Publisher: LWW Wolters Kluwer   (Total: 299 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 299 Journals sorted alphabetically
A&A Case Reports     Hybrid Journal   (Followers: 2, SJR: 0.278, CiteScore: 1)
Academic Medicine     Hybrid Journal   (Followers: 74, SJR: 2.53, CiteScore: 2)
ACG Case Reports J.     Open Access  
ACSMs Health & Fitness J.     Full-text available via subscription   (Followers: 15, SJR: 0.207, CiteScore: 0)
Addictive Disorders & Their Treatment     Hybrid Journal   (Followers: 5, SJR: 0.191, CiteScore: 0)
Advanced Emergency Nursing J.     Hybrid Journal   (Followers: 39, SJR: 0.235, CiteScore: 1)
Advances in Anatomic Pathology     Hybrid Journal   (Followers: 21, SJR: 1.012, CiteScore: 3)
Advances in Neonatal Care     Hybrid Journal   (Followers: 47, SJR: 0.438, CiteScore: 1)
Advances in Nursing Science     Hybrid Journal   (Followers: 38, SJR: 0.343, CiteScore: 1)
Advances in Skin & Wound Care     Hybrid Journal   (Followers: 29, SJR: 0.563, CiteScore: 1)
Adverse Drug Reaction Bulletin     Full-text available via subscription   (Followers: 5, SJR: 0.12, CiteScore: 0)
AIDS     Hybrid Journal   (Followers: 23, SJR: 2.919, CiteScore: 4)
AJSP: Reviews & Reports     Hybrid Journal  
Alzheimer Disease & Associated Disorders     Hybrid Journal   (Followers: 19, SJR: 1.157, CiteScore: 2)
American J. of Clinical Oncology     Hybrid Journal   (Followers: 60, SJR: 0.973, CiteScore: 2)
American J. of Dermatopathology     Hybrid Journal   (Followers: 17, SJR: 0.6, CiteScore: 1)
American J. of Forensic Medicine and Pathology     Hybrid Journal   (Followers: 29, SJR: 0.363, CiteScore: 1)
American J. of Gastroenterology, The     Hybrid Journal   (Followers: 175, SJR: 4.197, CiteScore: 5)
American J. of Nursing     Hybrid Journal   (Followers: 80, SJR: 0.284, CiteScore: 0)
American J. of Physical Medicine & Rehabilitation     Hybrid Journal   (Followers: 58, SJR: 0.636, CiteScore: 1)
American J. of Surgical Pathology     Hybrid Journal   (Followers: 38, SJR: 2.531, CiteScore: 6)
American J. of Therapeutics     Hybrid Journal   (Followers: 14, SJR: 0.399, CiteScore: 1)
Anesthesia & Analgesia     Hybrid Journal   (Followers: 254, SJR: 1.472, CiteScore: 3)
Anesthesiology     Hybrid Journal   (Followers: 229, SJR: 2.123, CiteScore: 3)
Annals of Plastic Surgery     Hybrid Journal   (Followers: 22, SJR: 0.893, CiteScore: 1)
Annals of Surgery     Hybrid Journal   (Followers: 77, SJR: 4.361, CiteScore: 5)
Anti-Cancer Drugs     Hybrid Journal   (Followers: 5, SJR: 0.716, CiteScore: 2)
Applied Immunohistochemistry & Molecular Morphology     Hybrid Journal   (Followers: 17, SJR: 0.765, CiteScore: 1)
ASAIO J.     Hybrid Journal   (Followers: 3, SJR: 0.771, CiteScore: 2)
Asia-Pacific J. of Ophthalmology     Full-text available via subscription   (Followers: 3, SJR: 0.64, CiteScore: 1)
Behavioural Pharmacology     Hybrid Journal   (Followers: 2, SJR: 0.916, CiteScore: 2)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Blood Coagulation & Fibrinolysis     Hybrid Journal   (Followers: 61, SJR: 0.438, CiteScore: 1)
Blood Pressure Monitoring     Hybrid Journal   (Followers: 1, SJR: 0.537, CiteScore: 1)
Brain & Life     Full-text available via subscription   (Followers: 3)
Canadian J. of Addiction     Hybrid Journal   (Followers: 1)
Cancer J.     Full-text available via subscription   (Followers: 8, SJR: 1.893, CiteScore: 4)
Cancer Nursing     Hybrid Journal   (Followers: 33, SJR: 0.858, CiteScore: 2)
Cardiology in Review     Hybrid Journal   (Followers: 8, SJR: 0.863, CiteScore: 2)
