[ { "key": "GJNFMJ3J", "version": 3, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/GJNFMJ3J", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/GJNFMJ3J", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Schuwirth et al.", "parsedDate": "2001-04", "numChildren": 0 }, "data": { "key": "GJNFMJ3J", "version": 3, "itemType": "journalArticle", "title": "Do short cases elicit different thinking processes than factual knowledge questions do?", "creators": [ { "creatorType": "author", "firstName": "L W", "lastName": "Schuwirth" }, { "creatorType": "author", "firstName": "M M", "lastName": "Verheggen" }, { "creatorType": "author", "firstName": "C P", "lastName": "van der Vleuten" }, { "creatorType": "author", "firstName": "H P", "lastName": "Boshuizen" }, { "creatorType": "author", "firstName": "G J", "lastName": "Dinant" } ], "abstractNote": "PURPOSE\n\nTo assess whether case-based questions elicit different thinking processes from factual knowledge-based questions.\n\n\nMETHOD\n\n20 general practitioners (GPs) and 20 students solved case-based questions and matched factual knowledge-based questions while thinking aloud. Verbatim protocols were analysed. Five indicators were defined: extent of protocols; immediate responses; re-reading of information given in the stem or case after the question had been read; order of re-reading information, and type of consideration, i.e. 'true-false' type or 'vector', that is, a deliberation which has a magnitude and a direction.\n\n\nRESULTS\n\nCases elicited longer protocols than factual knowledge questions. Students re-read more given information than GPs. GPs gave an immediate response on twice as many occasions as students. GPs re-ordered the case information, whereas students re-read the information in the order it was presented. This ordering difference was not found in the factual knowledge questions. Factual knowledge questions mainly led to 'true-false' considerations, whereas cases elicited mainly 'vector' considerations.\n\n\nCONCLUSION\n\nShort case-based questions lead to thinking processes which represent problem-solving ability better than those elicited by factual knowledge questions.", "publicationTitle": "Medical Education", "publisher": "", "place": "", "date": "Apr 2001", "volume": "35", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "348-356", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Med Educ", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11318998", "accessDate": "2012-02-16T17:51:50Z", "PMID": "11318998", "PMCID": "", "ISSN": "0308-0110", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Education, Medical", "type": 1 }, { "tag": "Educational Measurement", "type": 1 }, { "tag": "Family Practice", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Netherlands", "type": 1 }, { "tag": "Problem Solving", "type": 1 }, { "tag": "Thinking", "type": 1 } ], "collections": [ "ESAE26NQ" ], "relations": {}, "dateAdded": "2012-02-16T17:51:50Z", "dateModified": "2012-02-16T17:51:50Z" } }, { "key": "8CJDIDHT", "version": 3, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/8CJDIDHT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/8CJDIDHT", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Cook and Triola", "parsedDate": "2009-04", "numChildren": 0 }, "data": { "key": "8CJDIDHT", "version": 3, "itemType": "journalArticle", "title": "Virtual patients: a critical literature review and proposed next steps", "creators": [ { "creatorType": "author", "firstName": "David A", "lastName": "Cook" }, { "creatorType": "author", "firstName": "Marc M", "lastName": "Triola" } ], "abstractNote": "CONTEXT\n\nThe opposing forces of increased training expectations and reduced training resources have greatly impacted health professions education. Virtual patients (VPs), which take the form of interactive computer-based clinical scenarios, may help to reconcile this paradox.\n\n\nMETHODS\n\nWe summarise research on VPs, highlight the spectrum of potential variation and identify an agenda for future research. We also critically consider the role of VPs in the educational armamentarium.