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  1. Fulltext Pulmonary embolectomy in heparin-induced thrombocytopenia and thrombosis? Safety of heparin use
    Sachithanandan A
    Interact Cardiovasc Thorac Surg, 2010 Nov;11(5):681.
    PMID: 20962169 DOI: 10.1510/icvts.2010.247460A
    Matched MeSH terms: Heart Arrest, Induced
  2. Fulltext Ruptured sinus of Valsalva aneurysm with ventricular septal defect complicated by preoperative cardiogenic shock, cardiac arrest, and multiple organ dysfunction: a rare survivor and review of contemporary literature
    Furui M, Dillon J, Akhtar KMA, Bin Ja'apar AN
    J Surg Case Rep, 2020 Dec;2020(12):rjaa567.
    PMID: 33425326 DOI: 10.1093/jscr/rjaa567
    Sinus of Valsalva aneurysm (SVA) is a relatively rare cardiac condition, in which the patient is usually asymptomatic. However, once this aneurysm ruptures, patients present with acute symptoms of heart failure. Timely surgical intervention is essential. We present the case of a 27-year-old woman, who had a ruptured SVA with a ventricular septal defect (VSD). The patient collapsed before the emergency operation and needed cardiopulmonary resuscitation. The patient required preoperative high inotoropic support and postoperative management was difficult because of multiple organ dysfunction. However, the patient recovered after using inhaled nitric oxide and veno-venous hemofiltration and tracheostomy, and was discharged with no further complications. To the best of our knowledge, no such case of a ruptured SVA with VSD, complicated by preoperative cardiac arrest and multiple organ dysfunction that culminated in a successful recovery, has been reported to date.
    Matched MeSH terms: Heart Arrest
  3. Safety and Effectiveness of Del Nido Cardioplegia in Comparison to Blood-Based St. Thomas Cardioplegia in Congenital Heart Surgeries: A Prospective Randomized Controlled Study
    Haranal M, Chin HC, Sivalingam S, Raja N, Mohammad Shaffie MS, Namasiwayam TK, et al.
    World J Pediatr Congenit Heart Surg, 2020 Nov;11(6):720-726.
    PMID: 33164692 DOI: 10.1177/2150135120936119
    BACKGROUND: To compare the safety and effectiveness of del Nido cardioplegia with blood-based St Thomas Hospital (BSTH) cardioplegia in myocardial protection in congenital heart surgery.

    METHODS: It is a prospective, open-labeled, randomized controlled study conducted at National Heart Institute, Kuala Lumpur from July 2018 to July 2019. All patients with simple and complex congenital heart diseases (CHD) with good left ventricular function (left ventricular ejection fraction [LVEF] >50%) were included while those with LVEF <50% were excluded. A total of 100 patients were randomized into two groups of 50 each receiving either del Nido or BSTH cardioplegia. Primary end points were the spontaneous return of activity following aortic cross-clamp release and ventricular function between two groups. Secondary end point was myocardial injury as assessed by troponin T levels.

    RESULTS: Cardiopulmonary bypass and aortic cross-clamp time, return of spontaneous cardiac activity following the aortic cross-clamp release, the duration of mechanical ventilation, and intensive care unit stay were comparable between two groups. Statistically significant difference was seen in the amount and number of cardioplegia doses delivered (P < .001). The hemodilution was significantly less in the del Nido complex CHD group compared to BSTH cardioplegia (P = .001) but no difference in blood usage (P = .36). The myocardial injury was lesser (lower troponin T release) with del Nido compared to BSTH cardioplegia (P = .6).

    CONCLUSION: Our study showed that both del Nido and BSTH cardioplegia are comparable in terms of myocardial protection. However, single, less frequent, and lesser volume of del Nido cardioplegia makes it more suitable for complex repair.

    Matched MeSH terms: Heart Arrest, Induced
  4. Fulltext Leptospirosis with Pulseless Electrical Activity (PEA) cardiac arrest in multiple comorbid patient
    Amirudin, S., Ismail, M.S.
    Medicine & Health, 2020;15(2):290-296.