Cardiopulmonary Physical Therapy J.     Hybrid Journal   (Followers: 8)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1, SJR: 0.165, CiteScore: 0)
CIN : Computers Informatics Nursing     Hybrid Journal   (Followers: 11, SJR: 0.359, CiteScore: 1)
Clinical and Translational Gastroenterology     Open Access   (SJR: 1.844, CiteScore: 4)
Clinical Dysmorphology     Hybrid Journal   (SJR: 0.268, CiteScore: 0)
Clinical J. of Pain     Hybrid Journal   (Followers: 18, SJR: 1.406, CiteScore: 3)
Clinical J. of Sport Medicine     Hybrid Journal   (Followers: 35, SJR: 0.999, CiteScore: 2)
Clinical Neuropharmacology     Hybrid Journal   (Followers: 3, SJR: 0.506, CiteScore: 1)
Clinical Nuclear Medicine     Hybrid Journal   (Followers: 2, SJR: 0.652, CiteScore: 1)
Clinical Nurse Specialist     Hybrid Journal   (Followers: 28, SJR: 0.256, CiteScore: 0)
Clinical Nutrition Insight     Full-text available via subscription   (Followers: 14)
Clinical Obstetrics & Gynecology     Full-text available via subscription   (Followers: 27, SJR: 0.588, CiteScore: 1)
Clinical Orthopaedics and Related Research     Hybrid Journal   (Followers: 97, SJR: 1.908, CiteScore: 3)
Clinical Pulmonary Medicine     Hybrid Journal   (Followers: 2, SJR: 0.215, CiteScore: 0)
Clinical Spine Surgery     Hybrid Journal   (Followers: 2, SJR: 0.738, CiteScore: 1)
Cognitive and Behavioral Neurology     Hybrid Journal   (Followers: 9, SJR: 0.565, CiteScore: 1)
Colombian J. of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal  
Contemporary Diagnostic Radiology     Full-text available via subscription   (Followers: 3)
Contemporary Neurosurgery     Full-text available via subscription   (Followers: 3)
Contemporary Spine Surgery     Full-text available via subscription   (Followers: 4)
Continuum : Lifelong Learning in Neurology     Hybrid Journal   (Followers: 9, SJR: 0.618, CiteScore: 1)
Cornea     Hybrid Journal   (Followers: 12, SJR: 1.578, CiteScore: 2)
Coronary Artery Disease     Hybrid Journal   (Followers: 2, SJR: 0.705, CiteScore: 1)
Critical Care Explorations     Open Access   (Followers: 1)
Critical Care Medicine     Hybrid Journal   (Followers: 359, SJR: 3.116, CiteScore: 3)
Critical Care Nursing Quarterly     Full-text available via subscription   (Followers: 15, SJR: 0.273, CiteScore: 1)
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4, SJR: 0.411, CiteScore: 1)
Current Opinion in Allergy and Clinical Immunology     Hybrid Journal   (Followers: 8, SJR: 1.244, CiteScore: 3)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 60, SJR: 0.792, CiteScore: 3)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14, SJR: 0.97, CiteScore: 2)
Current Opinion in Clinical Nutrition & Metabolic Care     Hybrid Journal   (Followers: 21, SJR: 1.521, CiteScore: 4)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 74, SJR: 1.382, CiteScore: 3)
Current Opinion in Endocrinology, Diabetes and Obesity     Hybrid Journal   (Followers: 51, SJR: 1.467, CiteScore: 3)
Current Opinion in Gastroenterology     Hybrid Journal   (Followers: 15, SJR: 1.515, CiteScore: 3)
Current Opinion in Hematology     Hybrid Journal   (Followers: 18, SJR: 1.588, CiteScore: 3)
Current Opinion in HIV and AIDS     Hybrid Journal   (Followers: 11, SJR: 2.286, CiteScore: 4)
Current Opinion in Infectious Diseases     Hybrid Journal   (Followers: 25, SJR: 1.813, CiteScore: 4)
Current Opinion in Lipidology     Hybrid Journal   (Followers: 6, SJR: 1.847, CiteScore: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10, SJR: 1.513, CiteScore: 3)
