan, M., additional, Ramoglu, M., additional, Ucar, T., additional, Tutar, E., additional, Atalay, S., additional, Akar, R., additional, Kamps, M., additional, Leeuwerink, G., additional, Hofmeijer, J., additional, Hoiting, O., additional, Van der Hoeven, J., additional, Hoedemaekers, C., additional, Konkayev, A., additional, Kuklin, V., additional, Kondratyev, T., additional, Konkayeva, M., additional, Akhatov, N., additional, Sovershaev, M., additional, Tveita, T., additional, Dahl, V., additional, Wihersaari, L., additional, Skrifvars, M. B., additional, Bendel, S., additional, Kaukonen, K. M., additional, Vaahersalo, J., additional, Romppanen, J., additional, Pettilä, V., additional, Reinikainen, M., additional, Lybeck, A., additional, Cronberg, T., additional, Nielsen, N., additional, Rauber, M., additional, Steblovnik, K., additional, Jazbec, A., additional, Noc, M., additional, Kalasbail, P., additional, Garrett, F., additional, Kulstad, E., additional, Bergström, D. J., additional, Olsson, H. R., additional, Schmidbauer, S., additional, Mandel, I., additional, Mikheev, S., additional, Podoxenov, Y., additional, Suhodolo, I., additional, Podoxenov, A., additional, Svirko, J., additional, Sementsov, A., additional, Maslov, L., additional, Shipulin, V., additional, Vammen, L. V., additional, Rahbek, S. R., additional, Secher, N. S., additional, Povlsen, J. P., additional, Jessen, N. J., additional, Løfgren, B. L., additional, Granfeldt, A. G., additional, Grossestreuer, A., additional, Perman, S., additional, Patel, P., additional, Ganley, S., additional, Portmann, J., additional, Cocchi, M., additional, Donnino, M., additional, Nassar, Y., additional, Fathy, S., additional, Gaber, A., additional, Mokhtar, S., additional, Chia, Y. C., additional, Lewis-Cuthbertson, R., additional, Mustafa, K., additional, Sabra, A., additional, Evans, A., additional, Bennett, P., additional, Eertmans, W., additional, Genbrugge, C., additional, Boer, W., additional, Dens, J., additional, De Deyne, C., additional, Jans, F., additional, Skorko, A., additional, Thomas, M., additional, Casadio, M., additional, Coppo, A., additional, Vargiolu, A., additional, Villa, J., additional, Rota, M., additional, Avalli, L., additional, Citerio, G., additional, Moon, J. B., additional, Cho, J. H., additional, Park, C. W., additional, Ohk, T. G., additional, Shin, M. C., additional, Won, M. H., additional, Papamichalis, P., additional, Zisopoulou, V., additional, Dardiotis, E., additional, Karagiannis, S., additional, Papadopoulos, D., additional, Zafeiridis, T., additional, Babalis, D., additional, Skoura, A., additional, Staikos, I., additional, Komnos, A., additional, Passos, S. Silva, additional, Maeda, F., additional, Souza, L. Silva, additional, Filho, A. Amato, additional, Granjeia, T. Araújo Guerra, additional, Schweller, M., additional, Franci, D., additional, De Carvalho Filho, M., additional, Santos, T. Martins, additional, De Azevedo, P., additional, Wall, R., additional, Welters, I., additional, Tansuwannarat, P., additional, Sanguanwit, P., additional, Langer, T., additional, Carbonara, M., additional, Caccioppola, A., additional, Fusarini, C. Ferraris, additional, Carlesso, E., additional, Paradiso, E., additional, Battistini, M., additional, Cattaneo, E., additional, Zadek, F., additional, Maiavacca, R., additional, Stocchetti, N., additional, Pesenti, A., additional, Ramos, A., additional, Acharta, F., additional, Toledo, J., additional, Perezlindo, M., additional, Lovesio, L., additional, Dogliotti, A., additional, Lovesio, C., additional, Schroten, N., additional, Van der Veen, B., additional, De Vries, M. C., additional, Veenstra, J., additional, Abulhasan, Y. B., additional, Rachel, S., additional, Châtillon-Angle, M., additional, Alabdulraheem, N., additional, Schiller, I., additional, Dendukuri, N., additional, Angle, M., additional, Frenette, C., additional, Lahiri, S., additional, Schlick, K., additional, Mayer, S. A., additional, Lyden, P., additional, Akatsuka, M., additional, Arakawa, J., additional, Yamakage, M., additional, Rubio, J., additional, Mateo-Sidron, J. A. Rubio, additional, Sierra, R., additional, Celaya, M., additional, Benitez, L., additional, Alvarez-Ossorio, S., additional, Fernandez, A., additional, Gonzalez, O., additional, Engquist, H., additional, Rostami, E., additional, Enblad, P., additional, Canullo, L., additional, Nallino, J., additional, Perreault, M., additional, Talic, J., additional, Frenette, A. J., additional, Burry, L., additional, Bernard, F., additional, Williamson, D. R., additional, Adukauskiene, D., additional, Cyziute, J., additional, Adukauskaite, A., additional, Malciene, L., additional, Luca, L., additional, Rogobete, A., additional, Bedreag, O., additional, Papurica, M., additional, Sarandan, M., additional, Cradigati, C., additional, Popovici, S., additional, Vernic, C., additional, Sandesc, D., additional, Avakov, V., additional, Shakhova, I., additional, Trimmel, H., additional, Majdan, M., additional, Herzer, G. H., additional, Sokoloff, C. S., additional, Albert, M., additional, Williamson, D., additional, Odier, C., additional, Giguère, J., additional, Charbonney, E., additional, Husti, Z., additional, Kaptás, T., additional, Fülep, Z., additional, Gaál, Z., additional, Tusa, M., additional, Donnelly, J., additional, Aries, M., additional, Czosnyka, M., additional, Robba, C., additional, Liu, M., additional, Ercole, A., additional, Menon, D., additional, Hutchinson, P., additional, Smielewski, P., additional, López, R., additional, Graf, J., additional, Montes, J. M., additional, Kenawi, M., additional, Kandil, A., additional, Husein, K., additional, Samir, A., additional, Heijneman, J., additional, Huijben, J., additional, Abid-Ali, F., additional, Stolk, M., additional, Van Bommel, J., additional, Lingsma, H., additional, Van der Jagt, M., additional, Cihlar, R. C., additional, Mancino, G., additional, Bertini, P., additional, Forfori, F., additional, Guarracino, F., additional, Pavelescu, D., additional, Grintescu, I., additional, Mirea, L., additional, Alamri, S., additional, Tharwat, M., additional, Kono, N., additional, Okamoto, H., additional, Uchino, H., additional, Ikegami, T., additional, Fukuoka, T., additional, Simoes, M., additional, Trigo, E., additional, Coutinho, P., additional, Pimentel, J., additional, Franci, A., additional, Basagni, D., additional, Boddi, M., additional, Anichini, V., additional, Cecchi, A., additional, Markopoulou, D., additional, Venetsanou, K., additional, Papanikolaou, I., additional, Barkouri, T., additional, Chroni, D., additional, Alamanos, I., additional, Cingolani, E., additional, Bocci, M. G., additional, Pisapia, L., additional, Tersali, A., additional, Cutuli, S. L., additional, Fiore, V., additional, Palma, A., additional, Nardi, G., additional, Antonelli, M., additional, Coke, R., additional, Kwong, A., additional, Dwivedi, D. J., additional, Xu, M., additional, McDonald, E., additional, Marshall, J. C., additional, Fox-Robichaud, A. E., additional, Liaw, P. C., additional, Kuchynska, I., additional, Malysh, I. R., additional, Zgrzheblovska, L. V., additional, Mestdagh, L., additional, Verhoeven, E. F., additional, Hubloue, I., additional, Ruel-laliberte, J., additional, Zarychanski, R., additional, Lauzier, F., additional, Bonaventure, P. Lessard, additional, Green, R., additional, Griesdale, D., additional, Fowler, R., additional, Kramer, A., additional, Zygun, D., additional, Walsh, T., additional, Stanworth, S., additional, Léger, C., additional, Turgeon, A. F., additional, Baron, D. M., additional, Baron-Stefaniak, J., additional, Leitner, G. C., additional, Ullrich, R., additional, Tarabrin, O., additional, Mazurenko, A., additional, Potapchuk, Y., additional, Sazhyn, D., additional, Tarabrin, P., additional, Pérez, A. González, additional, Silva, J., additional, Artemenko, V., additional, Bugaev, A., additional, Tokar, I., additional, Konashevskaya, S., additional, Kolesnikova, I. M., additional, Roitman, E. V., additional, Kiss, T. Rengeiné, additional, Máthé, Z., additional, Piros, L., additional, Dinya, E., additional, Tihanyi, E., additional, Smudla, A., additional, Fazakas, J., additional, Ubbink, R., additional, Boekhorst te, P., additional, Mik, E., additional, Caneva, L., additional, Ticozzelli, G., additional, Pirrelli, S., additional, Passador, D., additional, Riccardi, F., additional, Ferrari, F., additional, Roldi, E. M., additional, Di Matteo, M., additional, Bianchi, I., additional, Iotti, G. A., additional, Zurauskaite, G., additional, Voegeli, A., additional, Meier, M., additional, Koch, D., additional, Haubitz, S., additional, Kutz, A., additional, Bargetzi, M., additional, Mueller, B., additional, Schuetz, P., additional, Von Meijenfeldt, G., additional, Van der