    MyJurnal
    Leptospirosis adalah salah satu penyakit yang endemik di Malaysia. Ia mempunyai pelbagai manifestasi klinikal bermula daripada yang ringan sehingga yang boleh membawa maut. Kami melaporkan sebuah kes tentang seorang lelaki berumur 56 tahun dengan pelbagai masalah kesihatan terdahulu, dengan sejarah tidak sihat kerana demam, batuk dan sakit perut selama dua hari. Pesakit datang ke Jabatan Kecemasan dalam keadaan tidak sedarkan diri dengan Pulseless Electrical Activity (PEA) cardiac arrest. Pesakit telah diresusitasi dan berjaya dipulihkan dengan mencapai peredaran darah spontan (return of spontaneous circulation) tidak berapa lama selepas itu. Keadaan pesakit dirumitkan lagi dengan keadaan Hyperosmolar Hyperglycemic State (HHS), oliguric acute kidney injury, dan non- ST elevation myocardial infarction (NSTEMI). Pesakit kemudian dimasukkan ke unit rawatan rapi dan dirawat dengan IV Ceftriaxone 2 g sekali sehari selama empat hari, dan kemudian ditukar kepada IV Ceftazidime 2 g dua kali sehari untuk seminggu disebabkan ventilator acquired pneumonia (VAP). Keadaan pesakit bertambah baik dan akhirnya di benarkan pulang ke rumah pada hari yang ke 18.

    Matched MeSH terms: Heart Arrest
  5. Fulltext Management of Severe Traumatic Brain Injury in Pregnancy: A Body with Two Lives
    Kho GS, Abdullah JM
    Malays J Med Sci, 2018 Sep;25(5):151-157.
    PMID: 30914871 MyJurnal DOI: 10.21315/mjms2018.25.5.14
    Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. The treatment of severe traumatic brain injury in pregnancy requires a multidisciplinary team approach. The management of a pregnant trauma patient warrants consideration of several issues specific to pregnancy, such as the alterations in the maternal physiology and anatomy. In the case of maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival is linked with the timing of caesarean section after maternal cardiac arrest. Moreover, the decision for perimortem caesarean section is clear after maternal cardiac arrest. The foetal survival rate is 67% if the operation is done before 15 min of cardiopulmonary compromise has occurred, and it drops to 40% at the duration range of 16-25 min. Whether minor or severe, traumatic brain injury during pregnancy is associated with unfavourable maternal outcomes. Injuries considered minor for the general population are not minor for pregnant women. Therefore, these patients should be intensively monitored, and multidisciplinary approaches should always be involved.
    Matched MeSH terms: Heart Arrest
  6. Fulltext Deaths of children during an outbreak of hand, foot, and mouth disease in Sarawak, Malaysia: clinical and pathological characteristics of the disease. For the Outbreak Study Group
    Chan LG, Parashar UD, Lye MS, Ong FG, Zaki SR, Alexander JP, et al.
    Clin Infect Dis, 2000 Sep;31(3):678-83.
    PMID: 11017815
    From April through June 1997, 29 previously healthy children aged <6 years (median, 1.5 years) in Sarawak, Malaysia, died of rapidly progressive cardiorespiratory failure during an outbreak of hand, foot, and mouth disease caused primarily by enterovirus 71 (EV71). The case children were hospitalized after a short illness (median duration, 2 days) that usually included fever (in 100% of case children), oral ulcers (66%), and extremity rashes (62%). The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting in cardiopulmonary arrest soon after hospitalization (median time, 9 h). Cardiac tissue from 10 patients showed normal myocardium, but central nervous system tissue from 5 patients showed inflammatory changes. Brain-stem specimens from 2 patients were available, and both specimens showed extensive neuronal degeneration, inflammation, and necrosis, suggesting that a central nervous system infection was responsible for the disease, with the cardiopulmonary dysfunction being neurogenic in origin. EV71 and possibly an adenovirus, other enteroviruses, or unknown cofactors are likely responsible for this rapidly fatal disease.