Current Opinion in Neurology     Hybrid Journal   (Followers: 24, SJR: 1.929, CiteScore: 4)
Current Opinion in Obstetrics & Gynecology     Hybrid Journal   (Followers: 13, SJR: 0.992, CiteScore: 3)
Current Opinion in Oncology     Hybrid Journal   (Followers: 24, SJR: 1.217, CiteScore: 3)
Current Opinion in Ophthalmology     Hybrid Journal   (Followers: 31, SJR: 1.434, CiteScore: 3)
Current Opinion in Organ Transplantation     Hybrid Journal   (Followers: 10, SJR: 1.153, CiteScore: 3)
Current Opinion in Otolaryngology & Head & Neck Surgery     Hybrid Journal   (Followers: 12, SJR: 0.683, CiteScore: 2)
Current Opinion in Pediatrics     Hybrid Journal   (Followers: 47, SJR: 1.128, CiteScore: 3)
Current Opinion in Psychiatry     Hybrid Journal   (Followers: 53, SJR: 1.745, CiteScore: 4)
Current Opinion in Pulmonary Medicine     Hybrid Journal   (Followers: 10, SJR: 1.092, CiteScore: 3)
Current Opinion in Rheumatology     Hybrid Journal   (Followers: 18, SJR: 2.187, CiteScore: 4)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 25, SJR: 0.558, CiteScore: 2)
Current Opinion in Urology     Hybrid Journal   (Followers: 11, SJR: 0.949, CiteScore: 2)
Current Orthopaedic Practice     Hybrid Journal   (Followers: 13, SJR: 0.143, CiteScore: 0)
Current Sports Medicine Reports     Full-text available via subscription   (Followers: 22, SJR: 0.448, CiteScore: 1)
Dermatitis     Hybrid Journal   (Followers: 1, SJR: 0.751, CiteScore: 2)
Dermatologic Surgery     Hybrid Journal   (Followers: 8, SJR: 1.168, CiteScore: 1)
Dimensions of Critical Care Nursing     Full-text available via subscription   (Followers: 9, SJR: 0.467, CiteScore: 1)
Diseases of the Colon & Rectum     Hybrid Journal   (Followers: 36, SJR: 1.647, CiteScore: 3)
Ear & Hearing     Hybrid Journal   (Followers: 15, SJR: 1.735, CiteScore: 3)
Egyptian J. of Histology     Partially Free   (SJR: 0.107, CiteScore: 0)
Egyptian J. of Oral and Maxillofacial Surgery     Partially Free   (Followers: 1)
Egyptian J. of Pathology     Partially Free   (Followers: 1)
Emergency Medicine News     Full-text available via subscription   (Followers: 8)
Environmental Epidemiology     Open Access  
Epidemiology     Hybrid Journal   (Followers: 58, SJR: 2.671, CiteScore: 3)
European J. of Anaesthesiology     Hybrid Journal   (Followers: 30, SJR: 1.179, CiteScore: 2)
European J. of Cancer Prevention     Hybrid Journal   (Followers: 3, SJR: 1.021, CiteScore: 2)
European J. of Emergency Medicine     Hybrid Journal   (Followers: 22, SJR: 0.597, CiteScore: 1)
European J. of Gastroenterology & Hepatology     Hybrid Journal   (Followers: 23, SJR: 0.986, CiteScore: 2)
Exercise and Sport Sciences Reviews     Hybrid Journal   (Followers: 54, SJR: 1.943, CiteScore: 4)
Eye & Contact Lens Science and Clinical Practice     Hybrid Journal   (Followers: 4, SJR: 0.949, CiteScore: 2)
Family & Community Health     Hybrid Journal   (Followers: 14, SJR: 0.539, CiteScore: 1)
Female Pelvic Medicine & Reconstructive Surgery     Hybrid Journal   (Followers: 1, SJR: 0.546, CiteScore: 1)
Gastroenterology Nursing     Hybrid Journal   (Followers: 8, SJR: 0.248, CiteScore: 0)
Global Reproductive Health     Open Access  
Harvard Review of Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.375, CiteScore: 3)
Health Care Management Review     Hybrid Journal   (Followers: 15, SJR: 1.244, CiteScore: 2)
Health Physics     Hybrid Journal   (Followers: 7, SJR: 0.528, CiteScore: 1)
