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Cardiology503 papers

Circulatory arrest

Last edited: 29 days ago

Overview

Circulatory arrest refers to a state where systemic circulation ceases, often necessitating interventions such as extracorporeal membrane oxygenation (ECMO) or mechanical circulatory support devices to restore perfusion. This condition can arise in various clinical scenarios, including severe sepsis, trauma, or congenital heart disease, particularly in pediatric patients.

Diagnosis

  • Clinical Presentation: Hypotension, altered mental status, and signs of organ dysfunction 11839.
  • Monitoring: Continuous hemodynamic monitoring, including arterial blood gases and lactate levels 118.
  • Imaging: Echocardiography to assess cardiac function and identify structural abnormalities 3139.
  • Laboratory Tests: Activated partial thromboplastin time (aPTT) and anti-Xa levels for heparin monitoring 5.
  • Management

  • First-Line Treatments:
  • - Fluid Resuscitation: Initial volume replacement to restore intravascular volume 3. - Inotropic Support: Use of catecholamines (e.g., epinephrine, norepinephrine) to maintain blood pressure 50.
  • Adjunctive Therapies:
  • - Mechanical Circulatory Support: ECMO or ventricular assist devices (VADs) for severe cases 1182748. - Anticoagulation: Bivalirudin for its balanced anticoagulation profile in ECMO patients 21. - Thrombolysis: Catheter-directed thrombolysis for clot dissolution 2.

    Special Populations

  • Pediatrics: Special attention to acquired von Willebrand syndrome and tailored anticoagulation strategies 18.
  • Elderly: Increased risk of complications; careful fluid management and monitoring for TACO 46.
  • Comorbidities: Consideration of underlying conditions like chronic myeloid disorders affecting hepatic circulation 76.
  • Key Recommendations

  • Initiate Early Fluid Resuscitation to address hypovolemia and improve perfusion (Evidence: Moderate 3).
  • Utilize ECMO or VADs in refractory circulatory failure to maintain organ perfusion (Evidence: Moderate 118).
  • Employ Bivalirudin for Anticoagulation in ECMO patients due to its efficacy and safety profile (Evidence: Moderate 21).
  • Monitor Hemodynamics Closely using echocardiography and laboratory parameters to guide therapy (Evidence: Moderate 131).
  • Consider Individualized Management based on patient-specific factors such as age and comorbidities (Evidence: Expert opinion 1846).
  • References

    Showing 100 most recent of 179 indexed papers.

