Comprehensive pre- and in-hospital near-infrared-spectroscopy (NIRS) monitoring after return of spontaneous circulation predicts neurological outcome following out-of-hospital cardiac arrest: a prospective observational study and literature review.

Background: An increase in regional cerebral oxygen saturation (rSO2) levels during advanced life support in patients with out-of-hospital cardiac arrest (OHCA) is associated with return of spontaneous circulation (ROSC) and can predict neurological outcome. Data from the post-ROSC phase are scarce but may predict clinical outcomes as well.

Methods: For this prospective observational study, we measured rSO2 via near-infrared spectroscopy (NIRS) in patients after ROSC following OHCA in both the pre- and in-hospital setting for up to 72 h.

The impact of additional special emergency medical service units on non-traumatic adult out-of-hospital cardiac arrest outcomes in a high-resource metropolitan area.

Background: Out-of-hospital cardiac arrest (OHCA) requires an effective cardiopulmonary resuscitation (CPR) and emergency medical service (EMS) response, yet survival rates remain low at 8.0-11.3 %.

Cerebral oxygen saturation in relation to end-tidal CO in cardiopulmonary resuscitation - Separate views of brain and body?

Background: An increase in both regional cerebral oxygen saturation (rSO) measured by near-infrared spectroscopy (NIRS) and end-tidal carbon dioxide (etCO) during advanced life support for out-of-hospital cardiac arrest (OHCA) is associated with a higher likelihood of return of spontaneous circulation (ROSC) and may predict neurological outcome. However, it remains unclear which marker is more predictive for which outcome parameter.

Methods: In this prospective observational study, we assessed rSO and etCO in patients treated for OHCA in the metropolitan area of Vienna between 05/2017 and 02/2022.

Landiolol bolus application for tachycardic dysrhythmia in the prehospital EMS setting - An observational study of a novel concept.

Background: Tachydysrhythmias are a challenging aspect of emergency medicine, with atrial fibrillation being the most common. Electrical cardioversion is recommended for hemodynamically unstable patients, while treatment varies according to the dysrhythmia subtype in others. Landiolol, a relatively new ultra-short-acting cardioselective beta-blocker, may be a promising option for prehospital use due to its advantageous pharmacological properties.

Minimal residual ascites 3 months after TIPS implantation implicates worse clinical outcomes in patients with cirrhosis.

Background & Aims: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is indicated for recurrent/refractory ascites in patients with cirrhosis. The prognostic impact of residual minimal ascites after TIPS implantation has not yet been investigated.

Methods: We included patients with cirrhosis undergoing covered TIPS implantation for refractory ascites in Vienna (2000-2022) and Hannover (2009-2021) with available abdominal ultrasound 3 months after TIPS insertion (3M).

CPR manikin diversity for BLS education: Current status mapped by an international cross-sectional survey and steps to reach health equity.

Background: Certain community groups receive less bystander Basic Life Support (BLS). To improve that it was proposed to include in BLS training manikins representing diverse groups, as in current BLS training most manikins are white, lean and male/flat-chested. However, instructors attitudes about the use of diverse manikins and their distribution worldwide are unclear.

Associations of Thyroid and Parathyroid Hormones with Arterial Stiffness in Emergency Department Patients: A Prospective Cross-Sectional Study.

Cardiovascular diseases are prevalent entities, especially in emergency patients. Arterial stiffness is a known predictor of cardiovascular risk and mortality and is quantified by carotid-femoral pulse wave velocity (cfPWV). It is caused in part by vascular calcification, but exact details of the underlying mechanisms are yet to be elucidated, and current data suggest endocrine influences.

Diversity of CPR manikins for basic life support education: use of manikin sex, race and body shape - a scoping review.

Background: Cardiopulmonary resuscitation (CPR) manikins typically appear white, lean and male. However, internationally, this does not represent the overall population or those who are at greatest risk of cardiac arrest. Diverse demographic groups including people of colour, women and obese people are known to be less likely to receive bystander CPR, public access defibrillation and suffer less favourable outcomes.

Association between postresuscitation 12-lead ECG features and long-term neurological outcome after out-of-hospital cardiac arrest: a post-hoc subanalysis of the PEACE study.

Background: Out-of-hospital cardiac arrest (OHCA) has low survival rates worldwide. For the diagnosis of acute coronary syndrome causing OHCA and the identification of patients eligible for immediate coronary angiography, the post-return of spontaneous circulation electrocardiogram (post-ROSC ECG) is crucial. However, it is still unclear whether post-ROSC ECG features also pose a sensible feature for outcome prediction.

Emergency Point-of-Care Blood Gas Analysis During Mass Gathering Events: Experiences of the Vienna City Marathon.

: Long-distance running impacts many organ systems. Aside from musculoskeletal and cardiopulmonary events, the gastrointestinal and renal system as well as metabolic homeostasis and electrolyte balance can be affected. A respective medical support strategy enabling rapid diagnosis, triage, and treatment in the context of large sports events is thus of utmost importance.

The Relation of Angiotensin-Converting Enzyme 2, Renin-Angiotensin-Aldosterone System Inhibitors, and Arterial Stiffness in Acute COVID-19 Emergency Department Patients-A Prospective Observational Study.