Hearing J.     Full-text available via subscription   (Followers: 5, SJR: 0.123, CiteScore: 0)
HemaSphere     Open Access  
Holistic Nursing Practice     Hybrid Journal   (Followers: 6, SJR: 0.239, CiteScore: 1)
Home Healthcare Now     Hybrid Journal   (Followers: 5, SJR: 0.178, CiteScore: 0)
Human Andrology     Partially Free   (Followers: 2)
IJS Global Health     Open Access  
IJS Oncology     Open Access  
Implant Dentistry     Hybrid Journal   (Followers: 7, SJR: 0.712, CiteScore: 1)
Infants and Young Children     Hybrid Journal   (Followers: 7, SJR: 0.412, CiteScore: 1)
Infectious Diseases in Clinical Practice     Hybrid Journal   (Followers: 12, SJR: 0.177, CiteScore: 0)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1, SJR: 0.432, CiteScore: 1)
Intl. Anesthesiology Clinics     Hybrid Journal   (Followers: 9, SJR: 0.201, CiteScore: 0)
Intl. Clinical Psychopharmacology     Hybrid Journal   (Followers: 2, SJR: 1.086, CiteScore: 3)
Intl. J. of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8, SJR: 0.931, CiteScore: 2)
Intl. J. of Gynecological Pathology     Hybrid Journal   (Followers: 9, SJR: 0.65, CiteScore: 1)
Intl. J. of Rehabilitation Research     Hybrid Journal   (Followers: 20, SJR: 0.583, CiteScore: 2)
Intl. Ophthalmology Clinics     Hybrid Journal   (Followers: 1, SJR: 0.59, CiteScore: 1)
Investigative Radiology     Hybrid Journal   (Followers: 10, SJR: 3.774, CiteScore: 6)
Itch : Intl. Forum for the Study of Itch     Open Access  
J. for Healthcare Quality     Hybrid Journal   (Followers: 24, SJR: 0.633, CiteScore: 1)
J. for Nurses in Professional Development     Hybrid Journal   (Followers: 13, SJR: 0.491, CiteScore: 1)
J. of Acute Care Physical Therapy     Hybrid Journal   (Followers: 1)
J. of Addiction Medicine     Hybrid Journal   (Followers: 7, SJR: 1.063, CiteScore: 2)
J. of Addictions Nursing     Hybrid Journal   (Followers: 7, SJR: 0.229, CiteScore: 0)
J. of Ambulatory Care Management, The     Hybrid Journal   (Followers: 4, SJR: 0.539, CiteScore: 1)
J. of Bronchology & Interventional Pulmonology     Hybrid Journal   (Followers: 5, SJR: 0.455, CiteScore: 1)
J. of Cardiopulmonary Rehabilitation and Prevention     Hybrid Journal   (Followers: 7, SJR: 0.816, CiteScore: 2)
J. of Cardiovascular Medicine     Hybrid Journal   (Followers: 2, SJR: 0.599, CiteScore: 1)
J. of Cardiovascular Nursing     Hybrid Journal   (Followers: 18, SJR: 0.709, CiteScore: 1)
J. of Cardiovascular Pharmacology     Hybrid Journal   (Followers: 7, SJR: 0.917, CiteScore: 2)
J. of Christian Nursing     Hybrid Journal   (Followers: 2, SJR: 0.137, CiteScore: 0)
J. of Clinical Engineering     Full-text available via subscription   (Followers: 1)
J. of Clinical Gastroenterology     Hybrid Journal   (Followers: 11, SJR: 1.245, CiteScore: 2)
J. of Clinical Neuromuscular Disease     Hybrid Journal   (Followers: 1, SJR: 0.358, CiteScore: 1)
J. of Clinical Neurophysiology     Hybrid Journal   (Followers: 3, SJR: 0.629, CiteScore: 2)
J. of Clinical Psychopharmacology     Hybrid Journal   (Followers: 24, SJR: 1.054, CiteScore: 2)
J. of Computer Assisted Tomography     Hybrid Journal   (Followers: 1, SJR: 0.648, CiteScore: 1)
J. of Continuing Education in the Health Professions     Hybrid Journal   (Followers: 12, SJR: 0.606, CiteScore: 1)
J. of Craniofacial Surgery     Hybrid Journal   (Followers: 4, SJR: 0.448, CiteScore: 1)
J. of Developmental & Behavioral Pediatrics     Hybrid Journal   (Followers: 12, SJR: 1.03, CiteScore: 2)
J. of ECT     Hybrid Journal   (Followers: 14, SJR: 0.822, CiteScore: 2)
