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3 results on '"Tonna, J. E."'

1. Prognostic factors associated with favourable functional outcome among adult patients requiring extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: A systematic review and meta-analysis

Author

Tran, A., Rochwerg, B., Fan, E., Belohlavek, J., Suverein, M. M., van de Poll, M. C. G., Lorusso, R., Price, S., Yannopoulos, D., Maclaren, G., Ramanathan, K., Ling, R. R., Thiara, S., Tonna, J. E., Shekar, K., Hodgson, C. L., Scales, D. C., Sandroni, Claudio, Nolan, J. P., Slutsky, A. S., Combes, A., Brodie, D., Fernando, S. M., Sandroni C. (ORCID:0000-0002-8878-2611), Tran, A., Rochwerg, B., Fan, E., Belohlavek, J., Suverein, M. M., van de Poll, M. C. G., Lorusso, R., Price, S., Yannopoulos, D., Maclaren, G., Ramanathan, K., Ling, R. R., Thiara, S., Tonna, J. E., Shekar, K., Hodgson, C. L., Scales, D. C., Sandroni, Claudio, Nolan, J. P., Slutsky, A. S., Combes, A., Brodie, D., Fernando, S. M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

Background: Extracorporeal cardiopulmonary resuscitation (ECPR), has demonstrated promise in the management of refractory out-of-hospital cardiac arrest (OHCA). However, evidence from observational studies and clinical trials are conflicting and the factors influencing outcome have not been well established. Methods: We conducted a systematic review and meta-analysis summarizing the association between pre-ECPR prognostic factors and likelihood of good functional outcome among adult patients requiring ECPR for OHCA. We searched Medline and Embase databases from inception to February 28, 2023 and screened studies with two independent reviewers. We performed meta-analyses of unadjusted and adjusted odds ratios, adjusted hazard ratios and mean differences separately. We assessed risk of bias using the QUIPS tool and certainty of evidence using the GRADE approach. Findings: We included 29 observational and randomized studies involving 7,397 patients. Factors with moderate or high certainty of association with increased survival with favourable functional outcome include pre-arrest patient factors, such as younger age (odds ratio (OR) 2.13, 95% CI 1.52 to 2.99) and female sex (OR 1.37, 95% CI 1.11 to 1.70), as well as intra-arrest factors, such as shockable rhythm (OR 2.79, 95% CI 2.04 to 3.80), witnessed arrest (OR 1.68 (95% CI 1.16 to 2.42), bystander CPR (OR 1.55, 95% CI 1.19 to 2.01), return of spontaneous circulation (OR 2.81, 95% CI 2.19 to 3.61) and shorter time to cannulation (OR 1.14, 95% CI 1.17 to 1.69 per 10 minutes). Interpretation: The findings of this review confirm several clinical concepts wellestablished in the cardiac arrest literature and their applicability to the patient for whom ECPR is considered – that is, the impact of pre-existing patient factors, the benefit of timely and effective CPR, as well as the prognostic importance of minimizing low-flow time. We advocate for the thoughtful consideration of these prognostic factors as part of a risk st