Laan, M., additional, Zeebregts, C., additional, Christopher, K. B., additional, Vernikos, P., additional, Melissopoulou, T., additional, Kanellopoulou, G., additional, Panoutsopoulou, M., additional, Xanthis, D., additional, Kolovou, K., additional, Kypraiou, T., additional, Floros, J., additional, Broady, H., additional, Pritchett, C., additional, Marshman, M., additional, Jannaway, N., additional, Ralph, C., additional, Lehane, C. L., additional, Keyl, C. K., additional, Zimmer, E. Z., additional, Trenk, D. T., additional, Ducloy-Bouthors, A. S., additional, Jonard, M. J., additional, Fourrier, F., additional, Piza, F., additional, Correa, T., additional, Marra, A., additional, Guerra, J., additional, Rodrigues, R., additional, Vilarinho, A., additional, Aranda, V., additional, Shiramizo, S., additional, Lima, M. R., additional, Kallas, E., additional, Cavalcanti, A. B., additional, Donoso, M., additional, Vargas, P., additional, McCartney, J., additional, Ramsay, S., additional, McDowall, K., additional, Novitzky-Basso, I., additional, Wright, C., additional, Medic, M Grgic, additional, Bielen, L, additional, Radonic, V, additional, Zlopasa, O, additional, Vrdoljak, N Gubarev, additional, Gasparovic, V, additional, Radonic, R, additional, Narváez, G., additional, Cabestrero, D., additional, Rey, L., additional, Aroca, M., additional, Gallego, S., additional, Higuera, J., additional, De Pablo, R., additional, González, L. Rey, additional, Chávez, G. Narváez, additional, Lucas, J. Higuera, additional, Alonso, D. Cabestrero, additional, Ruiz, M. Aroca, additional, Valarezo, L. Jaramillo, additional, De Pablo Sánchez, R., additional, Real, A. Quinza, additional, Wigmore, T. W., additional, Bendavid, I., additional, Cohen, J., additional, Avisar, I., additional, Serov, I., additional, Kagan, I., additional, Singer, P., additional, Hanison, J, additional, Mirza, U, additional, Conway, D, additional, Takasu, A., additional, Tanaka, H., additional, Otani, N., additional, Ohde, S., additional, Ishimatsu, S., additional, Coffey, F, additional, Dissmann, P, additional, Mirza, K, additional, Lomax, M, additional, Dissmann, P., additional, Coffey, F., additional, Mirza, K., additional, Lomax, M., additional, Miner, JR, additional, Leto, R, additional, Markota, AM, additional, Gradišek, PG, additional, Aleksejev, VA, additional, Sinkovič, AS, additional, Romagnoli, S., additional, Chelazzi, C., additional, Zagli, G., additional, Benvenuti, F., additional, Mancinelli, P., additional, Boninsegni, P., additional, Paparella, L., additional, Bos, A. T., additional, Thomas, O., additional, Goslar, T., additional, Martone, A., additional, Sandu, P. R., additional, Rosu, V. A., additional, Capilnean, A., additional, Murgoi, P., additional, Lecavalier, A., additional, Jayaraman, D., additional, Rico, P., additional, Bellemare, P., additional, Gelinas, C., additional, Nishida, T., additional, Kinoshita, T., additional, Iwata, N., additional, Yamakawa, K., additional, Fujimi, S., additional, Maggi, L., additional, Sposato, F., additional, Citterio, G., additional, Bonarrigo, C., additional, Rocco, M., additional, Zani, V., additional, De Blasi, R. A., additional, Alcorn, D, additional, Barry, L, additional, Riedijk, M. A., additional, Milstein, D. M., additional, Caldas, J., additional, Panerai, R., additional, Camara, L., additional, Ferreira, G., additional, Bor-Seng-Shu, E., additional, Lima, M., additional, Galas, F., additional, Mian, N., additional, Nogueira, R., additional, de Oliveira, G. Queiroz, additional, Almeida, J., additional, Jardim, J., additional, Robinson, T. G., additional, Gaioto, F., additional, Hajjar, L. A., additional, Zabolotskikh, I., additional, Musaeva, T., additional, Saasouh, W., additional, Freeman, J., additional, Turan, A., additional, Saseedharan, S., additional, Pathrose, E., additional, Poojary, S., additional, Messika, J., additional, Martin, Y., additional, Maquigneau, N., additional, Henry-Lagarrigue, M., additional, Puechberty, C., additional, Stoclin, A., additional, Martin-Lefevre, L., additional, Blot, F., additional, Dreyfuss, D., additional, Dechanet, A., additional, Hajage, D., additional, Ricard, J., additional, Almeida, E., additional, Landoni, G., additional, Fukushima, J., additional, Fominskiy, E., additional, De Brito, C., additional, Cavichio, L., additional, Almeida, L., additional, Ribeiro, U., additional, Osawa, E., additional, Boltes, R., additional, Battistella, L., additional, Hajjar, L., additional, Fontela, P., additional, Lisboa, T., additional, Junior, L. Forgiarini, additional, Friedman, G. F., additional, Abruzzi, F., additional, Primo, J. Azevedo Peixoto, additional, Filho, P. Marques, additional, de Andrade, J. Stormorvski, additional, Brenner, K. Matos, additional, boeira, M. Scorsato, additional, Leães, C., additional, Rodrigues, C., additional, Vessozi, A., additional, Machado, A. SantAnna, additional, Weiler, M., additional, Bryce, H., additional, Hudson, A., additional, Law, T., additional, Reece-Anthony, R., additional, Molokhia, A., additional, Abtahinezhadmoghaddam, F., additional, Cumber, E., additional, Channon, L., additional, Wong, A., additional, Groome, R., additional, Gearon, D., additional, Varley, J., additional, Wilson, A., additional, Reading, J., additional, Zampieri, F. G., additional, Bozza, F. A., additional, Ferez, M., additional, Fernandes, H., additional, Japiassú, A., additional, Verdeal, J., additional, Carvalho, A. C., additional, Knibel, M., additional, Salluh, J. I., additional, Soares, M., additional, Gao, J., additional, Ahmadnia, E., additional, Patel, B., additional, MacKay, A., additional, Binning, S., additional, Pugh, R. J., additional, Battle, C., additional, Hancock, C., additional, Harrison, W., additional, Szakmany, T., additional, Mulders, F., additional, Vandenbrande, J., additional, Dubois, J., additional, Stessel, B., additional, Siborgs, K., additional, Ramaekers, D., additional, Silva, U. V., additional, Homena, W. S., additional, Fernandes, G. C., additional, Moraes, A. P., additional, Brauer, L., additional, Lima, M. F., additional, De Marco, F., additional, Maric, N., additional, Mackovic, M., additional, Udiljak, N., additional, Bosso, CE, additional, Caetano, RD, additional, Cardoso, AP, additional, Souza, OA, additional, Pena, R, additional, Mescolotte, MM, additional, Souza, IA, additional, Mescolotte, GM, additional, Bangalore, H., additional, Borrows, E., additional, Barnes, D., additional, Ferreira, V., additional, Azevedo, L., additional, Alencar, G., additional, Andrade, A., additional, Bierrenbach, A., additional, Buoninsegni, L. Tadini, additional, Cecci, L., additional, Lindskog, J., additional, Rowland, K., additional, Sturgess, P., additional, Ankuli, A., additional, Rosa, R, additional, Tonietto, T, additional, Ascoli, A, additional, Madeira, L, additional, Rutzen, W, additional, Falavigna, M, additional, Robinson, C, additional, Salluh, J, additional, Cavalcanti, A, additional, Azevedo, L, additional, Cremonese, R, additional, Da Silva, D, additional, Dornelles, A, additional, Skrobik, Y, additional, Teles, J, additional, Ribeiro, T, additional, Eugênio, C, additional, Teixeira, C, additional, Zarei, M., additional, Hashemizadeh, H., additional, Eriksson, M., additional, Strandberg, G., additional, Lipcsey, M., additional, Larsson, A., additional, Lignos, M., additional, Crissanthopoulou, E., additional, Flevari, K., additional, Dimopoulos, P., additional, Armaganidis, A., additional, Golub, JG, additional, Stožer, AS, additional, Rüddel, H., additional, Ehrlich, C., additional, Burghold, C. M., additional, Hohenstein, C., additional, Winning, J., additional, Sellami, W., additional, Hajjej, Z., additional, Bousselmi, M., additional, Gharsallah, H., additional, Labbene, I., additional, Ferjani, M., additional, Sattler, J., additional, Steinbrunner, D., additional, Poppert, H., additional, Schneider, G., additional, Blobner, M., additional, Kanz, K. G., additional, Schaller, S. J., additional, Apap, K., additional, Xuereb, G., additional, Massa, L., additional, Delvau, N., additional, Penaloza, A, additional, Liistro, G, additional, Thys, F, additional, Delattre, I. K., additional, Hantson, P., additional, Roy, P. M., additional, Gianello, P., additional, Hadîrcă, L, additional, Ghidirimschi, A, additional, Catanoi, N, additional, Scurtov, N, additional, Bagrinovschi, M, additional, Sohn, Y. S., additional, Cho, Y. C., additional, Golovin, B., additional, Creciun, O., additional, Ghidirimschi, A., additional, Bagrinovschi, M., additional, Tabbara, R., additional, Whitgift, J. Z., additional, Ishimaru, A., additional, Yaguchi, A., additional, Akiduki, N., additional, Namiki, M., additional, Takeda, M., additional, Tamminen, J. N., additional, Uusaro, A., additional, Taylor, C. G., additional, Mills, E. D., additional, Mackay, A. D., additional, Ponzoni, C., additional, Rabello, R., additional, Serpa, A., additional, Assunção, M., additional, Pardini, A., additional, Shettino, G., additional, Corrêa, T., additional, Vidal-Cortés, P. V., additional, Álvarez-Rocha, L., additional, Fernández-Ugidos, P., additional, Virgós-Pedreira, A., additional, Pérez-Veloso, M. A., additional, Suárez-Paul, I. M., additional, Del