J. of Forensic Nursing     Hybrid Journal   (Followers: 7, SJR: 0.33, CiteScore: 1)
J. of Geriatric Physical Therapy     Hybrid Journal   (Followers: 11, SJR: 0.691, CiteScore: 2)
J. of Glaucoma     Hybrid Journal   (Followers: 2, SJR: 1.08, CiteScore: 2)
J. of Head Trauma Rehabilitation     Hybrid Journal   (Followers: 16, SJR: 1.545, CiteScore: 3)
J. of Healthcare Management     Hybrid Journal   (Followers: 12, SJR: 0.562, CiteScore: 1)
J. of Hospice & Palliative Nursing     Hybrid Journal   (Followers: 30, SJR: 0.305, CiteScore: 1)
J. of Hypertension     Hybrid Journal   (Followers: 13, SJR: 1.733, CiteScore: 3)
J. of Immunotherapy     Hybrid Journal   (Followers: 7, SJR: 1.373, CiteScore: 4)
J. of Infusion Nursing     Hybrid Journal   (Followers: 4, SJR: 0.251, CiteScore: 1)
J. of Lower Genital Tract Disease     Hybrid Journal   (SJR: 0.602, CiteScore: 1)
J. of Nervous and Mental Disease     Hybrid Journal   (Followers: 6, SJR: 0.988, CiteScore: 2)
J. of Neuro-Ophthalmology     Hybrid Journal   (Followers: 12, SJR: 0.605, CiteScore: 1)
J. of Neurologic Physical Therapy     Hybrid Journal   (Followers: 10, SJR: 1.227, CiteScore: 3)
J. of Neuroscience Nursing     Hybrid Journal   (Followers: 8, SJR: 0.388, CiteScore: 1)
J. of Neurosurgical Anesthesiology     Hybrid Journal   (Followers: 8, SJR: 0.914, CiteScore: 2)
J. of Nursing Administration     Hybrid Journal   (Followers: 32, SJR: 0.727, CiteScore: 1)
J. of Nursing Care Quality     Hybrid Journal   (Followers: 22, SJR: 0.772, CiteScore: 1)
J. of Nursing Research     Open Access   (Followers: 21, SJR: 0.492, CiteScore: 1)
J. of Occupational & Environmental Medicine     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 1)
J. of Orthopaedic Trauma     Hybrid Journal   (Followers: 19, SJR: 1.451, CiteScore: 2)
J. of Patient Safety     Hybrid Journal   (Followers: 15, SJR: 0.648, CiteScore: 1)
J. of Pediatric Gastroenterology and Nutrition (JPGN)     Hybrid Journal   (Followers: 49, SJR: 1.376, CiteScore: 2)
J. of Pediatric Hematology/Oncology     Hybrid Journal   (Followers: 6, SJR: 0.459, CiteScore: 1)
J. of Pediatric Orthopaedics     Hybrid Journal   (Followers: 14, SJR: 0.913, CiteScore: 2)
J. of Pediatric Orthopaedics B     Hybrid Journal   (Followers: 5, SJR: 0.356, CiteScore: 1)
J. of Pediatric Surgical Nursing     Hybrid Journal   (SJR: 0.123, CiteScore: 0)
J. of Perinatal & Neonatal Nursing     Hybrid Journal   (Followers: 16, SJR: 0.347, CiteScore: 1)
J. of Physical Therapy Education     Hybrid Journal   (Followers: 15)
J. of Prosthetics and Orthotics     Hybrid Journal   (Followers: 13, SJR: 0.214, CiteScore: 0)
J. of Psychiatric Practice     Hybrid Journal   (Followers: 2, SJR: 0.757, CiteScore: 1)
J. of Public Health Management and Practice     Hybrid Journal   (Followers: 5, SJR: 0.797, CiteScore: 1)
J. of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2, SJR: 1.115, CiteScore: 2)
J. of Strength and Conditioning Research     Hybrid Journal   (Followers: 75, SJR: 1.366, CiteScore: 2)
J. of the American Association of Nurse Practitioners     Hybrid Journal   (Followers: 7)
J. of the Dermatology Nurses' Association     Hybrid Journal   (Followers: 3, SJR: 0.175, CiteScore: 0)
J. of the Egyptian Women’s Dermatologic Society     Partially Free   (SJR: 0.119, CiteScore: 0)
J. of Thoracic Imaging     Hybrid Journal   (Followers: 3, SJR: 0.705, CiteScore: 2)
J. of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 33, SJR: 1.747, CiteScore: 3)