: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) can damage the endothelium and increase arterial stiffness, potentially leading to adverse cardiovascular events. In parallel, systemic inflammation in COVID-19 also impacts endothelial function. Angiotensin-converting enzyme 2 (ACE2) promotes vasodilation and anti-inflammatory effects, but also facilitates SARS-CoV-2 entry into human cells.

Decreasing interleukin-6 levels after TIPS predict outcomes in decompensated cirrhosis.

Background & Aims: Transjugular intrahepatic portosystemic shunt (TIPS) effectively treats complications of cirrhosis. Systemic inflammation (SI) is linked to acute-on-chronic liver failure (ACLF) and liver-related death. We aimed to assess the trajectory and clinical impact of SI parameters after TIPS implantation.

Short- and long-term risk stratification in acutely ill medical patients by implementing ankle-brachial index and pulse wave velocity in the emergency setting.

Objective: Ankle-brachial index (ABI) and carotid-femoral pulse-wave velocity (cfPWV) are well-established surrogate markers of overall cardiovascular risk. However, their prognostic value towards short- and long-term mortality in an emergency medicine setting is yet unknown.

Approach And Results: Acutely ill medical patients systematically underwent cfPWV and ABI measurements at the emergency department of a tertiary care hospital.

Secondary Hemophagocytic Lymphohistiocytosis in severe COVID-19 - a retrospective cohort study.

Hemophagocytic lymphohistiocytosis (HLH) is an excessive immune activation with cytokine storm und multi-organ dysfunction. It can occur secondarily, especially due to viral infections like COVID-19. Rapid treatment is crucial for favourable outcomes, but diagnosing HLH is challenging.

Identification of optimal portal pressure decrease to control ascites while minimizing HE after TIPS: A multicenter study.

Background And Aims: Clinically significant portal hypertension in patients with liver cirrhosis can lead to refractory ascites. A TIPS treats clinically significant portal hypertension but may cause overt hepatic encephalopathy (oHE). Our aim was to determine the optimal reduction of the portal pressure gradient (PPG) through TIPS to control ascites without raising oHE risk.

The Impact of Chronic Oral Beta-Blocker Intake on Intravenous Bolus Landiolol Response in Hospitalized Intensive Care Patients with Sudden-Onset Supraventricular Tachycardia-A Post Hoc Analysis of a Cross-Sectional Trial.

Landiolol, a highly cardioselective agent with a short half-life (2.4-4 min), is commonly used as a perfusor or bolus application to treat tachycardic arrhythmia. Some small studies suggest that prior oral β-blocker use results in a less effective response to intravenous β-blockers.

Incidence of heparin resistance and heparin failure in patients receiving extracorporeal membrane oxygenation: an exploratory retrospective analysis.

Background: Unfractionated heparin (UFH) is used in most centers for extracorporeal membrane oxygenation (ECMO) anticoagulation. When standard doses do not achieve desired target values, heparin resistance is reported, most commonly defined as doses of UFH > 35 000 IU/d.

Objectives: To study the incidence of heparin resistance and its association with thromboembolic complications in patients requiring ECMO support.

Anticoagulation with argatroban using hemoclot™ targets is safe and effective in CARDS patients receiving venovenous extracorporeal membrane oxygenation: An exploratory bi-centric cohort study.

Unlabelled: Direct thrombin inhibitors, including argatroban, are increasingly used for anticoagulation during venovenous extracorporeal membrane oxygenation (VV ECMO). In many centers activated partial thromboplastin time (aPTT) is used for monitoring, but it can be affected by several confounders. The aim of this study was to evaluate the safety and efficacy of anticoagulation with argatroban titrated according to diluted thrombin time targets (hemoclot™ assay) compared to anti-Xa guided anticoagulation with unfractionated heparin (UFH).

Prevalence of FXII-Deficiency and Its Relevance to Monitoring Anticoagulation in Adults Receiving Extracorporeal Membrane Oxygenation.

During extracorporeal membrane oxygenation (ECMO) blood is exposed to artificial surfaces, resulting in contact activation of the intrinsic coagulation pathway initiated by coagulation factor XII (FXII). Little is known about the prevalence of acquired FXII-deficiency, especially during ECMO. The primary outcome was the prevalence of acquired FXII-deficiency (FXII activity <60%) during ECMO.

Prevalence and Impact of Lupus Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation.

Background: Monitoring of blood coagulation is essential in ECMO patients. We investigated the prevalence of lupus anticoagulant (LA) and its association with coagulation testing and hemostaseologic complications in patients treated with ECMO.

Methods: This is a retrospective analysis including adult patients who received ECMO at a medical intensive care unit at the Medical University of Vienna.

The Feasibility of Ultra-Sensitive Phonocardiography in Acute Chest Pain Patients of a Tertiary Care Emergency Department (ScorED Feasibility Study).

Background: Thoracic pain is one of the most frequent chief complaints at emergency departments (EDs). However, a respective workup in cases without clear electrocardiographic signs is complex. In addition, after having ruled out acute coronary syndrome (ACS), patients are often left with an unclear etiology of their symptoms.