    Matched MeSH terms: Heart Arrest/etiology
  7. Fulltext Combined repair of aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision
    Eng JB
    Med J Malaysia, 2007 Jun;62(2):177-8.
    PMID: 18705461 MyJurnal
    A 58 year-old man presented with a large aneurysm of the aortic arch and severe coronary artery disease. He underwent combined repair of the aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision using deep hypothermic circulatory arrest and retrograde cerebral perfusion. He made an uncomplicated postoperative recovery. The operative techniques are discussed with a review of the relevant literature.
    Matched MeSH terms: Heart Arrest, Induced
  8. Fulltext Concurrence of duodenal carcinoid and diffuse gastric adenocarcinoma: a rare phenomenon
    Srilatha PS
    Saudi J Gastroenterol, 2007 Oct-Dec;13(4):197-9.
    PMID: 19858647 DOI: 10.4103/1319-3767.36754
    Synchronous tumors are well documented in the gastrointestinal tract. Various combinations have been studied. There are a few studies, which highlight the incidental finding of the yellow beauty-the "carcinoid" of the duodenum simultaneously occurring with the venomous "diffuse gastric adenocarcinoma". This is a report one such case in a 58 year-old man, who unfortunately died on the 4th postoperative day due to cardiopulmonary arrest.
    Matched MeSH terms: Heart Arrest
  9. Fulltext How can we improve code blue training for non-paediatricians: an experience from students-conducted assessment in national clinical skills conference
    Khoo, Erwin Jiayuan, Kutzsche, Stefan
    Malaysian Journal of Paediatrics and Child Health, 2018;24(1):27-42.
    MyJurnal
    Introduction: Training of all health personnel involved in paediatric care is a key determinant of successful outcome during paediatric emergencies. We aimed to identify the need for paediatric Mock Code Blue skills training among non-paediatricians in a pre-hospital setting through checklist assessment of their performance. Methods: A paediatric septic shock and cardiac arrest Mock Code Blue pre-hospital scenarios were presented for non-paediatricians during a National Clinical Skills Conference. Eight medical student assessors and four clinical facilitators were involved in this training. Participants were expected to be able to demonstrate the skills and teamwork necessary to managepaediatric emergencies according to the learning outcomes. Results: A total of 97 delegates participated in a facilitated paediatric Mock Code Blue for multidisciplinary groups of health personnel. Outcome measures showed a significant lack of communication and team work skills, and weakness in “closing the loop” as barriers to successful resuscitation. Conclusion: We recommend Mock Code Blue simulation training to be offered regularly to all groups of healthcare providers involved in paediatric and neonatal care while not overlooking the emphasis on non-technical skills.
    Matched MeSH terms: Heart Arrest
  10. Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training
    Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.
    Resuscitation, 2014 Jul;85(7):945-51.
    PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025
    Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.
    Matched MeSH terms: Heart Arrest/therapy*
  11. Fulltext Translating knowledge to attitude: a survey on the perception of bystander cardiopulmonary resuscitation among dental students in Universiti Sains Malaysia and school teachers in Kota Bharu, Kelantan
    Chew KS, Yazid MN, Kamarul BA, Rashidi A
    Med J Malaysia, 2009 Sep;64(3):205-9.
    PMID: 20527268
    This voluntary, anonymous questionnaire survey was performed to assess the willingness of Basic Life Support (BLS) participants to perform bystander cardiopulmonary resuscitation (CPR). A total of 55 dental students and 73 school teachers were assessed on their willingness to perform bystander CPR after completion of their BLS training. In general, only 29.0% of the total 128 participants said that they would offer to perform CPR under any cardiac arrest condition and 69.0% said that they would just offer to call the ambulance but they would not offer to perform CPR. When analyzed separately, only 16.4% of school teachers said that they would perform CPR as compared to 45.5% of dental students (p < 0.001). Knowing how to perform CPR does not necessarily translate into willingness to perform CPR.
    Matched MeSH terms: Heart Arrest/therapy*
  12. A case of cardiac arrest following oral 250 mg. mefenamic acid
    Leong LL
    Med J Malaysia, 1976 Mar;30(3):229-37.