J. of Trauma Nursing     Hybrid Journal   (Followers: 14, SJR: 0.251, CiteScore: 0)
J. of Trauma, The     Full-text available via subscription   (Followers: 22)
J. of Women’s Health Physical Therapy     Partially Free   (Followers: 5)
J. of Wound Ostomy & Continence Nursing     Hybrid Journal   (Followers: 18, SJR: 0.613, CiteScore: 1)
JAAOS : Global Research & Reviews     Open Access   (Followers: 1)

        1 2 | Last   [Sort by number of followers]   [Restore default list]

Similar Journals
Journal Cover
Current Opinion in Critical Care
Journal Prestige (SJR): 1.382
Citation Impact (citeScore): 3
Number of Followers: 74  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1070-5295 - ISSN (Online) 1531-7072
Published by LWW Wolters Kluwer Homepage  [299 journals]
  • Editorial introductions
    • Abstract: imageNo abstract available
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Monitor the quality of cardiopulmonary resuscitation in 2020
    • Authors: Genbrugge; Cornelia; Eertmans, Ward; Salcido, David D.
      Abstract: imagePurpose of review The current review will give an overview of different possibilities to monitor quality of cardiopulmonary resuscitation (CPR) from a physiologic and a process point of view and how these two approaches can/should overlap.Recent findings Technology is evolving fast with a lot of opportunities to improve the CPR quality. The role of smartphones and wearables are step-by-step identified as also the possibilities to perform patient tailored CPR based on physiologic parameters. The first steps have been taken, but more are to be expected. In this context, the limits of what is possible with human providers will become more and more clear.Summary To perform high-quality CPR, at first, one should optimize rate, depth and pause duration supported by process monitoring tools. Second, the evolving technological evolution gives opportunities to measure physiologic parameters in real-time which will open the way for patient-tailored CPR. The role of ultrasound, cerebral saturation and end-tidal CO2 in measuring the quality of CPR needs to be further investigated as well as the possible ways of influencing these measured parameters to improve neurological outcome and survival.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Extracorporeal cardiopulmonary resuscitation for cardiac arrest
    • Authors: Kalra; Rajat; Kosmopoulos, Marinos; Goslar, Tomaz; Raveendran, Ganesh; Bartos, Jason A.; Yannopoulos, Demetris
      Abstract: imagePurpose of review Extracorporeal cardiopulmonary resuscitation (ECPR) is a contemporary resuscitation approach that employs veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This approach is increasingly used worldwide to mitigate the widespread hemodynamic and multiorgan dysfunction that accompanies cardiac arrest.Recent findings In this review, the physiology of VA-ECMO and ECPR, the role of ECPR in contemporary resuscitation care, the complications associated with ECPR and VA-ECMO usage, and intensive care considerations for this population are discussed.Summary ECPR offers a promising mechanism to mitigate multiorgan injury and allow time for the institution of supportive interventions required to effectively treat cardiac arrest. More prospective data in the context of extensive prehospital and hospital collaboration is needed to promote its successful use.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • The impact of intra-arrest hypothermia
    • Authors: Nordberg; Per; Annoni, Filippo; Taccone, Fabio S.
