Penn Medicine’s TTM Academy Podcasts
Episode 20 - Resuscitation Guideline in the time of COVID-19

Episode 20 - Resuscitation Guideline in the time of COVID-19

July 3, 2020

Dr. Felipe Teran joins Drs. Cindy Hsu and Hans van Schuppen to discuss recent guidance regarding cardiac arrest resuscitation during the COVID-19 pandemic.

Key publications referenced in this episode:

  •  Couper K, Taylor-Phillips S, Grove A, et al. COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review. Resuscitation. 2020; 151:59-66. https://pubmed.ncbi.nlm.nih.gov/32325096/

  • Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With the Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, The Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists: Supporting Organizations: American Association of Critical Care Nurses and National EMS Physicians. Circulation. 2020 https://pubmed.ncbi.nlm.nih.gov/32270695/

  • Perkins GD, Morley PT, Nolan JP, et al. International Liaison Committee on Resuscitation: COVID-19 consensus on science, treatment recommendations and task force insights. Resuscitation. 2020; 151:145-147. https://pubmed.ncbi.nlm.nih.gov/32371027/

  • Perkins GD, Couper K. COVID-19: long-term effects on the community response to cardiac arrest? Lancet Public Health. 2020 https://pubmed.ncbi.nlm.nih.gov/32473112/

Episode 19 - OHCA during the COVID-19 pandemic: Implications of COVID-19 for resuscitation care

Episode 19 - OHCA during the COVID-19 pandemic: Implications of COVID-19 for resuscitation care

June 15, 2020

Dr. Felipe Teran discusses the recent studies pertainig to OHCA during the COVID-19 pandemic.

 

Key publications referenced in this episode:

  • Baldi E et al. Out-of-hospital cardiac arrest during the Covid-19 outbreak in ItalyN Engl J Med 2020 Apr 29; [e-pub]. (https://doi.org/10.1056/NEJMc2010418)
  • Marijon E, Karam N, Jost D, et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. Lancet Public Health. 2020
  • Sayre MR, Barnard LM, Counts CR, et al. Prevalence of COVID-19 in Out-of-Hospital Cardiac Arrest: Implications for Bystander CPR. Circulation. 2020. DOI: 10.1161/CIRCULATIONAHA.120.048951
Episode 18 - Survivorship: The new frontier in post-arrest care

Episode 18 - Survivorship: The new frontier in post-arrest care

March 6, 2020

Dr. Abella discusses a very recent American Heart Association scientific statement on cardiac arrest survivorship, increasingly recognized as an important topic around the globe. While many studies have evaluated survival to hospital discharge, or even survival at 90 or 180 days post-arrest – survival is not enough. Increasing data suggest that even among “good” neurologic survivors (those with Cerebral Performance Category 1 or 2), life-limited challenges remain, including depression, PTSD, cognitive deficits and other challenges to quality of life.

 

Key readings: 

Sawyer KN, et al. Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association. Circulation 2020 Feb 12 [epub ahead of print]. https://www.ncbi.nlm.nih.gov/pubmed/32078390

 

Lilja G, et al. Return to Work and Participation in Society After Out-of-Hospital Cardiac Arrest. Circ Cardiovasc Qual Outcomes. 2018 Jan;11(1):e003566. https://www.ncbi.nlm.nih.gov/pubmed/29326145

 

AHA Podcast on the Survivorship Scientific Statement: https://soundcloud.com/americanheartstroke/podcast-survivorship 

Episode 17 - New evidence: physician perspectives on post-arrest neuroprognostication

Episode 17 - New evidence: physician perspectives on post-arrest neuroprognostication

February 14, 2020

Drs. Teran and Abella discuss a hot-off-the-press survey study by Maciel CB et al (Critical Care Medicine, 2020), probing physician perspectives and practice on post-arrest neurologic assessment and prognostication. Do all of us follow the international guidelines for this phase of care? What are points of confusion in current “real world” practice?  Join us to answer these questions and hear about key action items for all of us who manage post-arrest care.