\n\n\nRESULTS\n\nWe propose that VPs' most unique and cost-effective function is to facilitate and assess the development of clinical reasoning. Clinical reasoning in experts involves a non-analytical process that matures through deliberate practice with multiple and varied clinical cases. Virtual patients are ideally suited to this task. Virtual patients can also be used in learner assessment, but scoring rubrics should emphasise non-analytical clinical reasoning rather than completeness of information or algorithmic approaches. Potential variations in VP design are practically limitless, yet few studies have rigorously explored design issues. More research is needed to inform instructional design and curricular integration.\n\n\nCONCLUSIONS\n\nVirtual patients should be designed and used to promote clinical reasoning skills. More research is needed to inform how to effectively use VPs.", "publicationTitle": "Medical Education", "publisher": "", "place": "", "date": "Apr 2009", "volume": "43", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "303-311", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Med Educ", "DOI": "10.1111/j.1365-2923.2008.03286.x", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19335571", "accessDate": "2012-02-16T17:40:38Z", "PMID": "19335571", "PMCID": "", "ISSN": "1365-2923", "archive": "", "archiveLocation": "", "shortTitle": "Virtual patients", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Clinical Competence", "type": 1 }, { "tag": "Computer-Assisted Instruction", "type": 1 }, { "tag": "Education, Medical, Undergraduate", "type": 1 }, { "tag": "Educational Measurement", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Patient Simulation", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2012-02-16T17:40:38Z", "dateModified": "2012-02-16T17:40:38Z" } }, { "key": "TJ9NBFVF", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/TJ9NBFVF", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/TJ9NBFVF", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/69234/items/WQHSGHTJ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } } }, "data": { "key": "TJ9NBFVF", "version": 1, "parentItem": "WQHSGHTJ", "itemType": "attachment", "linkMode": "linked_url", "title": "Wiley Full Text PDF", "accessDate": "2012-02-16T17:40:35Z", "url": "http://onlinelibrary.wiley.com.liboff.ohsu.edu/store/10.1111/j.1365-2923.2008.03286.x/asset/j.1365-2923.2008.03286.x.pdf?v=1&t=gyq2sudw&s=f9d23f0dcda5a1485dfce965b36d28213dbbcdbb", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2012-02-16T17:40:35Z", "dateModified": "2012-02-16T17:40:35Z" } }, { "key": "WQHSGHTJ", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/WQHSGHTJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/WQHSGHTJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Cook and Triola", "parsedDate": "2009-04-01", "numChildren": 1 }, "data": { "key": "WQHSGHTJ", "version": 1, "itemType": "journalArticle", "title": "Virtual patients: a critical literature review and proposed next steps", "creators": [ { "creatorType": "author", "firstName": "David A", "lastName": "Cook" }, { "creatorType": "author", "firstName": "Marc M", "lastName": "Triola" } ], "abstractNote": "Context  The opposing forces of increased training expectations and reduced training resources have greatly impacted health professions education. Virtual patients (VPs), which take the form of interactive computer-based clinical scenarios, may help to reconcile this paradox.", "publicationTitle": "Medical Education", "publisher": "", "place": "", "date": "2009/04/01", "volume": "43", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "303-311", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1111/j.1365-2923.2008.03286.x", "citationKey": "", "url": "http://onlinelibrary.wiley.com.liboff.ohsu.edu/doi/10.1111/j.1365-2923.2008.03286.x/abstract", "accessDate": "2012-02-16T17:40:35Z", "PMID": "", "PMCID": "", "ISSN": "1365-2923", "archive": "", "archiveLocation": "", "shortTitle": "Virtual patients", "language": "en", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "ESAE26NQ" ], "relations": {}, "dateAdded": "2012-02-16T17:40:35Z", "dateModified": "2012-02-16T17:40:35Z" } }, { "key": "Q998NBR4", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/Q998NBR4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/Q998NBR4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Neumar et al.", "parsedDate": "2008-12-02", "numChildren": 0 }, "data": { "key": "Q998NBR4", "version": 1, "itemType": "journalArticle", "title": "Post–Cardiac Arrest Syndrome", "creators": [ { "creatorType": "author", "firstName": "Robert W", "lastName": "Neumar" }, { "creatorType": "author", "firstName": "Jerry