Published
2023

2. Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry

Author

Barbaro, R, Maclaren, G, Boonstra, P, Iwashyna, T, Slutsky, A, Fan, E, Bartlett, R, Tonna, J, Hyslop, R, Fanning, J, Rycus, P, Hyer, S, Anders, M, Agerstrand, C, Hryniewicz, K, Diaz, R, Lorusso, R, Combes, A, Brodie, D, Alexander, P, Barrett, N, Belohlavek, J, Fisher, D, Fraser, J, Hssain, A, Jung, J, Mcmullan, M, Mehta, Y, Ogino, M, Paden, M, Shekar, K, Stead, C, Abu-Omar, Y, Agnoletti, V, Akbar, A, Alfoudri, H, Alviar, C, Aronsky, V, August, E, Auzinger, G, Aveja, H, Bakken, R, Balcells, J, Bangalore, S, Barnes, B, Bautista, A, Bellows, L, Beltran, F, Benharash, P, Benni, M, Berg, J, Bertini, P, Blanco-Schweizer, P, Brunsvold, M, Budd, J, Camp, D, Caridi-Scheible, M, Carton, E, Casanova-Ghosh, E, Castleberry, A, Chipongian, C, Choi, C, Circelli, A, Cohen, E, Collins, M, Copus, S, Coy, J, Crist, B, Cruz, L, Czuczwar, M, Daneshmand, M, Davis II, D, De la Cruz, K, Devers, C, Duculan, T, Durham, L, Elapavaluru, S, Elzo Kraemer, C, Filho, E, Fitzgerald, J, Foti, G, Fox, M, Fritschen, D, Fullerton, D, Gelandt, E, Gerle, S, Giani, M, Goh, S, Govener, S, Grone, J, Guber, M, Gudzenko, V, Gutteridge, D, Guy, J, Haft, J, Hall, C, Hassan, I, Herran, R, Hirose, H, Ibrahim, A, Igielski, D, Ivascu, F, Izquierdo Blasco, J, Jackson, J, Jain, H, Jaiswal, B, Johnson, A, Jurynec, J, Kellter, N, Kohl, A, Kon, Z, Kredel, M, Kriska, K, Kunavarapu, C, Lansink-Hartgring, O, Larocque, J, Larson, S, Layne, T, Ledot, S, Lena, N, Lillie, J, Lotz, G, Lucas, M, Ludwigson, L, Maas, J, Maertens, J, Mast, D, Mccardle, S, Mcdonald, B, Mclarty, A, Mcmahon, C, Meybohm, P, Meyns, B, Miller, C, Moraes Neto, F, Morris, K, Muellenbach, R, Nicholson, M, O'Brien, S, O'Keefe, K, Ogston, T, Oldenburg, G, Oliveira, F, Oppel, E, Pardo, D, Parker, S, Pedersen, F, Pellecchia, C, Pelligrini, J, Pham, T, Phillips, A, Pirani, T, Piwowarczyk, P, Plambeck, R, Pruett, W, Quandt, B, Ramanathan, K, Rey, A, Reyher, C, Riera del Brio, J, Roberts, R, Roe, D, Roeleveld, P, Rudy, J, Rueda, L, Russo, E, Sanchez Ballesteros, J, Satou, N, Saueressig, M, Saunders, P, Schlotterbeck, M, Schwarz, P, Scriven, N, Serra, A, Shamsah, M, Sim, L, Smart, A, Smith, A, Smith, D, Smith, M, Sodha, N, Sonntagbauer, M, Sorenson, M, Stallkamp, E, Stewart, A, Swartz, K, Takeda, K, Thompson, S, Toy, B, Tuazon, D, Uchiyama, M, Udeozo, O, van Poppel, S, Ventetuolo, C, Vercaemst, L, Vinh Chau, N, Wang, I, Williamson, C, Wilson, B, Winkels, H, Barbaro R. P., MacLaren G., Boonstra P. S., Iwashyna T. J., Slutsky A. S., Fan E., Bartlett R. H., Tonna J. E., Hyslop R., Fanning J. J., Rycus P. T., Hyer S. J., Anders M. M., Agerstrand C. L., Hryniewicz K., Diaz R., Lorusso R., Combes A., Brodie D., Alexander P., Barrett N., Belohlavek J., Fisher D., Fraser J., Hssain A. A., Jung J. S., McMullan M., Mehta Y., Ogino M. T., Paden M. L., Shekar K., Stead C., Abu-Omar Y., Agnoletti V., Akbar A., Alfoudri H., Alviar C., Aronsky V., August E., Auzinger G., Aveja H., Bakken R., Balcells J., Bangalore S., Barnes B. W., Bautista A., Bellows L. L., Beltran F., Benharash P., Benni M., Berg J., Bertini P., Blanco-Schweizer P., Brunsvold M., Budd J., Camp D., Caridi-Scheible M., Carton E., Casanova-Ghosh E., Castleberry A., Chipongian C. T., Choi C. W., Circelli A., Cohen E., Collins