    PMID: 1085401
    Matched MeSH terms: Heart Arrest/chemically induced*
  13. A Flowmeter Technique to Exclude Internal Mammary Artery Anastomosis Error in an Arrested Heart
    Hashim SA, Amin MA, Nair A, Raja Mokhtar RA, Krishnasamy S, Cheng K
    Heart Lung Circ, 2018 May;27(5):e59-e63.
    PMID: 29246681 DOI: 10.1016/j.hlc.2017.11.011
    The revision of an internal mammary artery graft anastomosis because of a technical error can be time-consuming and complicated and may lead to complications. Here, we describe the technical details and our early experience of using a standard transit-time flowmeter to exclude technical errors and facilitate rapid decision making for anastomosis revision in an arrested heart during aortic cross-clamping in the absence of ultrasound guidance.
    Matched MeSH terms: Heart Arrest*
  14. Fulltext Suxamethonium and cardiac arrest
    Lee YM, Fountain SW
    Singapore Med J, 1997 Jul;38(7):300-1.
    PMID: 9339098
    We report a case of cardiac arrest due to hyperkalaemia following administration of suxamethonium during a procedure to facilitate a change of endotracheal tube in a septic patient. The cause of this rare but fatal complication is briefly described and discussed. In view of this, suxamethonium should be used with great caution in patients with burns and other forms of physical injury, in a number of nervous system disorders, and in critically ill patients requiring prolonged ITU care.
    Matched MeSH terms: Heart Arrest/chemically induced*
  15. Fulltext Cardiomyopathy in pregnancy: 2 case reports
    Krishnamurthi S, Reddy SVG, Mohamed M
    Singapore Med J, 1989 Apr;30(2):208-9.
    PMID: 2609181
    Cardiomyopathy developed in the peripartum period in two healthy primigravida at 41 and 42 weeks of gestation are presented. In the first case, the patient presented with pulmonary oedema and had cardiac arrest immediately after admission. After resuscitation, a live baby was delivered by Caesarean section. Second cardiac arrest occurred after 12 hours of operation and the patient was resuscitated again. On the 8th post operative day, patient died of D.I.V.C. and renal failure. The second case was a twin pregnancy associated with pregnancy induced hypertension. Caesarean section was performed for foetal distress. She developed pulmonary oedema with left ventricular failure on the second post operative day, was resuscitated and discharged on the 15th day. These are the first two cases to be reported from Hospital University Sains Malaysia. Reference is made to three other cases in which a similar pathological process might have occurred.
    Matched MeSH terms: Heart Arrest/diagnosis
  16. Fulltext A Survey on The Knowledge, Attitude and Confidence Level of Adult Cardiopulmonary Resuscitation Among Junior Doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
    Chew F Z A W M N KS, Mohd Hashairi F, Ida Zarina Z, Shaik Farid AW, Abu Yazid MN, Nik Hisamuddin NA
    Med J Malaysia, 2011 Mar;66(1):56-9.
    PMID: 23765145 MyJurnal
    Junior doctors are often the "first line" doctors called to attend to patients in cardiac arrest. We performed an anonymous questionnaire study from October 2008 to December 2008 to assess the knowledge, attitude and skill of cardiopulmonary resuscitation among junior doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. Out of the 100 questionnaire forms sent out, 70 were returned completed. The majority (85.8%) stated that they were not confident of managing a resuscitation case. There was a statistically significant (p<0.001) association between duration of clinical practice and confidence level. Up to 77.1% said that BLS should be re-certified every two years.
    Matched MeSH terms: Heart Arrest
  17. Fulltext Diagnosing Perioperative Cardiovascular Risks in Noncardiac Surgery Patients
    Li P, Lei Y, Li Q, Lakshmipriya T, Gopinath SCB, Gong X
    J Anal Methods Chem, 2019;2019:6097375.