P", "lastName": "Nolan" }, { "creatorType": "author", "firstName": "Christophe", "lastName": "Adrie" }, { "creatorType": "author", "firstName": "Mayuki", "lastName": "Aibiki" }, { "creatorType": "author", "firstName": "Robert A", "lastName": "Berg" }, { "creatorType": "author", "firstName": "Bernd W", "lastName": "Böttiger" }, { "creatorType": "author", "firstName": "Clifton", "lastName": "Callaway" }, { "creatorType": "author", "firstName": "Robert S. B", "lastName": "Clark" }, { "creatorType": "author", "firstName": "Romergryko G", "lastName": "Geocadin" }, { "creatorType": "author", "firstName": "Edward C", "lastName": "Jauch" }, { "creatorType": "author", "firstName": "Karl B", "lastName": "Kern" }, { "creatorType": "author", "firstName": "Ivan", "lastName": "Laurent" }, { "creatorType": "author", "firstName": "W. T", "lastName": "Longstreth" }, { "creatorType": "author", "firstName": "Raina M", "lastName": "Merchant" }, { "creatorType": "author", "firstName": "Peter", "lastName": "Morley" }, { "creatorType": "author", "firstName": "Laurie J", "lastName": "Morrison" }, { "creatorType": "author", "firstName": "Vinay", "lastName": "Nadkarni" }, { "creatorType": "author", "firstName": "Mary Ann", "lastName": "Peberdy" }, { "creatorType": "author", "firstName": "Emanuel P", "lastName": "Rivers" }, { "creatorType": "author", "firstName": "Antonio", "lastName": "Rodriguez-Nunez" }, { "creatorType": "author", "firstName": "Frank W", "lastName": "Sellke" }, { "creatorType": "author", "firstName": "Christian", "lastName": "Spaulding" }, { "creatorType": "author", "firstName": "Kjetil", "lastName": "Sunde" }, { "creatorType": "author", "firstName": "Terry", "lastName": "Vanden Hoek" } ], "abstractNote": "", "publicationTitle": "Circulation", "publisher": "", "place": "", "date": "2008-12-02", "volume": "118", "issue": "23", "section": "", "partNumber": "", "partTitle": "", "pages": "2452-2483", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1161/CIRCULATIONAHA.108.190652", "citationKey": "", "url": "http://circ.ahajournals.org/content/118/23/2452.short", "accessDate": "2012-02-16T00:47:43Z", "PMID": "", "PMCID": "", "ISSN": "0009-7322, 1524-4539", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "circ.ahajournals.org", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "AHA Scientific Statements", "type": 1 }, { "tag": "cardiac arrest", "type": 1 }, { "tag": "emergency care", "type": 1 } ], "collections": [ "ESAE26NQ" ], "relations": {}, "dateAdded": "2012-02-16T01:22:21Z", "dateModified": "2012-02-16T01:22:21Z" } }, { "key": "HHP7P88E", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/HHP7P88E", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/HHP7P88E", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Jones et al.", "parsedDate": "2004", "numChildren": 0 }, "data": { "key": "HHP7P88E", "version": 1, "itemType": "journalArticle", "title": "Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients*", "creators": [ { "creatorType": "author", "firstName": "Alan E.", "lastName": "Jones" }, { "creatorType": "author", "firstName": "Vivek S.", "lastName": "Tayal" }, { "creatorType": "author", "firstName": "D Matthew", "lastName": "Sullivan" }, { "creatorType": "author", "firstName": "Jeffrey A.", "lastName": "Kline" } ], "abstractNote": "", "publicationTitle": "Critical Care Medicine", "publisher": "", "place": "", "date": "08/2004", "volume": "32", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "1703-1708", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1097/01.CCM.0000133017.34137.82", "citationKey": "", "url": "http://journals.lww.com/ccmjournal/Abstract/2004/08000/Randomized,_controlled_trial_of_immediate_versus.11.aspx", "accessDate": "2012-02-16T00:49:30Z", "PMID": "", "PMCID": "", "ISSN": "0090-3493", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "CrossRef", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "96JUVTXG" ], "relations": {}, "dateAdded": "2012-02-16T01:20:59Z", "dateModified": "2012-02-16T01:20:59Z" } }, { "key": "ZSNHMFEV", "version": 3, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/ZSNHMFEV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/ZSNHMFEV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Thiagarajan et al.", "parsedDate": "2009-03", "numChildren": 0 }, "data": { "key": "ZSNHMFEV", "version": 3, "itemType": "journalArticle", "title": "Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation in adults", "creators": [ { "creatorType": "author", "firstName": "Ravi R", "lastName": "Thiagarajan" }, { "creatorType": "author", "firstName": "Thomas