Río-Carbajo, L., additional, Fernández, S. Pita, additional, Castro-Iglesias, A., additional, Butt, A., additional, Alghabban, A. A., additional, Khurshid, S. K., additional, Ali, Z. A., additional, Nizami, I. N., additional, Salahuddin, N. S., additional, Alshahrani, M., additional, Alsubaie, A. W., additional, Alshamsy, A. S., additional, Alkhiliwi, B. A., additional, Alshammari, H. K., additional, Alshammari, M. B., additional, Telmesani, N. K., additional, Alshammari, R. B., additional, Asonto, L. P., additional, Damiani, L. P., additional, Bozza, F, additional, El Khattate, A., additional, Bizrane, M., additional, Madani, N., additional, Belayachi, J., additional, Abouqal, R., additional, Ramnarain, D., additional, Gouw-Donders, B., additional, Benstoem, C., additional, Moza, A., additional, Meybohm, P., additional, Stoppe, C., additional, Autschbach, R., additional, Devane, D., additional, Goetzenich, A., additional, Taniguchi, L. U., additional, Araujo, L., additional, Salgado, G., additional, Vieira, J. M., additional, Viana, J., additional, Ziviani, N., additional, Pessach, I., additional, Lipsky, A., additional, Nimrod, A., additional, O´Connor, M., additional, Matot, I., additional, Segal, E., additional, Kluzik, A., additional, Gradys, A., additional, Smuszkiewicz, P., additional, Trojanowska, I., additional, Cybulski, M., additional, De Jong, A., additional, Sebbane, M., additional, Chanques, G., additional, Jaber, S., additional, Rosa, R., additional, Robinson, C., additional, Bessel, M., additional, Cavalheiro, L., additional, Madeira, L., additional, Rutzen, W., additional, Oliveira, R., additional, Maccari, J., additional, Falavigna, M., additional, Sanchez, E., additional, Dutra, F., additional, Dietrich, C., additional, Balzano, P., additional, Rezende, J., additional, Teixeira, C., additional, Sinha, S., additional, Majhi, K., additional, Gorlicki, J. G., additional, Pousset, F. P., additional, Kelly, J., additional, Aron, J., additional, Gilbert, A. Crerar, additional, Urankar, N. Prevec, additional, Irazabal, M., additional, Bosque, M., additional, Manciño, J., additional, Kotsopoulos, A., additional, Jansen, N., additional, Abdo, W., additional, Casey, Ú. M., additional, O’Brien, B., additional, Plant, R., additional, and Doyle, B., additional
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- 2017
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25. Breakthrough in cardiac arrest: reports from the 4th Paris International Conference
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Kudenchuk, P.J., Sandroni, C., Drinhaus, H.R., Böttiger, B.W., Cariou, A., Sunde, K., Dworschak, M., Taccone, F.S., Deye, N., Friberg, H., Laureys, S., Ledoux, D., Oddo, M., Legriel, S., Hantson, P., Diehl, J.L., and Laterre, P.F.
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Jean-Luc Diehl The French Intensive Care Society organized on 5th and 6th June 2014 its 4th "Paris International Conference in Intensive Care", whose principle is to bring together the best international experts on a hot topic in critical care medicine. The 2014 theme was "Breakthrough in cardiac arrest", with many high-quality updates on epidemiology, public health data, pre-hospital and in-ICU cares. The present review includes short summaries of the major presentations, classified into six main chapters: Epidemiology of CA Pre-hospital management Post-resuscitation management: targeted temperature management Post-resuscitation management: optimizing organ perfusion and metabolic parameters Neurological assessment of brain damages Public healthcare.
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- 2015
26. Protocol for meta-analysis of temperature reduction in animal models of cardiac arrest
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Olai, H., primary, Thornéus, G., additional, Watson, H., additional, Macleod, M.R., additional, Friberg, H., additional, Rhodes, J., additional, Nielsen, N., additional, Cronberg, T., additional, and Deierborg, T., additional
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- 2016
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27. Erratum zu: Postreanimationsbehandlung
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Nolan, J. P., primary, Soar, J., additional, Cariou, A., additional, Cronberg, T., additional, Moulaert, V. R. M., additional, Deakin, C., additional, Böttiger, B. W., additional, Friberg, H., additional, Sunde, K., additional, and Sandroni, C., additional
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- 2016
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28. Postreanimationsbehandlung
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Nolan, J.P., primary, Soar, J., additional, Cariou, A., additional, Cronberg, T., additional, Moulaert, V.R.M., additional, Deakin, C., additional, Böttiger, B.W., additional, Friberg, H., additional, Sunde, K., additional, and Sandroni, C., additional
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- 2015
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29. Association between Early Airway Intervention in the Pre-Hospital setting and Outcomes in Out of Hospital Cardiac Arrest Patients: a post-hoc analysis of the Target Temperature Management-2 (TTM2) trial.
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Battaglini D, Schiavetti I, Ball L, Christian Jakobsen J, Lilja G, Friberg H, David Wendel-Garcia P, Young PJ, Eastwood G, Chew MS, Unden J, Thomas M, Joannidis M, Nichol A, Lundin A, Hollenberg J, Hammond N, Saxena M, Martin A, Solar M, Silvio Taccone F, Dankiewicz J, Nielsen N, Morten Grejs A, Wise MP, Hängghi M, Smid O, Patroniti N, and Robba C
- Abstract
Introduction: Airway management is a critical component of out-of-hospital cardiac arrest (OHCA) resuscitation. The primary aim of this study was to describe pre-hospital airway management in adult patients post-OHCA. Secondary aims were to investigate whether tracheal intubation (TI) versus use of supraglottic airway device (SGA) was associated with patients' outcomes, including ventilator-free days within 26 days of randomization, 6 months neurological outcome and mortality., Methods: Secondary analysis of the Target Temperature Management-2 (TTM2) trial conducted in 13 countries, including adult patients with OHCA and return of spontaneous circulation, with data available on pre-hospital airway management. A multivariate logistic regression model with backward stepwise selection was employed to assess whether TI versus SGA was associated with outcomes., Results: Of the 1900 TTM2 trial patients, 1702 patients (89.5%) were included, with a mean age of 64 years (Standard Deviation, SD=13.53); 79.1% were males. Pre-hospital airway management was SGA in 484 (28.4%), and TI in 1218 (71.6%) patients. At hospital admission, 87.8% of patients with SGA and 98.5% with TI were mechanically ventilated (p<0.001). In the multivariate analysis, TI in comparison with SGA was not independently associated with an increase in ventilator-free days within 26 days of randomization, improved neurological outcomes, or decreased mortality. The hazard ratio for mortality with TI vs. SGA was 1.06, 95%Confidence Interval (CI) 0.88-1.28, p=0.54., Conclusions: In the multicentre randomized TTM2-trial including patients with OHCA, most patients received prehospital endotracheal intubation to manage their airway. The choice of pre-hospital airway device was not independently associated with patient clinical outcomes., Trial Registration Number: NCT02908308., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fabio Silvio Taccone reports a relationship with Bard Medical that includes: funding grants. Fabio Silvio Taccone reports a relationship with ZOLL Medical Corporation that includes: funding grants. Manoj Saxena reports a relationship with Bard Medical that includes: consulting or advisory and speaking and lecture fees. Niklas Nielsen reports a relationship with Bard Medical that includes: consulting or advisory and speaking and lecture fees. Manoji Saxena reports a relationship with BrainCoo that includes: consulting or advisory and speaking and lecture fees. Niklas Nielsen reports a relationship with BrainCoo that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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30. Efficacy and immunogenicity following dengue virus-1 human challenge after a tetravalent prime-boost dengue vaccine regimen: an open-label, phase 1 trial.
