Pulseless electrical activity risk factors: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 19: Line 19:


==Beta Blockers and Calcium Channel Blockers as Risk Factors for PEA==
==Beta Blockers and Calcium Channel Blockers as Risk Factors for PEA==
It is not well established yet why [[beta blocker]]s and [[ACE inhibitor]]s are risk factors for PEA.  One possible explanation is that the use of [[beta blocker]]s and [[ACE inhibitor]]s in the context of [[ventricular fibrillation]] might lead to the conversion of [[ventricular fibrillation]] (VF) to [[pulseless electrical activity]] (PEA).<ref name="pmid19112286">{{cite journal| author=Gessman LJ| title=Do beta-blockers and ACE inhibitors decrease the duration of ventricular fibrillation, or cause spontaneous conversion of ventricular fibrillation? | journal=Crit Care Med | year= 2009 | volume= 37 | issue= 1 | pages= 329-30 | pmid=19112286 | doi=10.1097/CCM.0b013e3181930578 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19112286  }} </ref>  Another explanation for the association of [[beta blocker]]s and [[ACE inhibitor]]s with the increased incidence of [[PEA]] among patients with [[SCA]] is that the pharmacological treatment with beta blockers and ACE inhibitors of patients with [[VF]] have lead to a decrease in the prevalence of [[VF]] and subsequent relative increase in the incidence of PEA.<ref name="pmid12479765">{{cite journal| author=Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK| title=Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. | journal=JAMA | year= 2002 | volume= 288 | issue= 23 | pages= 3008-13 | pmid=12479765 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12479765  }} </ref> <ref name="pmid10924315">{{cite journal| author=Herlitz J, Andersson E, Bång A, Engdahl J, Holmberg M, lindqvist J et al.| title=Experiences from treatment of out-of-hospital cardiac arrest during 17 years in Göteborg. | journal=Eur Heart J | year= 2000 | volume= 21 | issue= 15 | pages= 1251-8 | pmid=10924315 | doi=10.1053/euhj.2000.2150 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10924315  }} </ref>
It is not yet well established why [[beta blocker]]s and [[ACE inhibitor]]s are risk factors for PEA.  One possible explanation is that the use of [[beta blocker]]s and [[ACE inhibitor]]s in the context of [[ventricular fibrillation]] might lead to the conversion of [[ventricular fibrillation]] (VF) to [[pulseless electrical activity]] (PEA).<ref name="pmid19112286">{{cite journal| author=Gessman LJ| title=Do beta-blockers and ACE inhibitors decrease the duration of ventricular fibrillation, or cause spontaneous conversion of ventricular fibrillation? | journal=Crit Care Med | year= 2009 | volume= 37 | issue= 1 | pages= 329-30 | pmid=19112286 | doi=10.1097/CCM.0b013e3181930578 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19112286  }} </ref>  Another explanation for the association is that the pharmacological treatment with beta blockers and ACE inhibitors of patients with [[VF]] have lead to a decrease in the prevalence of [[VF]] and subsequent relative increase in the incidence of PEA among patients with [[SCA]].<ref name="pmid12479765">{{cite journal| author=Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK| title=Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. | journal=JAMA | year= 2002 | volume= 288 | issue= 23 | pages= 3008-13 | pmid=12479765 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12479765  }} </ref> <ref name="pmid10924315">{{cite journal| author=Herlitz J, Andersson E, Bång A, Engdahl J, Holmberg M, lindqvist J et al.| title=Experiences from treatment of out-of-hospital cardiac arrest during 17 years in Göteborg. | journal=Eur Heart J | year= 2000 | volume= 21 | issue= 15 | pages= 1251-8 | pmid=10924315 | doi=10.1053/euhj.2000.2150 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10924315  }} </ref>


==References==
==References==

Revision as of 22:21, 16 December 2013



Resident
Survival
Guide

Pulseless electrical activity Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulseless Electrical Activity from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pulseless electrical activity risk factors On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pulseless electrical activity risk factors

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pulseless electrical activity risk factors

CDC on Pulseless electrical activity risk factors

Pulseless electrical activity risk factors in the news

Blogs on Pulseless electrical activity risk factors

Directions to Hospitals Treating Pulseless electrical activity

Risk calculators and risk factors for Pulseless electrical activity risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]

Overview

The administration of beta blockers and calcium channel blockers is associated with an increased risk of PEA. This may be due to their effect on the interactions between calcium and troponin and their inhibition of myocardial contractility. Syncope and pulmonary disease is also associated with a higher risk of PEA.[1]

Risk Factors

Beta Blockers and Calcium Channel Blockers as Risk Factors for PEA

It is not yet well established why beta blockers and ACE inhibitors are risk factors for PEA. One possible explanation is that the use of beta blockers and ACE inhibitors in the context of ventricular fibrillation might lead to the conversion of ventricular fibrillation (VF) to pulseless electrical activity (PEA).[4] Another explanation for the association is that the pharmacological treatment with beta blockers and ACE inhibitors of patients with VF have lead to a decrease in the prevalence of VF and subsequent relative increase in the incidence of PEA among patients with SCA.[5] [6]

References

  1. 1.0 1.1 Teodorescu C, Reinier K, Dervan C, Uy-Evanado A, Samara M, Mariani R; et al. (2010). "Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study". Circulation. 122 (21): 2116–22. doi:10.1161/CIRCULATIONAHA.110.966333. PMID 21060069.
  2. Pirolo JS, Hutchins GM, Moore GW (1985). "Electromechanical dissociation: pathologic explanations in 50 patients". Hum Pathol. 16 (5): 485–7. PMID 3988275.
  3. Herlitz J, Rosenfelt M, Bång A, Axelsson A, Ekström L, Wennerblom B; et al. (1996). "Prognosis among patients with out-of-hospital cardiac arrest judged as being caused by deterioration of obstructive pulmonary disease". Resuscitation. 32 (3): 177–84. PMID 8923578.
  4. Gessman LJ (2009). "Do beta-blockers and ACE inhibitors decrease the duration of ventricular fibrillation, or cause spontaneous conversion of ventricular fibrillation?". Crit Care Med. 37 (1): 329–30. doi:10.1097/CCM.0b013e3181930578. PMID 19112286.
  5. Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK (2002). "Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000". JAMA. 288 (23): 3008–13. PMID 12479765.
  6. Herlitz J, Andersson E, Bång A, Engdahl J, Holmberg M, lindqvist J; et al. (2000). "Experiences from treatment of out-of-hospital cardiac arrest during 17 years in Göteborg". Eur Heart J. 21 (15): 1251–8. doi:10.1053/euhj.2000.2150. PMID 10924315.

Template:WH Template:WS