Key reading:

  • Neuroprognostication Practices in Postcardiac Arrest Patients: An International Survey of Critical Care Providers. Maciel CB, Barden MM, Youn TS, Dhakar MB, Greer DM. Crit Care Med. 2020 Feb;48(2):e107-e114. https://www.ncbi.nlm.nih.gov/pubmed/31939809
Episode 16 - Gender differences in cardiac arrest and post-arrest care

Episode 16 - Gender differences in cardiac arrest and post-arrest care

January 10, 2020

Drs. Abella and Teran discuss the scientific literature surrounding gender differences in care during and following cardiac arrest. From differences in bystander CPR provision for public cardiac arrests to post-arrest DNR status and cardiac catheterization; listen to hear more.

 

Key publications for this episode:

  1. Lindgren E et al. Gender differences in utilization of coronary angiography and angiographic findings after out-of-hospital cardiac arrest: A registry study. Resuscitation. 2019 Oct;143:189-195. https://www.ncbi.nlm.nih.gov/pubmed/31330199
  2. Perman SM et al. Sex Differences in "Do Not Attempt Resuscitation" Orders After Out-of-Hospital Cardiac Arrest and the Relationship to Critical Hospital Interventions. Clin Ther. 2019 Jun;41(6):1029-1037. https://www.ncbi.nlm.nih.gov/pubmed/31047712
  3. Jeong JS et al. Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest. Am J Emerg Med. 2019 Apr;37(4):632-638. https://www.ncbi.nlm.nih.gov/pubmed/30563798
  4. Blewer AL et al. Gender Disparities Among Adult Recipients of Bystander Cardiopulmonary Resuscitation in the Public. Circ Cardiovasc Qual Outcomes. 2018 Aug;11(8):e004710. https://www.ncbi.nlm.nih.gov/pubmed/30354377
Episode 15 - ReSS Year in Review: Part 2 of 2

Episode 15 - ReSS Year in Review: Part 2 of 2

December 15, 2019

Drs. Robert Neumar and Cindy Hsu (both at University of Michigan) continue their discussion with Dr. Felipe Teran following the plenary “Year in Review” presentation by Dr. Neumar at the American Heart Association Resuscitation Science Symposium (ReSS) in Philadelphia. If you missed ReSS, this is your chance to hear summaries of the top studies that impacted cardiac arrest and post-arrest care in the past 12 months. Note that this is the second part of a two-part podcast: Check your earlier in this feed for Episode 14 contains the first half of this conversation.

Key readings for this podcast include:

  • Nordberg P et al. Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial. JAMA2019 May 7;321(17):1677-1685. https://www.ncbi.nlm.nih.gov/pubmed/31063573
  • Lascarrou JB et al. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019 Dec 12;381(24):2327-2337. https://www.ncbi.nlm.nih.gov/pubmed/31577396
  • Scarpino et al. Neurophysiology and neuroimaging accurately predict poor neurological outcome within 24 hours after cardiac arrest: The ProNeCA prospective multicentre prognostication study. Resuscitation. 2019 Oct;143:115-123. https://www.ncbi.nlm.nih.gov/pubmed/31400398
  • Moseby-Knappe M et al. Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest. JAMA Neurol. 2019 Jan 1;76(1):64-71. https://www.ncbi.nlm.nih.gov/pubmed/30383090
  • Oddo M et al. Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study. Intensive Care Med. 2018 Dec;44(12):2102-2111. https://www.ncbi.nlm.nih.gov/pubmed/30478620
  • Vreselja Z et al. Restoration of brain circulation and cellular functions hours post-mortem. Nature. 2019 Apr;568(7752):336-343. https://www.ncbi.nlm.nih.gov/pubmed/30996318
Episode 14 - ReSS Year in Review: Part 1 of 2

Episode 14 - ReSS Year in Review: Part 1 of 2

December 3, 2019

Resuscitation Science Top Studies of 2019: Part 1 of 2

Drs. Robert Neumar and Cindy Hsu (both at University of Michigan) are guest presenters in this special TTM Academy Podcast, hosted by Dr. Felipe Teran. They recap the plenary “Year in Review” presentation by Dr. Neumar at the American Heart Association Resuscitation Science Symposium (ReSS) in Philadelphia. If you missed ReSS, this is your chance to hear summaries of the top studies that impacted cardiac arrest and post-arrest care in the past 12 months. Note that this is a two-part podcast: Episode 15 will present the second alf of this discussion in two weeks.