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Lyke KE, Chua JV, Koren M, Friberg H, Gromowski GD, Rapaka RR, Waickman AT, Joshi S, Strauss K, McCracken MK, Gutierrez-Barbosa H, Shrestha B, Culbertson C, Bernal P, De La Barrera RA, Currier JR, Jarman RG, and Edelman R
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- Humans, Adult, Male, Female, Young Adult, Adolescent, Middle Aged, Antibodies, Neutralizing blood, Vaccines, Attenuated immunology, Vaccines, Attenuated administration & dosage, Vaccines, Attenuated adverse effects, Vaccine Efficacy, Immunization, Secondary, Immunogenicity, Vaccine, Dengue Vaccines immunology, Dengue Vaccines adverse effects, Dengue Vaccines administration & dosage, Dengue prevention & control, Dengue immunology, Dengue Virus immunology, Antibodies, Viral blood
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Background: Dengue human infection models (DHIMs) are important tools to down-select dengue vaccine candidates and establish tetravalent efficacy before advanced clinical field trials. We aimed to provide data for the safety and immunogenicity of DHIM and evaluate dengue vaccine efficacy., Methods: We performed an open-label, phase 1 trial at the University of Maryland (Baltimore, MD, USA). Eligible participants were healthy individuals aged 18-50 years who either previously received a tetravalent dengue purified inactivated vaccine prime followed by a live-attenuated vaccine boost (ie, the vaccinee group), or were unvaccinated flavivirus-naive participants (ie, the control group). Participants in the vaccinee group with detectable pre-challenge dengue virus-1 neutralising antibody titres and flavivirus-naive participants in the control group were inoculated with dengue virus-1 strain 45AZ5 in the deltoid region, 27-65 months following booster dosing. These participants were followed-up from days 4-16 following dengue virus-1 live virus human challenge, with daily real-time quantitative PCR specific to dengue virus-1 RNA detection, and dengue virus-1 solicited local and systemic adverse events were recorded. The primary outcomes were safety (ie, solicited local and systemic adverse events) and vaccine efficacy (ie, dengue virus-1 RNAaemia) following dengue challenge. This study is registered with ClinicalTrials.gov, number NCT04786457., Findings: In January 2021, ten eligible participants were enrolled; of whom, six (60%) were in the vaccinee group and four (40%) were in the control group. Daily quantitative PCR detected dengue virus-1 RNA in nine (90%) of ten participants (five [83%] of six in the vaccinee group and all four [100%] in the control group). The mean onset of RNAaemia occurred on day 5 (SD 1·0) in the vaccinee group versus day 8 (1·5) in the control group (95% CI 1·1-4·9; p=0·007), with a trend towards reduced RNAaemia duration in the vaccinee group compared with the control group (8·2 days vs 10·5 days; 95% CI -0·08 to 4·68; p=0·056). Mild-to-moderate symptoms (nine [90%] of ten), leukopenia (eight [89%] of nine), and elevated aminotransferases (seven [78%] of nine) were commonly observed. Severe adverse events were detected only in the vaccinee group (fever ≥38·9°C in three [50%] of six, headache in one [17%], and transient grade 4 aspartate aminotransferase elevation in one [17%]). No deaths were reported., Interpretation: Participants who had tetravalent dengue purified inactivated vaccine prime and live-attenuated vaccine boost were unprotected against dengue virus-1 infection and further showed increased clinical, immunological, and transcriptomic evidence for inflammation potentially mediated by pre-existing infection-enhancing antibodies. This study highlights the impact of small cohort, human challenge models studying dengue pathogenesis and downstream vaccine development., Funding: Military Infectious Disease Research Program and Medical Technology Enterprise Consortium and Advanced Technology International., Competing Interests: Declaration of interests KEL receives funding from the Gates Medical Research Institute and The Medical Technology Enterprise. JVC receives research funding from Gilead Sciences and BD Biosciences. RRR is funded by a Mentored Clinical Scientist Career Development Award from National Institute of Allergy and Infectious Diseases (K08AI143923) during the completion of this work, and is currently employed at Moderna and might own Moderna shares. ATW is founder and co-owner of Azimuth Biologics, and a compensated Scientific Advisory Board member for Takeda Pharmaceuticals. RE is a consultant to Takeda Vaccines. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
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- 2024
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31. Prolonged Fatigue and Mental Health Challenges in Critical COVID-19 Survivors.
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Hultgren M, Didriksson I, Håkansson A, Andertun S, Frigyesi A, Mellerstedt E, Nelderup M, Nilsson AC, Reepalu A, Spångfors M, Friberg H, and Lilja G
- Abstract
Background: The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. Study Design and Methods: A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical significance and suggested values for a minimally important difference (MID). Potential risk factors for long-lasting symptoms were analyzed by multivariable logistic regression. Results: At the 3-month follow-up, 262 survivors (87%) participated, 215 (72%) returned at 12 months. Fatigue was reported by 50% versus 40%, with a significant improvement at 12 months (MFIS; median 38 vs. 33, P < .001, MID ≥4). There were no significant differences in symptoms of mental illness between 3 and 12 months, with anxiety present in 33% versus 28%, depression in 30% versus 22%, and posttraumatic stress disorder in 17% versus 13%. A worse functional outcome and less sleep compared to before COVID-19 were risk factors for fatigue and mental illness at 12 months. Conclusions: Fatigue improved between 3 and 12 months but was still common. Symptoms of mental illness remained unchanged with anxiety being the most reported. A worse functional outcome and less sleep compared to before COVID-19 were identified as risk factors for reporting long-lasting symptoms., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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32. Increasing plasma calprotectin (S100A8/A9) is associated with 12-month mortality and unfavourable functional outcome in critically ill COVID-19 patients.
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Didriksson I, Lengquist M, Spångfors M, Leffler M, Sievert T, Lilja G, Frigyesi A, Friberg H, and Schiopu A
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Background: Calprotectin (S100A8/A9) is a pro-inflammatory mediator primarily released from neutrophils. Previous studies have revealed associations between plasma calprotectin, disease severity and in-hospital mortality in unselected COVID-19 patients., Objective: We aimed to assess whether plasma calprotectin dynamics during the first week of intensive care are associated with mortality and functional outcome in critically ill COVID-19 patients., Methods: This prospective study included 498 COVID-19 patients admitted to six intensive care units (ICUs) in Sweden between May 2020 and May 2021. Blood samples were collected on ICU admission and on day 7. The primary outcome was 12-month mortality. Secondary outcomes were functional outcome of survivors at 3 and 12 months, and the need for invasive mechanical ventilation (IMV) or continuous renal replacement therapy (CRRT) during the ICU stay. Functional outcome was assessed by the Glasgow Outcome Scale Extended (GOSE, range 1-8, with < 5 representing an unfavourable outcome). Associations between plasma calprotectin and outcomes were examined in binary logistic regression analyses adjusted for age, sex, BMI, hypertension, smoking, and creatinine., Results: High plasma calprotectin on admission and day 7 was independently associated with increased 12-month mortality. Increasing calprotectin from admission to day 7 was independently associated with higher mortality at 12 months [OR 2.10 (95% CI 1.18-3.74), p = 0.012], unfavourable functional outcome at 3 months [OR 2.53 (95% CI 1.07-6.10), p = 0.036], and the use of IMV [OR 2.23 (95% CI 1.10-4.53), p = 0.027)] and CRRT [OR 2.07 (95% CI 1.07-4.00), p = 0.031)]. A receiver operator characteristic (ROC) model including day 7 calprotectin and age was a good predictor of 12-month mortality [AUC 0.79 (95% CI 0.74-0.84), p < 0.001]. Day 7 calprotectin alone predicted an unfavourable functional outcome at 3 months [AUC 0.67 (95% CI 0.58-0.76), p < 0.001]., Conclusion: In critically ill COVID-19 patients, increasing calprotectin levels after admission to the ICU are associated with 12-month mortality and unfavourable functional outcome in survivors. Monitoring plasma calprotectin dynamics in the ICU may be considered to evaluate prognosis in critical COVID-19., Study Registration: ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020., (© 2024. The Author(s).)
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- 2024
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33. Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest: a prospective multicentre study.
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Lang M, Kenda M, Scheel M, Martola J, Wheeler M, Owen S, Johnsson M, Annborn M, Dankiewicz J, Deye N, Düring J, Friberg H, Halliday T, Jakobsen JC, Lascarrou JB, Levin H, Lilja G, Lybeck A, McGuigan P, Rylander C, Sem V, Thomas M, Ullén S, Undén J, Wise MP, Cronberg T, Wassélius J, Nielsen N, Leithner C, and Moseby-Knappe M
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- Humans, Male, Prospective Studies, Female, Middle Aged, Aged, Prognosis, Hypothermia, Induced methods, Hypothermia, Induced standards, Head diagnostic imaging, Predictive Value of Tests, Tomography, X-Ray Computed methods, Tomography, X-Ray Computed standards, Tomography, X-Ray Computed statistics & numerical data, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest diagnostic imaging
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Purpose: Application of standardised and automated assessments of head computed tomography (CT) for neuroprognostication after out-of-hospital cardiac arrest., Methods: Prospective, international, multicentre, observational study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial. Routine CTs from adult unconscious patients obtained > 48 h ≤ 7 days post-arrest were assessed qualitatively and quantitatively by seven international raters blinded to clinical information using a pre-published protocol. Grey-white-matter ratio (GWR) was calculated from four (GWR-4) and eight (GWR-8) regions of interest manually placed at the basal ganglia level. Additionally, GWR was obtained using an automated atlas-based approach. Prognostic accuracies for prediction of poor functional outcome (modified Rankin Scale 4-6) for the qualitative assessment and for the pre-defined GWR cutoff < 1.10 were calculated., Results: 140 unconscious patients were included; median age was 68 years (interquartile range [IQR] 59-76), 76% were male, and 75% had poor outcome. Standardised qualitative assessment and all GWR models predicted poor outcome with 100% specificity (95% confidence interval [CI] 90-100). Sensitivity in median was 37% for the standardised qualitative assessment, 39% for GWR-8, 30% for GWR-4 and 41% for automated GWR. GWR-8 was superior to GWR-4 regarding prognostic accuracies, intra- and interrater agreement. Overall prognostic accuracy for automated GWR (area under the curve [AUC] 0.84, 95% CI 0.77-0.91) did not significantly differ from manually obtained GWR., Conclusion: Standardised qualitative and quantitative assessments of CT are reliable and feasible methods to predict poor functional outcome after cardiac arrest. Automated GWR has the potential to make CT quantification for neuroprognostication accessible to all centres treating cardiac arrest patients., (© 2024. The Author(s).)
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- 2024
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34. Hypothermia After Cardiac Arrest in Large Animals (HACA-LA): Study protocol of a randomized controlled experimental trial.
