Intramuscular neural distribution of the vastus medialis for botulinum neurotoxin injection: application to spasticity.

Purpose: A comprehensive understanding of neural distribution within the vastus medialis is crucial for the effective administration of botulinum neurotoxin injections to manage spasticity. The aim of this study was to develop an anatomically informed approach to guide the administration of botulinum neurotoxin injections into the vastus medialis muscle.

Methods: Using a modified Sihler's method, we examined the vastus medialis muscles (20 specimens) to delineate the distribution of nerves relative to a transverse line extending from the anterior superior iliac spine to the base of patella.

Gastric Inflation in Prehospital Cardiopulmonary Resuscitation: Aspiration Pneumonia and Resuscitation Outcomes.

Background: Gastric inflation (GI) can induce gastric regurgitation and subsequent aspiration pneumonia, which can prolong intensive care unit stay. However, it has not been verified in patients with out-of-hospital cardiac arrest (OHCA). This study aimed to investigate the incidence of GI during prehospital resuscitation and its effect on aspiration pneumonia and resuscitation outcomes in patients with out-of-hospital cardiac arrest.

Prediction of blood pressure using chest compression waveform during cardiopulmonary resuscitation.

Objectives: This study aimed to predict blood pressure during CPR using chest compression waveform information obtained from a CPR feedback device.

Methods: Quantitative data including chest compression waveforms from a CPR feedback device and the blood pressure measured by arterial cannulation in patients with cardiac arrest during CPR were used. Forty-one features to predict blood pressure were selected from chest compression waveform and demographic characteristics with neighborhood component analysis algorithm.

Hemodynamic Effect of Repeated Epinephrine Doses Decreases With Cardiopulmonary Resuscitation Cycle Progression.

Background: Epinephrine is administered to increase coronary perfusion pressure during advanced life support and promote short-term survival. Recent cardiopulmonary resuscitation (CPR) guidelines recommend an epinephrine dosing interval of 3 to 5 minutes during resuscitation; however, scientific evidence supporting this recommendation is lacking. Therefore, we aimed to investigate the hemodynamic effects of repeated epinephrine doses during CPR by monitoring augmented blood pressure after its administration in a swine model of cardiac arrest.

End-tidal carbon dioxide after sodium bicarbonate infusion during mechanical ventilation or ongoing cardiopulmonary resuscitation.

Purpose: End-tidal CO is used to monitor the ventilation status or hemodynamic efficacy during mechanical ventilation or cardiopulmonary resuscitation (CPR), and it may be affected by various factors including sodium bicarbonate administration. This study investigated changes in end-tidal CO2 after sodium bicarbonate administration.

Materials And Methods: This single-center, prospective observational study included adult patients who received sodium bicarbonate during mechanical ventilation or CPR.

Ventricle tracking in transesophageal echocardiography (TEE) images during cardiopulmonary resuscitation (CPR) using deep learning and monogenic filtering.

Unlabelled: High-quality cardiopulmonary resuscitation (CPR) is the most important factor in promoting resuscitation outcomes; therefore, monitoring the quality of CPR is strongly recommended in current CPR guidelines. Recently, transesophageal echocardiography (TEE) has been proposed as a potential real-time feedback modality because physicians can obtain clear echocardiographic images without interfering with CPR. The quality of CPR would be optimized if the myocardial ejection fraction (EF) could be calculated in real-time during CPR.

Efficacy of Cardiopulmonary Resuscitation Using Automatic Compression-Defibrillation Apparatus: An Animal Study and A Manikin-Based Simulation Study.

Background: Chest compression and defibrillation are essential components of cardiac arrest treatment. Mechanical chest compression devices (MCCD) and automated external defibrillators (AED) are used separately in clinical practice. We developed an automated compression-defibrillation apparatus (ACDA) that performs mechanical chest compression and automated defibrillation.

Expert opinion on evidence after the 2020 Korean Cardiopulmonary Resuscitation Guidelines: a secondary publication.

Considerable evidence has been published since the 2020 Korean Cardiopulmonary Resuscitation Guidelines were reported. The International Liaison Committee on Resuscitation (ILCOR) also publishes the Consensus on CPR and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR) summary annually. This review provides expert opinions by reviewing the recent evidence on CPR and ILCOR treatment recommendations.

Circulating Vitamin D Level and Risk of Sudden Cardiac Death and Cardiovascular Mortality: A Dose-Response Meta-Analysis of Prospective Studies.

Background: We conducted a comprehensive meta-analysis of prospective cohort studies to analyze the effect of circulating vitamin D level on the risk of sudden cardiac death (SCD) and cardiovascular disease (CVD) mortality.

Methods: Prospective cohort studies evaluating the association between circulating vitamin D and risk of SCD and CVD mortality were systematically searched in the PubMed and Embase. Extracted data were analyzed using a random effects model and results were expressed in terms of hazard ratio (HR) and 95% confidence interval (CI).

Interaction effects between insomnia and depression on risk of out-of-hospital cardiac arrest: Multi-center study.