Year in Review Slides

Key readings for this podcast include:

Episode 13 – Transesophageal echocardiography during cardiac arrest resuscitation

Episode 13 – Transesophageal echocardiography during cardiac arrest resuscitation

November 8, 2019

Drs. Teran and Abella discuss the role of transesophageal echocardiography (TEE) in the resuscitation of cardiac arrest patients.  Listen for details of how this cutting-edge application of TEE could play a role in improving arrest diagnostics, CPR quality and possibly arrest outcomes.

 

Key Reading:

  1. Teran F et al. “Evaluation of out-of-hospital cardiac arrest using transesophageal echocardiography in the emergency department.” Resuscitation. 2019 Apr;137:140-147. https://www.ncbi.nlm.nih.gov/pubmed/30779977
  2. Catena E et al. “Association between left ventricular outflow tract opening and successful resuscitation after cardiac arrest.” Resuscitation. 2019 May;138:8-14. https://www.ncbi.nlm.nih.gov/pubmed/30825552
Episode 12 - HYPERION Results - TTM following non-shockable cardiac arrest

Episode 12 - HYPERION Results - TTM following non-shockable cardiac arrest

October 4, 2019

Earlier this week, results from the HYPERION trial were published in the New England Journal of Medicine. Drs. Abella and Teran discuss the use of TTM for patients resuscitated from cardiac arrest with a non-shockable initial rhythm.

 

Suggested Readings:

  1. Lascarrou JB et at., “Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm.” N Engl J Med. 2019 Oct 2.https://www.ncbi.nlm.nih.gov/pubmed/31577396
  2. Perman SM et al., “The Utility of Therapeutic Hypothermia for Post-Cardiac Arrest Syndrome Patients With an Initial Nonshockable Rhythm.” Circulation. 2015 Dec 1;132(22):2146-51. https://www.ncbi.nlm.nih.gov/pubmed/26572795
  3. Grossestreuer AV et al., “Magnitude of temperature elevation is associated with neurologic and survival outcomes in resuscitated cardiac arrest patients with postrewarming pyrexia.” J Crit Care. 2017 Apr;38:78-83. https://www.ncbi.nlm.nih.gov/pubmed/27866109
  4. Neilsen N et al., “Targeted temperature management at 33°C versus 36°C after cardiac arrest.” N Engl J Med. 2013 Dec 5;369(23):2197-206.https://www.ncbi.nlm.nih.gov/pubmed/24237006
Episode 11 - ECMO Implementation for Refractory Cardiac Arrest in the ED

Episode 11 - ECMO Implementation for Refractory Cardiac Arrest in the ED

September 20, 2019

Following the success of Episode 6, which discussed the scientific evidence for ECMO in cardiac arrest, we decided to take a deeper look at the implementation of ECMO in the ED. Drs. Felipe Teran and Joseph Tonna discuss the utilization of ECMO for refractory cardiac arrest, the expansion of hospital ECMO programs to the emergency department and implementation of an ECMO program for cardiac arrest. This episode was recorded on location in Salt Lake City, Utah.

 

Key Reading:

  1. Tonna JE et al., “Practice characteristics of Emergency Department extracorporeal cardiopulmonary resuscitation (eCPR) programs in the United States: The current state of the art of Emergency Department extracorporeal membrane oxygenation (ED ECMO).” Resuscitation. 2016 Oct;107:38-46. https://www.ncbi.nlm.nih.gov/pubmed/27523953
  2. Tonna JE et al., “Development and Implementation of a Comprehensive, Multidisciplinary Emergency Department Extracorporeal Membrane Oxygenation Program.” Ann Emerg Med. 2017 Jul;70(1):32-40. https://www.ncbi.nlm.nih.gov/pubmed/28139304

Play this podcast on Podbean App