Penn Medicine’s TTM Academy Podcasts
Episode 8 – Oxygen Delivery After Cardiac Arrest Resuscitation 

Episode 8 – Oxygen Delivery After Cardiac Arrest Resuscitation 

August 9, 2019

Episode 8 – Oxygen Delivery After Cardiac Arrest Resuscitation

 

During cardiac arrest resuscitation, most patients are intubated and placed on 100% oxygen. In this podcast, Drs. Teran and Abella discuss recent investigations that suggest that too much oxygen may worsen post-arrest injury. Global resuscitation guidelines suggest down-titration of oxygen as tolerated to maintain adequate O2 saturation, but it’s not clear how well this is done- many patients are left on high oxygen “dose” for hours.

 

Key readings for this podcast:

  1. Robert BW et al, “Association Between Early Hyperoxia Exposure After Resuscitation From Cardiac Arrest and Neurological Disability: Prospective Multicenter Protocol-Directed Cohort Study.” Circulation. 2018 May 15;137(20):2114-2124. https://www.ncbi.nlm.nih.gov/pubmed/29437118
  2. Kilgannon JH et al, “Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality.” JAMA. 2010 Jun 2;303(21):2165-71. https://www.ncbi.nlm.nih.gov/pubmed/20516417
Episode 7 - Cardiac Arrest Regionalized Care

Episode 7 - Cardiac Arrest Regionalized Care

July 19, 2019

Drs. Felipe Teran and Ben Abella discuss an important recent publication in Annals of Emergency Medicine by Elmer et al, in which some of the strongest evidence to date are presented that support the concept of “cardiac arrest centers”, much like trauma or stroke centers. This has been proposed before (Nichol G et al, Circulation 2010 – see below) – but evidence is now accumulating in support of the idea.

Key readings:

  1. Nichol G et al, “Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association.”, Circulation 2010;121:709-29. https://www.ncbi.nlm.nih.gov/pubmed/20075331
  2. Elmer J et al, “Long-Term Outcomes of Out-of-Hospital Cardiac Arrest Care at Regionalized Centers.”, Ann Emerg Med 2019; 73:29-39. https://www.ncbi.nlm.nih.gov/pubmed/30060961
Episode 6 - ECMO for Cardiac Arrest

Episode 6 - ECMO for Cardiac Arrest

July 5, 2019

Drs. Benjamin Abella, John Greenwood and Felipe Teran discuss the use of ECMO (extra corporeal membrane oxygenation) for cardaic arrest patients. 

 

Referenced article:

Weisfeldt ML, Becker LB.  Resuscitation after cardiac arrest: a 3-phase time-sensitive model. JAMA. 2002 Dec 18;288(23):3035-8. https://doi.org/10.1001/jama.288.23.3035

 

Episode 5 - The Importance of Neurological Monitoring Post-Arrest

Episode 5 - The Importance of Neurological Monitoring Post-Arrest

June 14, 2019

Dr. Felipe Teran discusses with Dr. Ramani Balu the importance of post-arrest neurological monitoring.

 

The Online TTM Course is now OPEN! Visit upenn.cloud-cme.com/ttmonline for more information or to register.

Episode 4  - Transnasal Cooling During Cardiac Arrest

Episode 4 - Transnasal Cooling During Cardiac Arrest

May 13, 2019

Dr. Abella discusses the recent publication in JAMA regarding the PRINCESS trial of intra-arrest brain cooling.

JAMA Article: https://doi.org/10.1001/jama.2019.4149

Pre-hospital cold saline:  https://doi.org/10.1001/jama.2013.282173

 

TTM Academy: https://pennmedonline.upenn.edu/ttmacademy/

 

 

Episode 3 - Neuroprognostication

Episode 3 - Neuroprognostication

April 12, 2019

Dr. Abella discusses neuroprognostication following cardiac arrest and how long to continue care before considering withdrawl.

TTM Academy: www.med.upenn.edu/resuscitation/ttm-academy.html

For updates: text TTM to 31996 or email TTMtraining@pennmedicine.upenn.edu

 ** TTM Academy podcasts are intended for medical education only and should not be used for clinical decision making.

Episode 2 - Post-Arrest Coronary Angiography

Episode 2 - Post-Arrest Coronary Angiography

March 29, 2019

Dr. Abella discusses the recent publication - Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. For the full article abstract visit: https://www.nejm.org/doi/full/10.1056/NEJMoa1816897

 

** TTM Academy podcasts are intended for medical education only and should not be used for clinical decision making.

Episode 1 - Goal Temperature for Targeted Temperature Management

Episode 1 - Goal Temperature for Targeted Temperature Management

March 7, 2019

Welcome to the first episode of Penn Medicine's TTM Academy Podcast. Dr. Benjamin Abella discusses the goal temperatures for TTM. 

Send ideas for new topics to TTMtraining@pennmedicine.upenn.edu

Learn more about TTM Academy: www.med.upenn.edu/resuscitation/ttm-academy.html

** TTM Academy podcasts are intended for medical education only and should not be used for clinical decision making.