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Persson O, Valerianova A, Bělohlávek J, Cronberg T, Nielsen N, Englund E, Mlček M, and Friberg H
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Background: Induced hypothermia post-cardiac arrest is neuroprotective in animal experiments, but few high-quality studies have been performed in larger animals with human-like brains. The neuroprotective effect of postischemic hypothermia has recently been questioned in human trials. Our aim is to investigate whether hypothermia post-cardiac arrest confers a benefit compared to normothermia in large adult animals. Our hypothesis is that induced hypothermia post cardiac arrest is neuroprotective and that the effect diminishes when delayed two hours ., Methods: Adult female pigs were anesthetized, mechanically ventilated and kept at baseline parameters including normothermia (38 °C). All animals were subjected to ten minutes of cardiac arrest (no-flow) by induced ventricular fibrillation, followed by four minutes of cardiopulmonary resuscitation with mechanical compressions, prior to the first countershock. Animals with sustained return of spontaneous circulation (systolic blood pressure >60 mmHg for ten minutes) within fifteen minutes from start of life support were included and randomized to three groups; immediate or delayed (2 h) intravenous cooling, both targeting 33 °C, or intravenously controlled normothermia (38 °C). Temperature control was applied for thirty hours including cooling time, temperature at target and controlled rewarming (0.5 °C/h). Animals were extubated and kept alive for seven days. The primary outcome measure is histological brain injury on day seven. Secondary outcomes include neurological and neurocognitive recovery, and the trajectory of biomarkers of brain injury., Conclusion: High-quality animal experiments in clinically relevant large animal models are necessary to close the gap of knowledge regarding neuroprotective effects of induced hypothermia after cardiac arrest. Trial registration: Preclinicaltrials.eu (PCTE0000272), published 2021-11-03., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)
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- 2024
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35. Lateral episiotomy or no episiotomy in vacuum assisted delivery in nulliparous women (EVA): multicentre, open label, randomised controlled trial.
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Bergendahl S, Jonsson M, Hesselman S, Ankarcrona V, Leijonhufvud Å, Wihlbäck AC, Wallström T, Rydström E, Friberg H, Kopp Kallner H, and Brismar Wendel S
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- Humans, Female, Pregnancy, Adult, Sweden, Obstetric Labor Complications prevention & control, Lacerations prevention & control, Lacerations etiology, Young Adult, Episiotomy methods, Episiotomy statistics & numerical data, Episiotomy adverse effects, Vacuum Extraction, Obstetrical adverse effects, Anal Canal injuries, Parity
- Abstract
Objective: To assess the effect of lateral episiotomy, compared with no episiotomy, on obstetric anal sphincter injury in nulliparous women requiring vacuum extraction., Design: A multicentre, open label, randomised controlled trial., Setting: Eight hospitals in Sweden, 2017-23., Participants: 717 nulliparous women with a single live fetus of 34 gestational weeks or more, requiring vacuum extraction were randomly assigned (1:1) to lateral episiotomy or no episiotomy using sealed opaque envelopes. Randomisation was stratified by study site., Intervention: A standardised lateral episiotomy was performed during the vacuum extraction, at crowning of the fetal head, starting 1-3 cm from the posterior fourchette, at a 60° (45-80°) angle from the midline, and 4 cm (3-5 cm) long. The comparison was no episiotomy unless considered indispensable., Main Outcome Measures: The primary outcome of the episiotomy in vacuum assisted delivery (EVA) trial was obstetric anal sphincter injury, clinically diagnosed by combined visual inspection and digital rectal and vaginal examination. The primary analysis used a modified intention-to-treat population that included all consenting women with attempted or successful vacuum extraction. As a result of an interim analysis at significance level P<0.01, the primary endpoint was tested at 4% significance level with accompanying 96% confidence interval (CI)., Results: From 1 July 2017 to 15 February 2023, 717 women were randomly assigned: 354 (49%) to lateral episiotomy and 363 (51%) to no episiotomy. Before vacuum extraction attempt, one woman withdrew consent and 14 had a spontaneous birth, leaving 702 for the primary analysis. In the intervention group, 21 (6%) of 344 women sustained obstetric anal sphincter injury, compared with 47 (13%) of 358 women in the comparison group (P=0.002). The risk difference was -7.0% (96% CI -11.7% to -2.5%). The risk ratio adjusted for site was 0.47 (96% CI 0.23 to 0.97) and unadjusted risk ratio was 0.46 (0.28 to 0.78). No significant differences were noted between groups in postpartum pain, blood loss, neonatal outcomes, or total adverse events, but the intervention group had more wound infections and dehiscence., Conclusions: Lateral episiotomy can be recommended for nulliparous women requiring vacuum extraction to significantly reduce the risk of obstetric anal sphincter injury., Trial Registration: ClinicalTrials.gov NCT02643108., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: funding from the Swedish Research Council (2016-00526), the Stockholm Region (FoUI-960261/2021), and the Uppsala-Örebro Research Council (RFR-939428); no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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36. Sepsis mimics among presumed sepsis patients at intensive care admission: a retrospective observational study.
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Lengquist M, Varadarajan A, Alestam S, Friberg H, Frigyesi A, and Mellhammar L
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- Humans, Retrospective Studies, Male, Female, Middle Aged, Aged, Sweden epidemiology, Aged, 80 and over, Adult, Diagnosis, Differential, Sepsis diagnosis, Sepsis mortality, Intensive Care Units statistics & numerical data
- Abstract
Background: Diagnosing sepsis remains a challenge because of the lack of gold-standard diagnostics. Since there are no simple, broadly accepted criteria for infection, there is a risk of misclassifying sepsis patients (sepsis mimics) among patients with organ failure. The main objective of this study was to investigate the proportion of non-infected patients (sepsis mimics) in ICU patients with presumed sepsis at intensive care unit (ICU) admission., Methods: Adult patients were screened retrospectively during 3.5 years in four ICUs in Sweden for fulfilment of the sepsis-3 criteria at ICU admission (presumed sepsis). Proxy criteria for suspected infection were sampled blood culture(s) and concomitant antibiotic administration. Culture-negative presumed sepsis patients were screened for infection according to the Linder-Mellhammar Criteria of Infection (LMCI). Sepsis mimics were defined as without probable infection according to the LMCI. Confirmed sepsis was defined as presumed sepsis after the exclusion of sepsis mimics., Results: In the ICU presumed sepsis cohort (2664 patients), 25% were considered sepsis mimics. The most common reasons for ICU admission among sepsis mimics were acute heart failure and unspecific respiratory failure. Comparing sepsis mimics and confirmed sepsis showed that confirmed sepsis patients were slightly more severely ill but had similar mortality. C-reactive protein had modest discriminatory power (AUROC 0.71) with confirmed sepsis as the outcome., Conclusions: One-fourth of a presumed ICU sepsis population identified with the sepsis-3 criteria could be considered sepsis mimics. The high proportion of sepsis mimics has a potential dilutional effect on the presumed sepsis population, which threatens the validity of results from sepsis studies using recommended sepsis criteria., (© 2024. The Author(s).)
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- 2024
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37. Low-dose dengue virus 3 human challenge model: a phase 1 open-label study.
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Waickman AT, Newell K, Lu JQ, Fang H, Waldran M, Gebo C, Currier JR, Friberg H, Jarman RG, Klick MD, Ware LA, Endy TP, and Thomas SJ
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- Humans, Adult, Male, Female, Young Adult, Cytokines blood, Cytokines metabolism, RNA, Viral blood, Seroconversion, Memory T Cells immunology, Middle Aged, Dengue Virus immunology, Dengue immunology, Dengue virology, Dengue Vaccines immunology, Dengue Vaccines administration & dosage, Dengue Vaccines adverse effects, Antibodies, Viral blood, Antibodies, Viral immunology, Viremia
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Dengue human infection models present an opportunity to explore the potential of a vaccine, anti-viral or immuno-compound for clinical benefit in a controlled setting. Here we report the outcome of a phase 1 open-label assessment of a low-dose dengue virus 3 (DENV-3) challenge model (NCT04298138), in which nine participants received a subcutaneous inoculation with 0.5 ml of a 1.4 × 10
3 plaque-forming unit per ml suspension of the attenuated DENV-3 strain CH53489. The primary and secondary endpoints of the study were to assess the safety of this DENV-3 strain in healthy flavivirus-seronegative individuals. All participants developed RNAaemia within 7 days after inoculation with peak titre ranging from 3.13 × 104 to 7.02 × 108 genome equivalents per ml. Solicited symptoms such as fever and rash, clinical laboratory abnormalities such as lymphopenia and thrombocytopenia, and self-reported symptoms such as myalgia were consistent with mild-to-moderate dengue in all volunteers. DENV-3-specific seroconversion and memory T cell responses were observed within 14 days after inoculation as assessed by enzyme-linked immunosorbent assay and interferon-gamma-based enzyme-linked immunospot. RNA sequencing and serum cytokine analysis revealed anti-viral responses that overlapped with the period of viraemia. The magnitude and frequency of clinical and immunologic endpoints correlated with an individual's peak viral titre., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)- Published
- 2024
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38. Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest.
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Arctaedius I, Levin H, Thorgeirsdóttir B, Moseby-Knappe M, Cronberg T, Annborn M, Nielsen N, Zetterberg H, Blennow K, Ashton NJ, Frigyesi A, Friberg H, Lybeck A, and Mattsson-Carlgren N
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- Humans, Glial Fibrillary Acidic Protein, Retrospective Studies, Intermediate Filaments, Prognosis, Biomarkers, Out-of-Hospital Cardiac Arrest
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Background: The purpose was to evaluate glial fibrillary acidic protein (GFAP) and total-tau in plasma as predictors of poor neurological outcome after out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA), including comparisons with neurofilament light (NFL) and neuron-specific enolase (NSE)., Methods: Retrospective multicentre observational study of patients admitted to an intensive care unit (ICU) in three hospitals in Sweden 2014-2018. Blood samples were collected at ICU admission, 12 h, and 48 h post-cardiac arrest. Poor neurological outcome was defined as Cerebral Performance Category 3-5 at 2-6 months after cardiac arrest. Plasma samples were retrospectively analysed for GFAP, tau, and NFL. Serum NSE was analysed in clinical care. Prognostic performances were tested with the area under the receiver operating characteristics curve (AUC)., Results: Of the 428 included patients, 328 were OHCA, and 100 were IHCA. At ICU admission, 12 h and 48 h post-cardiac arrest, GFAP predicted neurological outcome after OHCA with AUC (95% CI) 0.76 (0.70-0.82), 0.86 (0.81-0.90) and 0.91 (0.87-0.96), and after IHCA with AUC (95% CI) 0.77 (0.66-0.87), 0.83 (0.74-0.92) and 0.83 (0.71-0.95). At the same time points, tau predicted outcome after OHCA with AUC (95% CI) 0.72 (0.66-0.79), 0.75 (0.69-0.81), and 0.93 (0.89-0.96) and after IHCA with AUC (95% CI) 0.61 (0.49-0.74), 0.68 (0.56-0.79), and 0.77 (0.65-0.90). Adding the change in biomarker levels between time points did not improve predictive accuracy compared to the last time point. In a subset of patients, GFAP at 12 h and 48 h, as well as tau at 48 h, offered similar predictive value as NSE at 48 h (the earliest time point NSE is recommended in guidelines) after both OHCA and IHCA. The predictive performance of NFL was similar or superior to GFAP and tau at all time points after OHCA and IHCA., Conclusion: GFAP and tau are promising biomarkers for neuroprognostication, with the highest predictive performance at 48 h after OHCA, but not superior to NFL. The predictive ability of GFAP may be sufficiently high for clinical use at 12 h after cardiac arrest., (© 2024. The Author(s).)