V", "lastName": "Brogan" }, { "creatorType": "author", "firstName": "Mark A", "lastName": "Scheurer" }, { "creatorType": "author", "firstName": "Peter C", "lastName": "Laussen" }, { "creatorType": "author", "firstName": "Peter T", "lastName": "Rycus" }, { "creatorType": "author", "firstName": "Susan L", "lastName": "Bratton" } ], "abstractNote": "BACKGROUND\n\nExtracorporeal membrane oxygenation (ECMO) to support cardiopulmonary resuscitation (CPR) has been shown to improve survival in children and adults. We describe outcomes after the use of ECMO to support CPR (E-CPR) in adults using multiinstitutional data from the Extracorporeal Life Support Organization (ELSO) registry.\n\n\nMETHODS\n\nPatients greater than 18 years of age using ECMO to support CPR (E-CPR) during 1992 to 2007 were extracted from the ELSO registry and analyzed.\n\n\nRESULTS\n\nTwo hundred and ninety-seven (11% of 2,633 adult ECMO uses) reports of E-CPR use in 295 patients were analyzed. Median age was 52 years (interquartile range [IQR], 35, 64) and most patients had cardiac disease (n = 221; 75%). Survival to hospital discharge was 27%. Brain death occurred in 61 (28%) of nonsurvivors. In a multivariate logistic regression model, pre-ECMO factors including a diagnosis of acute myocarditis (odds ratio [OR]: 0.18; 95% confidence interval [CI]: 0.05 to 0.69) compared with noncardiac diagnoses and use of percutaneous cannulation technique (OR: 0.42; 95% CI: 0.21 to 0.87) lowered odds of mortality, whereas a lower pre-ECMO arterial blood partial pressure of oxygen (Pao(2)) less than 70 mm Hg (OR: 2.7; 95% CI: 1.21 to 6.07) compared with a Pao(2)of 149 mm Hg or greater increased odds of mortality. The need for renal replacement therapy during ECMO increased odds of mortality (OR: 2.41; 95% CI: 1.34 to 4.34).\n\n\nCONCLUSIONS\n\nThe use of E-CPR was associated with survival in 27% of adults with cardiac arrest facing imminent mortality. Further studies are warranted to evaluate and better define patients who may benefit from E-CPR.", "publicationTitle": "The Annals of Thoracic Surgery", "publisher": "", "place": "", "date": "Mar 2009", "volume": "87", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "778-785", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann. Thorac. Surg.", "DOI": "10.1016/j.athoracsur.2008.12.079", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19231388", "accessDate": "2012-01-31T05:34:12Z", "PMID": "19231388", "PMCID": "", "ISSN": "1552-6259", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Cardiopulmonary Resuscitation", "type": 1 }, { "tag": "Extracorporeal Membrane Oxygenation", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "TR56EEV2" ], "relations": {}, "dateAdded": "2012-02-16T01:20:49Z", "dateModified": "2012-02-16T01:20:49Z" } }, { "key": "3QMRNW4X", "version": 3, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/3QMRNW4X", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/3QMRNW4X", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Liu et al.", "parsedDate": "2011-03", "numChildren": 0 }, "data": { "key": "3QMRNW4X", "version": 3, "itemType": "journalArticle", "title": "Extracorporeal membrane oxygenation to support prolonged conventional cardiopulmonary resuscitation in adults with cardiac arrest from acute myocardial infarction at a very low-volume centre", "creators": [ { "creatorType": "author", "firstName": "Ying", "lastName": "Liu" }, { "creatorType": "author", "firstName": "Yi Tso", "lastName": "Cheng" }, { "creatorType": "author", "firstName": "Jui Chi", "lastName": "Chang" }, { "creatorType": "author", "firstName": "Sheng Feng", "lastName": "Chao" }, { "creatorType": "author", "firstName": "Bee Song", "lastName": "Chang" } ], "abstractNote": "We aimed to analyse the outcomes of the deployment of extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation (E-CPR) 11 times for acute myocardial infarction (AMI) in 10 adult patients at a very low-volume (VLV) centre, where perfusionists or surgeons are not always available. We conducted a three-year retrospective chart review. E-CPR was performed 13 times in 12 adult patients who had cardiac arrest events and who underwent conventional CPR for longer than 10 min. We excluded other aetiologies that led to E-CPR. All 11 selected episodes of E-CPR were diagnosed as AMI. Seven patients (63.6%) were successfully weaned off extracorporeal membrane oxygenation (ECMO). Four patients