    PMID: 31534814 DOI: 10.1155/2019/6097375
    Every year, over 200 million adults are undergoing noncardiac surgery. These noncardiac surgery patients may face the risk of cardiac mortality and morbidity during the perioperative and recovery periods. Around ten million patients who underwent noncardiac surgery experience cardiac complications within the first 30 days of the postoperative period; the complications are myocardial infarction, cardiac death, and cardiac arrest. This cardiovascular risk is mostly faced by the patients having cerebrovascular or cardiac disease and the patients with the age greater than 50 years. Monitoring and treating cardiac diseases with a suitable biomarker during the perioperative period is necessary for the early recovery of noncardiac surgery patients. This review discussed the risk factors and the key guidelines to avoid the cardiovascular risks during the perioperative period of noncardiac surgery patients. In addition, the biomarkers and identification strategies for cardiac diseases are discussed.
    Matched MeSH terms: Heart Arrest
  18. Fulltext A case of cardiac arrest due to air embolism during scoliosis surgery
    Haji Mohd Amin MZ, Beng JTB, Young BTY, Faruk Seman NA, Ching TS, Chek WC
    J Orthop Surg (Hong Kong), 2019 4 9;27(2):2309499019840083.
    PMID: 30955449 DOI: 10.1177/2309499019840083
    Cardiac arrest during scoliosis surgery is rare in idiopathic scoliosis. We present a case of cardiorespiratory collapse during corrective surgery in a young patient with idiopathic scoliosis. A diagnosis of venous air embolism was made by exclusion. A cardiorespiratory resuscitation was performed in supine position. Patient recovered without any sequelae and had operation completed 6 weeks later.
    Matched MeSH terms: Heart Arrest/diagnosis; Heart Arrest/etiology*; Heart Arrest/therapy
  19. Fulltext A Study of House Officers in a Teaching Hospital on Knowledge, Perception of Skills and Confidence Level in
    Ismail Mohd Saiboon, Noraliza Mohd Ariffin, Teodoro Javier Herbosa, Ahmad Khaldun Ismail, Nariman Singmamae, Shamsuriani Md Jamal, et al.
    Medicine & Health, 2007;2(2):110-116.
    MyJurnal
    Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these doctors are usually the first to attend.  Therefore an HO must be confident with CPR skills. They must be competent in performing CPR. The authors assessed 26 new HOs from Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception about CPR skills, confidence level in performing CPR and knowledge in performing CPR. Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed themselves to have inadequate knowledge and 46.2% had no confidence in performing CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal paddle and cardiac apex paddle positions correctly placed respectively. In conclusion, knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and need further assessment and improvement. Medical schools need to review their CPR curriculum in order to prepare HOs adequately to work in emergency situations.
    Matched MeSH terms: Heart Arrest
  20. Fulltext Improving perception and confidence towards bystander cardiopulmonary resuscitation and public access automated external defibrillator program: how does training program help?
    Liaw SY, Chew KS, Zulkarnain A, Wong SSL, Singmamae N, Kaushal DN, et al.
    Int J Emerg Med, 2020 Mar 17;13(1):13.
    PMID: 32183687 DOI: 10.1186/s12245-020-00271-3
    BACKGROUND: In conjunction with an automated external defibrillator (AED) placement program at various locations within a public university in Malaysia, a series of structured training programs were conducted. The objectives of this study is to (1) evaluate the effectiveness of a structured training program in improving the perception of the importance of AED and cardiopulmonary resuscitation (CPR), (2) evaluate the confidence of the employees in using an AED and performing bystander CPR, (3) identify the fears and concerns of these employees in using AED and performing CPR, and (4) determine the perception of these employees towards the strategy of the AEDs placed at various locations within the university.

    METHODS: In this single-center observational study, a validated questionnaire aimed to assess the university employees' attitude and confidence in handling AED and performing CPR before (pre-test) and immediately after (post-test) the training program was conducted.

    RESULTS: A total of 184 participants participated in this study. Using the Wilcoxon signed-rank test, the training programs appeared to have improved the perception that "using AED is important for unresponsive victims" (z = 4.32, p arrest is yet to be seen.

    Matched MeSH terms: Heart Arrest
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