Background: Insomnia and depression have been known to be risk factors of several diseases, including coronary heart disease. We hypothesized that insomnia affects the out-of-hospital cardiac arrest (OHCA) incidence, and these effects may vary depending on whether it is accompanied by depression. This study aimed to determine the association between insomnia and OHCA incidence and whether the effect of insomnia is influenced by depression.

A simple scoring rule to predict survival to discharge after out of hospital cardiac arrest at the time of ED arrival.

Background: It is important to be able to predict the chance of survival to hospital discharge upon ED arrival in order to determine whether to continue or terminate resuscitation efforts after out of hospital cardiac arrest. This study was conducted to develop and validate a simple scoring rule that could predict survival to hospital discharge at the time of ED arrival.

Methods: This was a multicenter retrospective cohort study based on a nationwide registry (Korean Cardiac Arrest Research Consortium) of out of hospital cardiac arrest (OHCA).

Development of an automatic device performing chest compression and external defibrillation: An animal-based pilot study.

Background: Automatic chest compression devices (ACCDs) can promote high-quality cardiopulmonary resuscitation (CPR) and are widely used worldwide. Early application of automated external defibrillators (AEDs) along with high-quality CPR is crucial for favorable outcomes in patients with cardiac arrest. Here, we developed an automated CPR (A-CPR) apparatus that combines ACCD and AED and evaluated its performance in a pilot animal-based study.

Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography.

Objective: Myocardial rupture is a fatal complication of acute myocardial infarction (AMI). Early diagnosis of myocardial rupture is feasible when emergency physicians (EPs) perform emergency transthoracic echocardiography (TTE). The purpose of this study was to report the echocardiographic features of myocardial rupture on emergency TTE performed by EPs in the emergency department (ED).

Interactions between Sleep Apnea and Coronary Artery Disease on the Incidence of Sudden Cardiac Arrest: A Multi-Center Case-Control Study.

Purpose: Sleep apnea (SA) is a risk factor for coronary artery disease (CAD), and SA and CAD increase the incidence of sudden cardiac arrest (SCA). This study aimed to investigate the effect of SA on the incidence of SCA and explore the effect of varying degrees of SA with or without CAD on the incidence of SCA.

Materials And Methods: This prospective multi-center, case-control study was performed using the phase II Cardiac Arrest Pursuit Trial with Unique Registry and Epidemiologic Surveillance (CAPTURES-II) database for SCA cases and community-based controls in Korea.

Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation.

Determining the cause of cardiac arrest (CA) and the heart status during CA is crucial for its treatment. Transesophageal echocardiography (TEE) is an imaging method that facilitates close observation of the heart without interfering with cardiopulmonary resuscitation (CPR). Intra-arrest TEE is a point-of-care ultrasound technique that is used during CPR.

Diet-related complications according to the timing of enteral nutrition support in patients who recovered from out-of-hospital cardiac arrest: a propensity score matched analysis.

Background: A proper nutritional plan for resuscitated patients is important in intensive care; however, specific nutritional guidelines have not yet been established. This study aimed to determine the incidence of diet-related complications that were affected by the timing of enteral nutrition in resuscitated patients after cardiac arrest.

Methods: This retrospective and 1:1 propensity score matching study involved patients who recovered after nontraumatic, out-of-hospital cardiac arrest at a tertiary hospital.

Trends in maintenance status and usability of public automated external defibrillators during a 5-year on-site inspection.

This study aimed to assess the trend of the maintenance status and usability of public automated external defibrillators (AEDs). Public AEDs installed in Seoul from 2013 to 2017 were included. An inspector checked the maintenance status and usability of the AEDs annually using a checklist.

Right-to-Left Shunts Occur During Cardiopulmonary Resuscitation: Echocardiographic Observations.

Objectives: A significant proportion of the population has a patent foramen ovale (PFO). The intracardiac pressure during cardiopulmonary resuscitation (CPR) may differ from that of normal circulation, which may result in a right-to-left shunt in the presence of a PFO. In this study, transesophageal echocardiography (TEE) was conducted to evaluate whether CPR carried out in patients after cardiac arrest causes right-to-left shunt.

Healthy lifestyle factors, cardiovascular comorbidities, and the risk of sudden cardiac arrest: A case-control study in Korea.

Aims: We investigated the impact of healthy lifestyle factors and cardiovascular comorbidities for sudden cardiac arrest.

Methods: A case-control study, including patients with sudden cardiac arrest aged 20-79 years and community-based 1:2 matched controls, was conducted from September 2017 to December 2020. All participants completed a structured questionnaire.

Diagnostic and therapeutic characteristics of diabetes mellitus and risk of out-of-hospital cardiac arrest.

This study aimed to evaluate the risks of diabetes mellitus (DM) on out-of-hospital cardiac arrest (OHCA) and to investigate whether the risks of DM on OHCA varied according to the diagnostic and therapeutic characteristics of diabetes. We conducted a multicenter prospective case-control study in 17 University hospitals in Korea from September 2017 to December 2020. Cases were EMS-treated OHCA patients aged 20 to 79 with a presumed cardiac etiology.