survived to discharge without neurological deficits or other postE-CPR complications (36.3%). Seven patients died after E-CPR, and with one patient, there was no return of spontaneous beating during E-CPR (0.9%). Three patients died of unstable haemodynamics despite revascularisation of the coronary circulation. Three patients were successfully weaned off ECMO; however, they died subsequently of multiple organ dysfunction, unstable haemodynamic changes and septic shock from nosocomial infections, respectively. The outcome of E-CPR in adults with AMI was compared with previous studies at high-volume centres. Mortality or morbidity rates are not higher at a VLV centre.", "publicationTitle": "Interactive Cardiovascular and Thoracic Surgery", "publisher": "", "place": "", "date": "Mar 2011", "volume": "12", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "389-393", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Interact Cardiovasc Thorac Surg", "DOI": "10.1510/icvts.2010.256388", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/21172947", "accessDate": "2012-01-31T05:34:49Z", "PMID": "21172947", "PMCID": "", "ISSN": "1569-9285", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Aged", "type": 1 }, { "tag": "Cardiopulmonary Resuscitation", "type": 1 }, { "tag": "Extracorporeal Membrane Oxygenation", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Heart Arrest", "type": 1 }, { "tag": "Hospital Mortality", "type": 1 }, { "tag": "Hospitals, General", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Myocardial Infarction", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Survival Analysis", "type": 1 }, { "tag": "Survival Rate", "type": 1 }, { "tag": "Taiwan", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "TR56EEV2" ], "relations": {}, "dateAdded": "2012-02-16T01:20:49Z", "dateModified": "2012-02-16T01:20:49Z" } }, { "key": "MKN67WDE", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/MKN67WDE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/MKN67WDE", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Kane et al.", "parsedDate": "2010", "numChildren": 0 }, "data": { "key": "MKN67WDE", "version": 1, "itemType": "journalArticle", "title": "Rapid-Response Extracorporeal Membrane Oxygenation to Support Cardiopulmonary Resuscitation in Children With Cardiac Disease", "creators": [ { "creatorType": "author", "firstName": "David A.", "lastName": "Kane" }, { "creatorType": "author", "firstName": "Ravi R.", "lastName": "Thiagarajan" }, { "creatorType": "author", "firstName": "David", "lastName": "Wypij" }, { "creatorType": "author", "firstName": "Mark A.", "lastName": "Scheurer" }, { "creatorType": "author", "firstName": "Francis", "lastName": "Fynn-Thompson" }, { "creatorType": "author", "firstName": "Sitaram", "lastName": "Emani" }, { "creatorType": "author", "firstName": "Pedro J.", "lastName": "del Nido" }, { "creatorType": "author", "firstName": "Peter", "lastName": "Betit" }, { "creatorType": "author", "firstName": "Peter C.", "lastName": "Laussen" } ], "abstractNote": "Background—Survival of children with in-hospital cardiac arrest that does not respond to conventional cardiopulmonary resuscitation (CPR) is poor. We report on survival and early neurological outcomes of children with heart disease supported with rapid-response extracorporeal membrane oxygenation (ECMO) to aid cardiopulmonary resuscitation (ECPR).Methods and Results—Children with heart disease supported with ECPR were identified from our ECMO database. Demographic, CPR, and ECMO details associated with mortality were evaluated using multivariable logistic regression. Pediatric overall performance category and pediatric cerebral performance category scores were assigned to ECPR survivors to assess neurological outcomes. There were 180 ECPR runs in 172 patients. Eighty-eight patients (51%) survived to discharge. Survival in patients who underwent ECPR after cardiac surgery (54%) did not differ from nonsurgical patients (46%). Survival did not vary by cardiac diagnosis and CPR duration did not differ between survivors and nonsurvivors. Factors associated with mortality included noncardiac structural or chromosomal abnormalities (OR, 3.2; 95% CI, 1.3–7.9), use of blood-primed ECMO circuit (OR, 7.1; 95% CI, 1.4–36), and arterial pH <7.00 after ECMO deployment (OR, 6.0; 95% CI, 2.1–17.4). Development of end-organ injury on ECMO and longer ECMO duration were associated with increased mortality. Of