M., Copus S., Coy J., Crist B., Cruz L., Czuczwar M., Daneshmand M., Davis II D., De la Cruz K., Devers C., Duculan T., Durham L., Elapavaluru S., Elzo Kraemer C. V., Filho E. C., Fitzgerald J., Foti G., Fox M., Fritschen D., Fullerton D., Gelandt E., Gerle S., Giani M., Goh S. G., Govener S., Grone J., Guber M., Gudzenko V., Gutteridge D., Guy J., Haft J., Hall C., Hassan I. F., Herran R., Hirose H., Ibrahim A. S., Igielski D., Ivascu F. A., Izquierdo Blasco J., Jackson J., Jain H., Jaiswal B., Johnson A. C., Jurynec J. A., Kellter N. M., Kohl A., Kon Z., Kredel M., Kriska K., Kunavarapu C., Lansink-Hartgring O., LaRocque J., Larson S. B., Layne T., Ledot S., Lena N., Lillie J., Lotz G., Lucas M., Ludwigson L., Maas J. J., Maertens J., Mast D., McCardle S., McDonald B., McLarty A., McMahon C., Meybohm P., Meyns B., Miller C., Moraes Neto F., Morris K., Muellenbach R., Nicholson M., O'Brien S., O'Keefe K., Ogston T., Oldenburg G., Oliveira F. M., Oppel E., Pardo D., Parker S. J., Pedersen F. M., Pellecchia C., Pelligrini J. A. S., Pham T. T. N., Phillips A. R., Pirani T., Piwowarczyk P., Plambeck R., Pruett W., Quandt B., Ramanathan K., Rey A., Reyher C., Riera del Brio J., Roberts R., Roe D., Roeleveld P. P., Rudy J., Rueda L. F., Russo E., Sanchez Ballesteros J., Satou N., Saueressig M. G., Saunders P. C., Schlotterbeck M., Schwarz P., Scriven N., Serra A., Shamsah M., Sim L., Smart A., Smith A., Smith D., Smith M., Sodha N., Sonntagbauer M., Sorenson M., Stallkamp E. B., Stewart A., Swartz K., Takeda K., Thompson S., Toy B., Tuazon D., Uchiyama M., Udeozo O. I., van Poppel S., Ventetuolo C., Vercaemst L., Vinh Chau N. V., Wang I. -W., Williamson C., Wilson B., Winkels H., Barbaro, R, Maclaren, G, Boonstra, P, Iwashyna, T, Slutsky, A, Fan, E, Bartlett, R, Tonna, J, Hyslop, R, Fanning, J, Rycus, P, Hyer, S, Anders, M, Agerstrand, C, Hryniewicz, K, Diaz, R, Lorusso, R, Combes, A, Brodie, D, Alexander, P, Barrett, N, Belohlavek, J, Fisher, D, Fraser, J, Hssain, A, Jung, J, Mcmullan, M, Mehta, Y, Ogino, M, Paden, M, Shekar, K, Stead, C, Abu-Omar, Y, Agnoletti, V, Akbar, A, Alfoudri, H, Alviar, C, Aronsky, V, August, E, Auzinger, G, Aveja, H, Bakken, R, Balcells, J, Bangalore, S, Barnes, B, Bautista, A, Bellows, L, Beltran, F, Benharash, P, Benni, M, Berg, J, Bertini, P, Blanco-Schweizer, P, Brunsvold, M, Budd, J, Camp, D, Caridi-Scheible, M, Carton, E, Casanova-Ghosh, E, Castleberry, A, Chipongian, C, Choi, C, Circelli, A, Cohen, E, Collins, M, Copus, S, Coy, J, Crist, B, Cruz, L, Czuczwar, M, Daneshmand, M, Davis II, D, De la Cruz, K, Devers, C, Duculan, T, Durham, L, Elapavaluru, S, Elzo Kraemer, C, Filho, E, Fitzgerald, J, Foti, G, Fox, M, Fritschen, D, Fullerton, D, Gelandt, E, Gerle, S, Giani, M, Goh, S, Govener, S, Grone, J, Guber, M, Gudzenko, V, Gutteridge, D, Guy, J, Haft, J, Hall, C, Hassan, I, Herran, R, Hirose, H, Ibrahim, A, Igielski, D, Ivascu, F, Izquierdo Blasco, J, Jackson, J, Jain, H, Jaiswal, B, Johnson, A, Jurynec, J, Kellter, N, Kohl, A, Kon, Z, Kredel, M, Kriska, K, Kunavarapu, C, Lansink-Hartgring, O, Larocque, J, Larson, S, Layne, T, Ledot, S, Lena, N, Lillie, J, Lotz, G, Lucas, M, Ludwigson, L, Maas, J, Maertens, J, Mast, D, Mccardle, S, Mcdonald, B, Mclarty, A, Mcmahon, C, Meybohm, P, Meyns, B, Miller, C, Moraes