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- 2024
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39. 2021 European Resuscitation Council/European Society of Intensive Care Medicine Algorithm for Prognostication of Poor Neurological Outcome After Cardiac Arrest-Can Entry Criteria Be Broadened?
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Arctaedius I, Levin H, Larsson M, Friberg H, Cronberg T, Nielsen N, Moseby-Knappe M, and Lybeck A
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- Aged, Female, Humans, Male, Critical Care, Prognosis, Retrospective Studies, Middle Aged, Cardiopulmonary Resuscitation methods, Hypothermia, Induced methods, Out-of-Hospital Cardiac Arrest therapy
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Objectives: To explore broadened entry criteria of the 2021 European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM) algorithm for neuroprognostication including patients with ongoing sedation and Glasgow Coma Scale-Motor score (GCS-M) scores 4-5., Design: Retrospective multicenter observational study., Setting: Four ICUs, Skane, Sweden., Patients: Postcardiac arrest patients managed at targeted temperature 36°C, 2014-2018. Neurologic outcome was assessed after 2-6 months according to the Cerebral Performance Category scale., Interventions: None., Measurements and Main Results: In 794 included patients, median age was 69.5 years (interquartile range, 60.6-77.0 yr), 241 (30.4%) were female, 550 (69.3%) had an out-of-hospital cardiac arrest, and 314 (41.3%) had a shockable rhythm. Four hundred ninety-five patients were dead at follow-up, 330 of 495 died after a decision on withdrawal of life-sustaining therapies. At 72 hours after cardiac arrest 218 patients remained unconscious. The entry criteria of the original algorithm (GCS-M 1-3) was fulfilled by 163 patients and 115 patients with poor outcome were identified, with false positive rate (FPR) of 0% (95% CI, 0-79.4%) and sensitivity of 71.0% (95% CI, 63.6-77.4%). Inclusion of patients with ongoing sedation identified another 13 patients with poor outcome, generating FPR of 0% (95% CI, 0-65.8%) and sensitivity of 69.6% (95% CI, 62.6-75.8%). Inclusion of all unconscious patients (GCS-M 1-5), regardless of sedation, identified one additional patient, generating FPR of 0% (95% CI, 0-22.8) and sensitivity of 62.9% (95% CI, 56.1-69.2). The few patients with true negative prediction (patients with good outcome not fulfilling guideline criteria of a poor outcome) generated wide 95% CI for FPR., Conclusion: The 2021 ERC/ESICM algorithm for neuroprognostication predicted poor neurologic outcome with a FPR of 0%. Broadening inclusion criteria to include all unconscious patients regardless of ongoing sedation identified an additional small number of patients with poor outcome but did not affect the FPR. Results are limited by high rate of withdrawal of life-sustaining therapies and few patients with true negative prediction., Competing Interests: Dr. Arctaedius received funding from Tegger Stiftelsen and Swedish Society of Anesthesiology and Intensive Care (for educational purpose and not research related). Dr. Friberg disclosed they participated in the 2021 European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM) advisory statement on neuroprognostication after cardiac arrest. Dr. Cronberg disclosed they were a guideline author of the 2021 ERC/ESICM guidelines for postresuscitation care. Drs. Moseby-Knappe’s and Lybeck’s institutions received funding from the Swedish National Health Service and Regional Research Support Region Skåne. Dr. Moseby-Knappe’s institution received funding from the Segerfalk Foundation at Lund University and the Bundy Academy at Lund University. The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)
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- 2024
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40. Plasma neutrophil gelatinase-associated lipocalin independently predicts dialysis need and mortality in critical COVID-19.
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Engström J, Koozi H, Didriksson I, Larsson A, Friberg H, Frigyesi A, and Spångfors M
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- Adult, Humans, Lipocalin-2, Cystatin C, Cohort Studies, Prospective Studies, Creatinine, Renal Dialysis, Biomarkers, COVID-19 therapy, Acute Kidney Injury
- Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) is a novel kidney injury and inflammation biomarker. We investigated whether NGAL could be used to predict continuous renal replacement therapy (CRRT) and mortality in critical coronavirus disease 2019 (COVID-19). This prospective multicenter cohort study included adult COVID-19 patients in six intensive care units (ICUs) in Sweden between May 11, 2020 and May 10, 2021. Blood was sampled at admission, days two and seven in the ICU. The samples were batch analyzed for NGAL, creatinine, and cystatin c after the end of the study period. Initiation of CRRT and 90-day survival were used as dependent variables in regression models. Of 498 included patients, 494 were analyzed regarding CRRT and 399 were analyzed regarding survival. Seventy patients received CRRT and 154 patients did not survive past 90 days. NGAL, in combination with creatinine and cystatin c, predicted the subsequent initiation of CRRT with an area under the curve (AUC) of 0.95. For mortality, NGAL, in combination with age and sex, had an AUC of 0.83. In conclusion, NGAL is a valuable biomarker for predicting subsequent initiation of CRRT and 90-day mortality in critical COVID-19. NGAL should be considered when developing future clinical scoring systems., (© 2024. The Author(s).)
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- 2024
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41. Protective Role of NS1-Specific Antibodies in the Immune Response to Dengue Virus through Antibody-Dependent Cellular Cytotoxicity.
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Sanchez-Vargas LA, Mathew A, Salje H, Sousa D, Casale NA, Farmer A, Buddhari D, Anderson K, Iamsirithaworn S, Kaewhiran S, Friberg H, Currier JR, and Rothman AL
- Abstract
Background: Dengue virus (DENV) non-structural protein 1 (NS1) has multiple functions within infected cells, on the cell surface, and in secreted form, and is highly immunogenic. Immunity from previous DENV infections is known to exert both positive and negative effects on subsequent DENV infections, but the contribution of NS1-specific antibodies to these effects is incompletely understood., Methods: We investigated the functions of NS1-specific antibodies and their significance in DENV infection. We analyzed plasma samples collected in a prospective cohort study prior to symptomatic or subclinical secondary DENV infection. We measured binding to purified recombinant NS1 protein and to NS1-expressing CEM cells, antibody-mediated NK cell activation by plate-bound NS1 protein, and antibody-dependent cellular cytotoxicity (ADCC) of NS1-expressing target cells., Results: We found that antibody responses to NS1 were highly serotype-cross-reactive and that subjects who experienced subclinical DENV infection had significantly higher antibody responses to NS1 in pre-infection plasma than subjects who experienced symptomatic infection. We observed strong positive correlations between antibody binding and NK activation., Conclusions: These findings demonstrate the involvement of NS1-specific antibodies in ADCC and provide evidence for a protective effect of NS1-specific antibodies in secondary DENV infection., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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42. Agreement between self-reported and objectively assessed physical activity among out-of-hospital cardiac arrest survivors.
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Heimburg K, Lilja G, Blennow Nordström E, Friberg H, Gregersen Oestergaard L, Grejs AM, Keeble TR, Mion M, Nielsen N, Rylander C, Segerström M, Thomsen IK, Ullén S, Undén J, Wise MP, Cronberg T, and Tornberg ÅB
- Subjects
- Humans, Self Report, Cross-Sectional Studies, Exercise, Survivors, Accelerometry, Out-of-Hospital Cardiac Arrest diagnosis, Out-of-Hospital Cardiac Arrest therapy
- Abstract
Background: Low level of physical activity is a risk factor for new cardiac events in out-of-hospital cardiac arrest (OHCA) survivors. Physical activity can be assessed by self-reporting or objectively by accelerometery., Aim: To investigate the agreement between self-reported and objectively assessed physical activity among OHCA survivors HYPOTHESIS: Self-reported levels of physical activity will show moderate agreement with objectively assessed levels of physical activity., Method: Cross-sectional study including OHCA survivors in Sweden, Denmark, and the United Kingdom. Two questions about moderate and vigorous intensity physical activity during the last week were used as self-reports. Moderate and vigorous intensity physical activity were objectively assessed with accelerometers (ActiGraph GT3X-BT) worn upon the right hip for 7 consecutive days., Results: Forty-nine of 106 OHCA survivors answered the two questions for self-reporting and had 7 valid days of accelerometer assessment. More physically active days were registered by self-report compared with accelerometery for both moderate intensity (median 5 [3:7] vs. 3 [0:5] days; p < 0.001) and vigorous intensity (1 [0:3] vs. 0 [0:0] days; p < 0.001). Correlations between self-reported and accelerometer assessed physical activity were sufficient (moderate intensity: r
s = 0.336, p = 0.018; vigorous intensity: rs = 0.375, p = 0.008), and agreements were fair and none to slight (moderate intensity: k = 0.269, p = 0.001; vigorous intensity: k = 0.148, p = 0.015). The categorization of self-reported versus objectively assessed physical activity showed that 26% versus 65% had a low level of physical activity., Conclusion: OHCA survivors reported more physically active days compared with the results of the accelerometer assessment and correlated sufficiently and agreed fairly and none to slightly., (© 2023 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.)- Published
- 2024
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43. Hypothermia vs Normothermia in Patients With Cardiac Arrest and Nonshockable Rhythm: A Meta-Analysis.