pediatric overall performance category/pediatric cerebral performance category scores assigned to survivors, 75% had scores ≤2, indicating no to mild neurological injury.Conclusions—ECPR may promote survival in children with cardiac disease experiencing cardiac arrest unresponsive to conventional CPR with favorable early neurological outcomes. CPR duration was not associated with mortality, whereas patients with metabolic acidosis and noncardiac structural or chromosomal anomalies had higher mortality.", "publicationTitle": "Circulation", "publisher": "", "place": "", "date": "2010", "volume": "122", "issue": "11 suppl 1", "section": "", "partNumber": "", "partTitle": "", "pages": "S241 -S248", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1161/CIRCULATIONAHA.109.928390", "citationKey": "", "url": "http://circ.ahajournals.org/content/122/11_suppl_1/S241.abstract", "accessDate": "2012-01-31T05:29:04Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "Highwire 2.0", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "TR56EEV2" ], "relations": {}, "dateAdded": "2012-02-16T01:20:49Z", "dateModified": "2012-02-16T01:20:49Z" } }, { "key": "BBW9X9XE", "version": 1, "library": { "type": "group", "id": 69234, "name": "OHSU Emergency Medicine", "links": { "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/69234/items/BBW9X9XE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/ohsu_emergency_medicine/items/BBW9X9XE", "type": "text/html" } }, "meta": { "createdByUser": { "id": 800720, "username": "mlh1122", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/mlh1122", "type": "text/html" } } }, "creatorSummary": "Thiagarajan et al.", "parsedDate": "2007-10-09", "numChildren": 0 }, "data": { "key": "BBW9X9XE", "version": 1, "itemType": "journalArticle", "title": "Extracorporeal Membrane Oxygenation to Aid Cardiopulmonary Resuscitation in Infants and Children", "creators": [ { "creatorType": "author", "firstName": "Ravi R.", "lastName": "Thiagarajan" }, { "creatorType": "author", "firstName": "Peter C.", "lastName": "Laussen" }, { "creatorType": "author", "firstName": "Peter T.", "lastName": "Rycus" }, { "creatorType": "author", "firstName": "Robert H.", "lastName": "Bartlett" }, { "creatorType": "author", "firstName": "Susan L.", "lastName": "Bratton" } ], "abstractNote": "Background— Extracorporeal membrane oxygenation (ECMO) has been used to support cardiorespiratory function during pediatric cardiopulmonary resuscitation (CPR). We report on outcomes and predictors of in-hospital mortality after ECMO used to support CPR (E-CPR).Methods and Results— Outcomes for patients aged <18 years using E-CPR were analyzed with data from the Extracorporeal Life Support Organization, and predictors of in-hospital mortality were determined. Of 26 242 ECMO uses reported, 695 (2.6%) were for E-CPR (n=682 patients). Survival to hospital discharge was 38%. In a multivariable model, pre-ECMO factors such as cardiac disease (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.31 to 0.82) and neonatal respiratory disease (OR 0.28, 95% CI 0.12 to 0.66), white race (OR 0.65, 95% CI 0.45 to 0.94), and pre-ECMO arterial blood pH >7.17 (OR 0.50, 95% CI 0.30 to 0.84) were associated with decreased odds of mortality. During ECMO, renal dysfunction (OR 1.89, 95% CI 1.17 to 3.03), pulmonary hemorrhage (OR 2.23, 95% CI 1.11 to 4.50), neurological injury (OR 2.79, 95% CI 1.55 to 5.02), CPR during ECMO (OR 3.06, 95% CI 1.42 to 6.58), and arterial blood pH <7.2 (OR 2.23, 95% CI 1.23 to 4.06) were associated with increased odds of mortality.Conclusions— ECMO used to support CPR rescued one third of patients in whom death was otherwise certain. Patient diagnosis, absence of severe metabolic acidosis before ECMO support, and uncomplicated ECMO course were associated with improved survival.", "publicationTitle": "Circulation", "publisher": "", "place": "", "date": "October 09 , 2007", "volume": "116", "issue": "15", "section": "", "partNumber": "", "partTitle": "", "pages": "1693 -1700", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1161/CIRCULATIONAHA.106.680678", "citationKey": "", "url": "http://circ.ahajournals.org/content/116/15/1693.abstract", "accessDate": "2012-01-31T05:29:40Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "Highwire 2.0", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "TR56EEV2" ], "relations": {}, "dateAdded": "2012-02-16T01:20:49Z", "dateModified": "2012-02-16T01:20:49Z" } } ]