Neto, F, Morris, K, Muellenbach, R, Nicholson, M, O'Brien, S, O'Keefe, K, Ogston, T, Oldenburg, G, Oliveira, F, Oppel, E, Pardo, D, Parker, S, Pedersen, F, Pellecchia, C, Pelligrini, J, Pham, T, Phillips, A, Pirani, T, Piwowarczyk, P, Plambeck, R, Pruett, W, Quandt, B, Ramanathan, K, Rey, A, Reyher, C, Riera del Brio, J, Roberts, R, Roe, D, Roeleveld, P, Rudy, J, Rueda, L, Russo, E, Sanchez Ballesteros, J, Satou, N, Saueressig, M, Saunders, P, Schlotterbeck, M, Schwarz, P, Scriven, N, Serra, A, Shamsah, M, Sim, L, Smart, A, Smith, A, Smith, D, Smith, M, Sodha, N, Sonntagbauer, M, Sorenson, M, Stallkamp, E, Stewart, A, Swartz, K, Takeda, K, Thompson, S, Toy, B, Tuazon, D, Uchiyama, M, Udeozo, O, van Poppel, S, Ventetuolo, C, Vercaemst, L, Vinh Chau, N, Wang, I, Williamson, C, Wilson, B, Winkels, H, Barbaro R. P., MacLaren G., Boonstra P. S., Iwashyna T. J., Slutsky A. S., Fan E., Bartlett R. H., Tonna J. E., Hyslop R., Fanning J. J., Rycus P. T., Hyer S. J., Anders M. M., Agerstrand C. L., Hryniewicz K., Diaz R., Lorusso R., Combes A., Brodie D., Alexander P., Barrett N., Belohlavek J., Fisher D., Fraser J., Hssain A. A., Jung J. S., McMullan M., Mehta Y., Ogino M. T., Paden M. L., Shekar K., Stead C., Abu-Omar Y., Agnoletti V., Akbar A., Alfoudri H., Alviar C., Aronsky V., August E., Auzinger G., Aveja H., Bakken R., Balcells J., Bangalore S., Barnes B. W., Bautista A., Bellows L. L., Beltran F., Benharash P., Benni M., Berg J., Bertini P., Blanco-Schweizer P., Brunsvold M., Budd J., Camp D., Caridi-Scheible M., Carton E., Casanova-Ghosh E., Castleberry A., Chipongian C. T., Choi C. W., Circelli A., Cohen E., Collins M., Copus S., Coy J., Crist B., Cruz L., Czuczwar M., Daneshmand M., Davis II D., De la Cruz K., Devers C., Duculan T., Durham L., Elapavaluru S., Elzo Kraemer C. V., Filho E. C., Fitzgerald J., Foti G., Fox M., Fritschen D., Fullerton D., Gelandt E., Gerle S., Giani M., Goh S. G., Govener S., Grone J., Guber M., Gudzenko V., Gutteridge D., Guy J., Haft J., Hall C., Hassan I. F., Herran R., Hirose H., Ibrahim A. S., Igielski D., Ivascu F. A., Izquierdo Blasco J., Jackson J., Jain H., Jaiswal B., Johnson A. C., Jurynec J. A., Kellter N. M., Kohl A., Kon Z., Kredel M., Kriska K., Kunavarapu C., Lansink-Hartgring O., LaRocque J., Larson S. B., Layne T., Ledot S., Lena N., Lillie J., Lotz G., Lucas M., Ludwigson L., Maas J. J., Maertens J., Mast D., McCardle S., McDonald B., McLarty A., McMahon C., Meybohm P., Meyns B., Miller C., Moraes Neto F., Morris K., Muellenbach R., Nicholson M., O'Brien S., O'Keefe K., Ogston T., Oldenburg G., Oliveira F. M., Oppel E., Pardo D., Parker S. J., Pedersen F. M., Pellecchia C., Pelligrini J. A. S., Pham T. T. N., Phillips A. R., Pirani T., Piwowarczyk P., Plambeck R., Pruett W., Quandt B., Ramanathan K., Rey A., Reyher C., Riera del Brio J., Roberts R., Roe D., Roeleveld P. P., Rudy J., Rueda L. F., Russo E., Sanchez Ballesteros J., Satou N., Saueressig M. G., Saunders P. C., Schlotterbeck M., Schwarz P., Scriven N., Serra A., Shamsah M., Sim L., Smart A., Smith A., Smith D., Smith M., Sodha N., Sonntagbauer M., Sorenson M., Stallkamp E. B., Stewart A., Swartz K., Takeda K., Thompson S., Toy B., Tuazon D., Uchiyama M., Udeozo O. I., van Poppel S., Ventetuolo C., Vercaemst L., Vinh Chau N. V., Wang I. -W., Williamson C., Wilson B., and Winkels H.