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Taccone FS, Dankiewicz J, Cariou A, Lilja G, Asfar P, Belohlavek J, Boulain T, Colin G, Cronberg T, Frat JP, Friberg H, Grejs AM, Grillet G, Girardie P, Haenggi M, Hovdenes J, Jakobsen JC, Levin H, Merdji H, Njimi H, Pelosi P, Rylander C, Saxena M, Thomas M, Young PJ, Wise MP, Nielsen N, and Lascarrou JB
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- Male, Adult, Humans, Aged, Prognosis, Unconsciousness, Out-of-Hospital Cardiac Arrest therapy, Hypothermia, Induced methods, Hypothermia, Cardiopulmonary Resuscitation
- Abstract
Importance: International guidelines recommend body temperature control below 37.8 °C in unconscious patients with out-of-hospital cardiac arrest (OHCA); however, a target temperature of 33 °C might lead to better outcomes when the initial rhythm is nonshockable., Objective: To assess whether hypothermia at 33 °C increases survival and improves function when compared with controlled normothermia in unconscious adults resuscitated from OHCA with initial nonshockable rhythm., Data Sources: Individual patient data meta-analysis of 2 multicenter, randomized clinical trials (Targeted Normothermia after Out-of-Hospital Cardiac Arrest [TTM2; NCT02908308] and HYPERION [NCT01994772]) with blinded outcome assessors. Unconscious patients with OHCA and an initial nonshockable rhythm were eligible for the final analysis., Study Selection: The study cohorts had similar inclusion and exclusion criteria. Patients were randomized to hypothermia (target temperature 33 °C) or normothermia (target temperature 36.5 to 37.7 °C), according to different study protocols, for at least 24 hours. Additional analyses of mortality and unfavorable functional outcome were performed according to age, sex, initial rhythm, presence or absence of shock on admission, time to return of spontaneous circulation, lactate levels on admission, and the cardiac arrest hospital prognosis score., Data Extraction and Synthesis: Only patients who experienced OHCA and had a nonshockable rhythm with all causes of cardiac arrest were included. Variables from the 2 studies were available from the original data sets and pooled into a unique database and analyzed. Clinical outcomes were harmonized into a single file, which was checked for accuracy of numbers, distributions, and categories. The last day of follow-up from arrest was recorded for each patient. Adjustment for primary outcome and functional outcome was performed using age, gender, time to return of spontaneous circulation, and bystander cardiopulmonary resuscitation., Main Outcomes and Measures: The primary outcome was mortality at 3 months; secondary outcomes included unfavorable functional outcome at 3 to 6 months, defined as a Cerebral Performance Category score of 3 to 5., Results: A total of 912 patients were included, 490 from the TTM2 trial and 422 from the HYPERION trial. Of those, 442 had been assigned to hypothermia (48.4%; mean age, 65.5 years; 287 males [64.9%]) and 470 to normothermia (51.6%; mean age, 65.6 years; 327 males [69.6%]); 571 patients had a first monitored rhythm of asystole (62.6%) and 503 a presumed noncardiac cause of arrest (55.2%). At 3 months, 354 of 442 patients in the hypothermia group (80.1%) and 386 of 470 patients in the normothermia group (82.1%) had died (relative risk [RR] with hypothermia, 1.04; 95% CI, 0.89-1.20; P = .63). On the last day of follow-up, 386 of 429 in the hypothermia group (90.0%) and 413 of 463 in the normothermia group (89.2%) had an unfavorable functional outcome (RR with hypothermia, 0.99; 95% CI, 0.87-1.15; P = .97). The association of hypothermia with death and functional outcome was consistent across the prespecified subgroups., Conclusions and Relevance: In this individual patient data meta-analysis, including unconscious survivors from OHCA with an initial nonshockable rhythm, hypothermia at 33 °C did not significantly improve survival or functional outcome.
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- 2024
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44. Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society.
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Hirsch KG, Abella BS, Amorim E, Bader MK, Barletta JF, Berg K, Callaway CW, Friberg H, Gilmore EJ, Greer DM, Kern KB, Livesay S, May TL, Neumar RW, Nolan JP, Oddo M, Peberdy MA, Poloyac SM, Seder D, Taccone FS, Uzendu A, Walsh B, Zimmerman JL, and Geocadin RG
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- United States, Humans, American Heart Association, Critical Care methods, Cardiopulmonary Resuscitation methods, Heart Arrest therapy, Emergency Medical Services
- Abstract
The critical care management of patients after cardiac arrest is burdened by a lack of high-quality clinical studies and the resultant lack of high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty and variability in management. Critical care management is crucial in patients after cardiac arrest and affects outcome. Although guidelines address some relevant topics (including temperature control and neurological prognostication of comatose survivors, 2 topics for which there are more robust clinical studies), many important subject areas have limited or nonexistent clinical studies, leading to the absence of guidelines or low-certainty evidence. The American Heart Association Emergency Cardiovascular Care Committee and the Neurocritical Care Society collaborated to address this gap by organizing an expert consensus panel and conference. Twenty-four experienced practitioners (including physicians, nurses, pharmacists, and a respiratory therapist) from multiple medical specialties, levels, institutions, and countries made up the panel. Topics were identified and prioritized by the panel and arranged by organ system to facilitate discussion, debate, and consensus building. Statements related to postarrest management were generated, and 80% agreement was required to approve a statement. Voting was anonymous and web based. Topics addressed include neurological, cardiac, pulmonary, hematological, infectious, gastrointestinal, endocrine, and general critical care management. Areas of uncertainty, areas for which no consensus was reached, and future research directions are also included. Until high-quality studies that inform practice guidelines in these areas are available, the expert panel consensus statements that are provided can advise clinicians on the critical care management of patients after cardiac arrest., (© 2023. The Author(s).)
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- 2024
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45. The predictive value of highly malignant EEG patterns after cardiac arrest: evaluation of the ERC-ESICM recommendations.
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Turella S, Dankiewicz J, Friberg H, Jakobsen JC, Leithner C, Levin H, Lilja G, Moseby-Knappe M, Nielsen N, Rossetti AO, Sandroni C, Zubler F, Cronberg T, and Westhall E
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- Humans, Critical Care, Electroencephalography methods, Prognosis, Clinical Trials as Topic, Multicenter Studies as Topic, Cardiopulmonary Resuscitation methods, Heart Arrest diagnosis, Heart Arrest therapy, Hypothermia, Induced methods
- Abstract
Purpose: The 2021 guidelines endorsed by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) recommend using highly malignant electroencephalogram (EEG) patterns (HMEP; suppression or burst-suppression) at > 24 h after cardiac arrest (CA) in combination with at least one other concordant predictor to prognosticate poor neurological outcome. We evaluated the prognostic accuracy of HMEP in a large multicentre cohort and investigated the added value of absent EEG reactivity., Methods: This is a pre-planned prognostic substudy of the Targeted Temperature Management trial 2. The presence of HMEP and background reactivity to external stimuli on EEG recorded > 24 h after CA was prospectively reported. Poor outcome was measured at 6 months and defined as a modified Rankin Scale score of 4-6. Prognostication was multimodal, and withdrawal of life-sustaining therapy (WLST) was not allowed before 96 h after CA., Results: 845 patients at 59 sites were included. Of these, 579 (69%) had poor outcome, including 304 (36%) with WLST due to poor neurological prognosis. EEG was recorded at a median of 71 h (interquartile range [IQR] 52-93) after CA. HMEP at > 24 h from CA had 50% [95% confidence interval [CI] 46-54] sensitivity and 93% [90-96] specificity to predict poor outcome. Specificity was similar (93%) in 541 patients without WLST. When HMEP were unreactive, specificity improved to 97% [94-99] (p = 0.008)., Conclusion: The specificity of the ERC-ESICM-recommended EEG patterns for predicting poor outcome after CA exceeds 90% but is lower than in previous studies, suggesting that large-scale implementation may reduce their accuracy. Combining HMEP with an unreactive EEG background significantly improved specificity. As in other prognostication studies, a self-fulfilling prophecy bias may have contributed to observed results., (© 2024. The Author(s).)
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- 2024
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46. Cortical somatosensory evoked potential amplitudes and clinical outcome after cardiac arrest: a retrospective multicenter study.