    1 Lofy T, Juul J, Duewell B, Tchen S, Held-Godgluck B, Brazauskas R et al.. Retrospective, Single-Center Cohort Study of Bivalirudin Compared to Unfractionated Heparin in Patients Receiving Extracorporeal Membrane Oxygenation. The Annals of pharmacotherapy 2026. link 2 Chaudhry-Waterman N, Schardt TQ, Soderstrom RM, Warren BB, Buckvold S, Morgan G et al.. Catheter-Directed Bivalirudin for Local Anticoagulation and Clot Dissolution in Children Requiring Mechanical Circulatory Support. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2026. link 3 Mekontso Dessap A, AlShamsi F, Belletti A, De Backer D, Delaney A, Møller MH et al.. European Society of Intensive Care Medicine (ESICM) 2025 clinical practice guideline on fluid therapy in adult critically ill patients: part 2-the volume of resuscitation fluids. Intensive care medicine 2025. link 4 Cucinotta FA, Saganti PB. Residual radiation risk disparities across sex and race or ethnic groups for lifetime never-smokers on lunar missions. Life sciences in space research 2024. link 5 Li S, Li A, Beckman JA, Kim C, Granich MA, Mondin J et al.. Discordance between aPTT and anti-Xa in monitoring heparin anticoagulation in mechanical circulatory support. ESC heart failure 2024. link 6 Ivaniuk AV. CONCEPTUAL, FUNCTIONAL-ORGANISATIONAL MODEL OF THE REGIONAL CENTRE FOR CARDIOLOGY AND CARDIAC SURGERY BASED ON PUBLIC-PRIVATE PARTNERSHIP. Wiadomosci lekarskie (Warsaw, Poland : 1960) 2023. link 7 Villeneuve PJ, Morrison HI, Volesky K, Lane RSD. Circulatory system disease mortality and occupational exposure to radon progeny in the cohort of Newfoundland Fluorspar Miners between 1950 and 2016. International archives of occupational and environmental health 2023. link 8 Sheikh Rezaei S, Gatterer C, Sulzgruber P, Hofer F, Mittlboeck H, Gavrilovic S et al.. Risk stratification and long-term outcome of patients receiving in-hospital medical emergency team critical care: experience from Austria's largest medical center. Minerva medica 2023. link 9 Choi W, Kim KY. Association between exposure level of air pollutants and incidence rate of circulatory disease in residential and industrial areas of South Korea. International journal of environmental health research 2022. link 10 Zhou X, Wang C, Chen P, Chen Y, Yin L, Du W et al.. Time series analysis of short-term effects of particulate matter pollution on the circulatory system disease mortality risk in Lishui District, China. Environmental science and pollution research international 2022. link 11 Chen Z, Zhang J, Li T, Tran D, Griffith BP, Wu ZJ. The impact of shear stress on device-induced platelet hemostatic dysfunction relevant to thrombosis and bleeding in mechanically assisted circulation. Artificial organs 2020. link 12 Brown MC, Ramos V, Voskoboynikov N. Evolution and clinical adoption of the Autologs system: An automated analysis for enhanced patient management in MCS. Artificial organs 2020. link 13 Katheria AC, Rich WD, Lakshminrusimha S. Circulatory emergencies in the delivery room. Seminars in fetal & neonatal medicine 2019. link 14 Chen YC, Hu HY, Fan HY, Kao WS, Chen HY, Huang SJ. Where and How Centenarians Die? The Role of Hospice Care. The American journal of hospice & palliative care 2019. link 15 Sandfort V, Johnson AEW, Kunz LM, Vargas JD, Rosing DR. Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database. Journal of intensive care medicine 2019. link 16 Rossetto C, Soares JV, Brandão ML, Rosa NGD, Rosset I. Causes of hospital admissions and deaths among Brazilian elders between 2005 and 2015. Revista gaucha de enfermagem 2019. link 17 Tume SC, Conway J, Ryan KR, Philip J, Fortkiewicz JM, Murray J. Developments in Pediatric Ventricular Assist Device Support. World journal for pediatric & congenital heart surgery 2019. link 18 Kubicki R, Stiller B, Kroll J, Siepe M, Beyersdorf F, Benk C et al.. Acquired von Willebrand syndrome in paediatric patients during mechanical circulatory support. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 2019. link 19 Vloet LCM, de Kreek A, van der Linden EMC, van Spijk JJA, Theunissen VAH, van Wanrooij M et al.. A retrospective comparison between non-conveyed and conveyed patients in ambulance care. Scandinavian journal of trauma, resuscitation and emergency medicine 2018. link 20 Zhivin S, Guseva Canu I, Davesne E, Blanchardon E, Garsi JP, Samson E et al.. Circulatory disease in French nuclear fuel cycle workers chronically exposed to uranium: a nested case-control study. Occupational and environmental medicine 2018. link 21 Hicks SA, Cimarolli VR. The effects of telehealth use for post-acute rehabilitation patient outcomes. Journal of telemedicine and telecare 2018. link 22 Kotsopoulos AMM, Böing-Messing F, Jansen NE, Vos P, Abdo WF. External validation of prediction models for time to death in potential donors after circulatory death. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2018. link 23 Rozenbaum Z, Khoury S, Aviram G, Gura Y, Sherez J, Man A et al.. Discriminating Circulatory Problems From Deconditioning: Echocardiographic and Cardiopulmonary Exercise Test Analysis. Chest 2017. link 24 Aletti F, Gambarotta N, Penn AH, Ferrario M, Schmid-Schönbein GW. Heart period and blood pressure characteristics in splanchnic arterial occlusion shock-induced collapse. Journal of clinical monitoring and computing 2017. link 25 Almendra R, Santana P, Vasconcelos J, Silva G, Gonçalves F, Ambrizzi T. The influence of the winter North Atlantic Oscillation index on hospital admissions through diseases of the circulatory system in Lisbon, Portugal. International journal of biometeorology 2017. link 26 Grignola JC, Domingo E. Acute Right Ventricular Dysfunction in Intensive Care Unit. BioMed research international 2017. link 27 Wind J, van Mook WN, Dhanani S, van Heurn EW. Determination of death after circulatory arrest by intensive care physicians: A survey of current practice in the Netherlands. Journal of critical care 2016. link 28 Griffith KE, Jenkins E, Copenhaver W, Williams DM. Novel use of the AngioVac® system to remove thrombus during simultaneous extracorporeal membrane oxygenation life support. Perfusion 2016. link 29 Little MP, Zablotska LB, Brenner AV, Lipshultz SE. Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study. European journal of epidemiology 2016. link 30 Appleby PN, Crowe FL, Bradbury KE, Travis RC, Key TJ. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. The American journal of clinical nutrition 2016. link 31 Arntfield R, Pace J, Hewak M, Thompson D. Focused Transesophageal Echocardiography by Emergency Physicians is Feasible and Clinically Influential: Observational Results from a Novel Ultrasound Program. The Journal of emergency medicine 2016. link 32 Wirth MD, Shivappa N, Hurley TG, Hébert JR. Association between previously diagnosed circulatory conditions and a dietary inflammatory index. Nutrition research (New York, N.Y.) 2016. link 33 Palanisamy V, Km P. A tribute to a scientist extraordinaire - Ernest H. Starling (1866-1927). Acta medico-historica adriatica : AMHA 2015. link 34 Müller WU. Current discussions of DDREF, cataracts, circulatory diseases and dose limits. Radiation protection dosimetry 2015. link 35 Cruz AM, Sarmento S, Almeida SM, Silva AV, Alves C, Freitas MC et al.. Association between atmospheric pollutants and hospital admissions in Lisbon. Environmental science and pollution research international 2015. link 36 Suzuki H, Hikiji W, Tanifuji T, Abe N, Fukunaga T. Characteristics of sudden bath-related death investigated by medical examiners in Tokyo, Japan. Journal of epidemiology 2015. link 37 Credeur DP, Holwerda SW, Restaino RM, King PM, Crutcher KL, Laughlin MH et al.. Characterizing rapid-onset vasodilation to single muscle contractions in the human leg. Journal of applied physiology (Bethesda, Md. : 1985) 2015. link 38 Kim KI, Lee HS, Kim HS, Ha SO, Lee WY, Park SJ et al.. The pre-ECMO simplified acute physiology score II as a predictor for mortality in patients with initiation ECMO support at the emergency department for acute circulatory and/or respiratory failure: a retrospective study. Scandinavian journal of trauma, resuscitation and emergency medicine 2015. link 39 Blohm ME, Obrecht D, Hartwich J, Singer D. Effect of cerebral circulatory arrest on cerebral near-infrared spectroscopy in pediatric patients. Paediatric anaesthesia 2014. link 40 Renzaho AM, Houng B, Oldroyd J, Nicholson JM, D'Esposito F, Oldenburg B. Stressful life events and the onset of chronic diseases among Australian adults: findings from a longitudinal survey. European journal of public health 2014. link 41 Duff JP, Decaen A, Guerra GG, Lequier L, Buchholz H. Diagnosis and management of circulatory arrest in pediatric ventricular assist device patients: presentation of two cases and suggested guidelines. Resuscitation 2013. link 42 Krestinina LY, Epifanova S, Silkin S, Mikryukova L, Degteva M, Shagina N et al.. Chronic low-dose exposure in the Techa River Cohort: risk of mortality from circulatory diseases. Radiation and environmental biophysics 2013. link 43 Smyth B, Evans DS, Kelly A, Cullen L, O'Donovan D. The farming population in Ireland: mortality trends during the 'Celtic Tiger' years. European journal of public health 2013. link 44 Hoffmann R, Plug I, McKee M, Khoshaba B, Westerling R, Looman C et al.. Innovations in medical care and mortality trends from four circulatory diseases between 1970 and 2005. European journal of public health 2013. link 45 Ramos JM, Sánchez-Martínez R, Nieto F, Sastre J, Valero B, Priego M et al.. Characteristics and outcome in nonagenarians admitted in general internal medicine and other specialties. European journal of internal medicine 2013. link 46 Lieberman L, Maskens C, Cserti-Gazdewich C, Hansen M, Lin Y, Pendergrast J et al.. A retrospective review of patient factors, transfusion practices, and outcomes in patients with transfusion-associated circulatory overload. Transfusion medicine reviews 2013. link 47 Bhopal RS, Rafnsson SB, Agyemang C, Fagot-Campagna A, Giampaoli S, Hammar N et al.. Mortality from circulatory diseases by specific country of birth across six European countries: test of concept. 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    Original source

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