Abstract

Background: Multiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. However, initial reports of ECMO use in patients with COVID-19 described very high mortality and there have been no large, international cohort studies of ECMO for COVID-19 reported to date. Methods: We used data from the Extracorporeal Life Support Organization (ELSO) Registry to characterise the epidemiology, hospital course, and outcomes of patients aged 16 years or older with confirmed COVID-19 who had ECMO support initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36 countries. The primary outcome was in-hospital death in a time-to-event analysis assessed at 90 days after ECMO initiation. We applied a multivariable Cox model to examine whether patient and hospital factors were associated with in-hospital mortality. Findings: Data for 1035 patients with COVID-19 who received ECMO support were included in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were discharged home or to an acute rehabilitation centre, 101 (10%) were discharged to a long-term acute care centre or unspecified location, 176 (17%) were discharged to another hospital, and 380 (37%) died. The estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 37·4% (95% CI 34·4–40·4). Mortality was 39% (380 of 968) in patients with a final disposition of death or hospital discharge. The use of ECMO for circulatory support was independently associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI 1·20–2·97). In the subset of patients with COVID-19 receiving respiratory (venovenous) ECMO and characterised as having acute respiratory distress syndrome, the estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 38·0% (95% CI 34·6–41·5). Interpretation: In patients with COVID-19 who received ECMO, both estimated

Published
2020

3. Intramuscular adrenaline for out-of-hospital cardiac arrest is associated with faster drug delivery: A feasibility study.

Author

Pugh AE, Stoecklein HH, Tonna JE, Hoareau GL, Johnson MA, and Youngquist ST

Abstract

Background: Early adrenaline administration is associated with return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA). Animal data demonstrate a similar rate of ROSC when early intramuscular (IM) adrenaline is given compared to early intravenous (IV) adrenaline., Aim: To evaluate the feasibility of protocolized first-dose IM adrenaline in OHCA and it's effect on time from Public Safety Access Point (PSAP) call receipt to adrenaline administration when compared to IO and IV administration., Methods: This is a before-and-after feasibility study of adult OHCAs in a single EMS service following adoption of a protocol for first-dose IM adrenaline. Time from PSAP call to administration and outcomes were compared to 674 historical controls (from January 1, 2013-February 8, 2021) who received at least one dose of adrenaline by IV or IO routes., Results: During the study period, first-dose IM adrenaline was administered to 99 patients (December 1, 2019-February 8, 2021). IM adrenaline was given a median of 12.2 min (95% CI 11.4-13.1 min) after the PSAP call receipt compared to 15.3 min for the IV route (95% CI 14.6-16.0 min) and 15.3 min for the IO route (95% CI 14.9-15.7 min) with a time savings of 3 min (95% CI 2-4 min). Rates of survival to hospital discharge appeared similar between groups: 10% for IM, 8% for IV and 7% for IO. However, results related to survival were underpowered for statistical comparison., Conclusions: Within the limitations of a small sample size and before-and-after design, first-dose IM adrenaline was feasible and reduced the time to adrenaline administration., (© 2021 The Author(s).)

Published
2021
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