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Aalberts N, Westhall E, Johnsen B, Hahn K, Kenda M, Cronberg T, Friberg H, Preuß S, Ploner CJ, Storm C, Nee J, Leithner C, and Endisch C
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- Humans, Cohort Studies, Retrospective Studies, Evoked Potentials, Somatosensory physiology, Prognosis, Coma diagnosis, Coma etiology, Heart Arrest complications
- Abstract
Objective: Bilaterally absent cortical somatosensory evoked potentials (SSEPs) reliably predict poor outcome in comatose cardiac arrest (CA) patients. Cortical SSEP amplitudes are a recent prognostic extension; however, amplitude thresholds, inter-recording, and inter-rater agreement remain uncertain., Methods: In a retrospective multicenter cohort study, we determined cortical SSEP amplitudes of comatose CA patients using a standardized evaluation pathway. We studied inter-recording agreement in repeated SSEPs and inter-rater agreement by four raters independently determining 100 cortical SSEP amplitudes. Primary outcome was assessed using the cerebral performance category (CPC) upon intensive care unit discharge dichotomized into good (CPC 1-3) and poor outcome (CPC 4-5)., Results: Of 706 patients with SSEPs with median 3 days after CA, 277 (39.2%) had good and 429 (60.8%) poor outcome. Of patients with bilaterally absent cortical SSEPs, one (0.8%) survived with CPC 3 and 130 (99.2%) had poor outcome. Otherwise, the lowest cortical SSEP amplitude in good outcome patients was 0.5 µV. 184 (42.9%) of 429 poor outcome patients had lower cortical SSEP amplitudes. In 106 repeated SSEPs, there were 6 (5.7%) with prognostication-relevant changes in SSEP categories. Following a standardized evaluation pathway, inter-rater agreement was almost perfect with a Fleiss' kappa of 0.88., Interpretation: Bilaterally absent and cortical SSEP amplitudes below 0.5 µV predicted poor outcome with high specificity. A standardized evaluation pathway provided high inter-rater and inter-recording agreement. Regain of consciousness in patients with bilaterally absent cortical SSEPs rarely occurs. High-amplitude cortical SSEP amplitudes likely indicate the absence of severe brain injury., (© 2023. The Author(s).)
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- 2023
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47. [The Swecrit Biobank, associated clinical registries, and machine learning (artificial intelligence) improve critical care knowledge].
- Author
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Frigyesi A, Lengquist M, Johnsson P, Lybeck A, Spångfors M, Helena L, Jakobsson A, and Friberg H
- Subjects
- Humans, Proteomics, Machine Learning, Critical Care, Registries, Artificial Intelligence, Biological Specimen Banks
- Abstract
The unique Swecrit Biobank and its associated clinical registries for sepsis, ARDS, cardiac arrest, trauma, and COVID-19 include more than 150,000 blood samples and descriptions of critically ill patients. These assets provide a unique opportunity to research and improve the care of the most seriously ill patients through biomarker analyses, proteomic studies, and genetic and epigenetic studies using modern machine learning techniques (artificial intelligence). Interested researchers are invited to submit their proposals and participate.
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- 2023
48. Effects of Hypothermia vs Normothermia on Societal Participation and Cognitive Function at 6 Months in Survivors After Out-of-Hospital Cardiac Arrest: A Predefined Analysis of the TTM2 Randomized Clinical Trial.
- Author
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Lilja G, Ullén S, Dankiewicz J, Friberg H, Levin H, Nordström EB, Heimburg K, Jakobsen JC, Ahlqvist M, Bass F, Belohlavek J, Olsen RB, Cariou A, Eastwood G, Fanebust HR, Grejs AM, Grimmer L, Hammond NE, Hovdenes J, Hrecko J, Iten M, Johansen H, Keeble TR, Kirkegaard H, Lascarrou JB, Leithner C, Lesona ME, Levis A, Mion M, Moseby-Knappe M, Navarra L, Nordberg P, Pelosi P, Quayle R, Rylander C, Sandberg H, Saxena M, Schrag C, Siranec M, Tiziano C, Vignon P, Wendel-Garcia PD, Wise MP, Wright K, Nielsen N, and Cronberg T
- Abstract
Importance: The Targeted Hypothermia vs Targeted Normothermia After Out-of-Hospital Cardiac Arrest (TTM2) trial reported no difference in mortality or poor functional outcome at 6 months after out-of-hospital cardiac arrest (OHCA). This predefined exploratory analysis provides more detailed estimation of brain dysfunction for the comparison of the 2 intervention regimens., Objectives: To investigate the effects of targeted hypothermia vs targeted normothermia on functional outcome with focus on societal participation and cognitive function in survivors 6 months after OHCA., Design, Setting, and Participants: This study is a predefined analysis of an international multicenter, randomized clinical trial that took place from November 2017 to January 2020 and included participants at 61 hospitals in 14 countries. A structured follow-up for survivors performed at 6 months was by masked outcome assessors. The last follow-up took place in October 2020. Participants included 1861 adult (older than 18 years) patients with OHCA who were comatose at hospital admission. At 6 months, 939 of 1861 were alive and invited to a follow-up, of which 103 of 939 declined or were missing., Interventions: Randomization 1:1 to temperature control with targeted hypothermia at 33 °C or targeted normothermia and early treatment of fever (37.8 °C or higher)., Main Outcomes and Measures: Functional outcome focusing on societal participation assessed by the Glasgow Outcome Scale Extended ([GOSE] 1 to 8) and cognitive function assessed by the Montreal Cognitive Assessment ([MoCA] 0 to 30) and the Symbol Digit Modalities Test ([SDMT] z scores). Higher scores represent better outcomes., Results: At 6 months, 836 of 939 survivors with a mean age of 60 (SD, 13) (range, 18 to 88) years (700 of 836 male [84%]) participated in the follow-up. There were no differences between the 2 intervention groups in functional outcome focusing on societal participation (GOSE score, odds ratio, 0.91; 95% CI, 0.71-1.17; P = .46) or in cognitive function by MoCA (mean difference, 0.36; 95% CI,-0.33 to 1.05; P = .37) and SDMT (mean difference, 0.06; 95% CI,-0.16 to 0.27; P = .62). Limitations in societal participation (GOSE score less than 7) were common regardless of intervention (hypothermia, 178 of 415 [43%]; normothermia, 168 of 419 [40%]). Cognitive impairment was identified in 353 of 599 survivors (59%)., Conclusions: In this predefined analysis of comatose patients after OHCA, hypothermia did not lead to better functional outcome assessed with a focus on societal participation and cognitive function than management with normothermia. At 6 months, many survivors had not regained their pre-arrest activities and roles, and mild cognitive dysfunction was common., Trial Registration: ClinicalTrials.gov Identifier: NCT02908308.
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- 2023
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49. Comparison of four clinical risk scores in comatose patients after out-of-hospital cardiac arrest.
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Schmidbauer S, Rylander C, Cariou A, Wise MP, Thomas M, Keeble TR, Erlinge D, Haenggi M, Wendel-Garcia PD, Bělohlávek J, Grejs AM, Nielsen N, Friberg H, and Dankiewicz J
- Subjects
- Humans, Coma diagnosis, Coma etiology, Coma therapy, Prognosis, Risk Factors, Hypothermia, Induced, Out-of-Hospital Cardiac Arrest therapy, Cardiopulmonary Resuscitation
- Abstract
Background and Aims: Several different scoring systems for early risk stratification after out-of-hospital cardiac arrest have been developed, but few have been validated in large datasets. The aim of the present study was to compare the well-validated Out-of-hospital Cardiac Arrest (OHCA) and Cardiac Arrest Hospital Prognosis (CAHP)-scores to the less complex MIRACLE2- and Target Temperature Management (TTM)-scores., Methods: This was a post-hoc analysis of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Missing data were handled by multiple imputation. The primary outcome was discriminatory performance assessed as the area under the receiver operating characteristics-curve (AUROC), with the outcome of interest being poor functional outcome or death (modified Rankin Scale 4-6) at 6 months after OHCA., Results: Data on functional outcome at 6 months were available for 1829 cases, which constituted the study population. The pooled AUROC for the MIRACLE2-score was 0.810 (95% CI 0.790-0.828), 0.835 (95% CI 0.816-0.852) for the TTM-score, 0.820 (95% CI 0.800-0.839) for the CAHP-score and 0.770 (95% CI 0.748-0.791) for the OHCA-score. At the cut-offs needed to achieve specificities >95%, sensitivities were <40% for all four scoring systems., Conclusions: The TTM-, MIRACLE2- and CAHP-scores are all capable of providing objective risk estimates accurate enough to be used as part of a holistic patient assessment after OHCA of a suspected cardiac origin. Due to its simplicity, the MIRACLE2-score could be a practical solution for both clinical application and risk stratification within trials., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Authors AC and HF are members of the editorial board of Resuscitation.’., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2023
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50. Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19: a prospective multicenter study.
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Sievert T, Didriksson I, Spångfors M, Lilja G, Blennow K, Zetterberg H, Frigyesi A, and Friberg H
- Abstract
Background: Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total-tau protein (tau) are novel blood biomarkers of neurological injury, and may be used to predict outcomes in critical COVID-19., Methods: A prospective multicentre cohort study of 117 consecutive and critically ill COVID-19 patients in six intensive care units (ICUs) in southern Sweden between May and November 2020. Serial NfL, GFAP and tau were analysed in relation to mortality, the Glasgow Outcome Scale Extended (GOSE) and the physical (PCS) and mental (MCS) components of health-related quality of life at one year., Results: NfL, GFAP and tau on ICU admission predicted one-year mortality with an area under the curve (AUC) of 0.82 (95% confidence interval [CI] 0.74[Formula: see text]0.90), 0.72 (95% CI 0.62[Formula: see text]0.82) and 0.66 (95% CI 0.54[Formula: see text]0.77). NfL on admission was an independent predictor of one-year mortality (p = 0.039). Low NfL and GFAP values were associated with good PCS ([Formula: see text]45) at one year but not with good MCS ([Formula: see text]45) or GOSE ([Formula: see text]5)., Conclusions: NfL on ICU admission was an independent predictor of mortality. High levels of NfL, GFAP and tau were associated with mortality but not with poor GOSE in survivors at one year. Low levels of NfL and GFAP were associated with improved physical health-related quality of life., (© 2023. European Society of Intensive Care Medicine and Springer Nature Switzerland AG.)
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- 2023
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