      Abstract: imagePurpose of review To address the impact of therapeutic hypothermia induced already during cardiopulmonary resuscitation (i.e. intra-arrest cooling) and its association with neurologic functional outcome.Recent findings Intra-arrest cooling is superior than post-ROSC cooling to mitigate brain injuries in experimental models of cardiac arrest. The delayed initiation of hypothermia in human studies may not have adequately addressed the underlying pathophysiology of ischemia and reperfusion. The assessment of early initiation of cooling has been complicated by increased rate of hemodynamic adverse events caused by infusion of cold intravenous fluids. These adverse events have been more deleterious in patients with initial shockable rhythms. A recent randomized study shows that an alternative intra-arrest cooling method using trans-nasal evaporative cooling was well tolerated and effective to shorten time to target temperature. However, the neurologic outcomes (CPC 1–2 at 90 days) in favor of intra-arrest cooling compared to hospital cooling (34.8% vs 25.9%, P = 0.11) in patients with initial shockable rhythms did not reach statistical significance.Summary Therapeutic intra-arrest hypothermia can be initiated safely at the scene of the arrest using transnasal evaporative cooling. The potential beneficial effect of intra-arrest cooling on neurologic recovery in patients with initial shockable rhythms should be explored further.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Drugs during cardiopulmonary resuscitation
    • Authors: Vallentin; Mikael F.; Granfeldt, Asger; Holmberg, Mathias J.; Andersen, Lars W.
      Abstract: imagePurpose of review The current narrative review outlines the evidence for the most common drugs given during adult cardiopulmonary resuscitation.Recent findings Two large clinical trials recently made the roles of adrenaline and antiarrhythmic drugs clearer. Adrenaline leads to a substantially higher rate of return of spontaneous circulation and a moderate increase in survival. Amiodarone and lidocaine increase short-term outcomes, and point estimates suggest a small but uncertain effect on long-term survival. There is still a lack of high-quality evidence for other drugs during cardiac arrest such as bicarbonate, calcium, and magnesium, but small-scale randomized clinical trials show no effect. A promising entity may be the combination of vasopressin and glucocorticoids, but external validation of preliminary trials is needed. Data from observational studies and subgroup analyses of trials generally favor intravenous over intraosseous access, while the latter remains a reasonable alternative.Summary Guidelines for the above-mentioned drugs have been updated yet remain largely unchanged over the last decades. There are still multiple unanswered questions related to drugs during cardiopulmonary resuscitation. On the contrary, only few trials are ongoing.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Optimal ventilator settings after return of spontaneous circulation
    • Authors: Eastwood; Glenn M.; Nichol, Alistair
      Abstract: imagePurpose of review To describe current practice, recent advances in knowledge and future directions for research related to the post return of spontaneous circulation (ROSC) ventilatory management of cardiac arrest patients.Recent findings Out-of-hospital cardiac arrest (OHCA) is a major public health problem with an estimated incidence of approximately one per 1000 persons per year. A priority of intensive care management of resuscitated OHCA patients is to reduce secondary reperfusion injury. Most OHCA patients are mechanically ventilated. Most of these require mechanical ventilation as they are unconscious and for oxygen (O2) management and carbon dioxide (CO2) control. Low levels of O2 and CO2 following OHCA is associated with poor outcome. Recently, very high fraction of inspired oxygen has been associated with poor outcomes and elevated CO2 levels have been associated with improved neurological outcomes. Moreover, it is increasingly being appreciated that the ventilator may be a tool to adjust physiological parameters to enhance the chances of favourable outcomes. Finally, ventilator settings themselves and the adoption of protective ventilation strategies may affect lung–brain interactions and are being explored as other avenues for therapeutic benefit.Summary Current evidence supports the targeting of normal arterial O2 and CO2 tensions during mechanical ventilation following ROSC after cardiac arrest. Use of protective lung strategies during mechanical ventilation in resuscitated cardiac arrest patients is advocated. The potential therapeutic benefits of conservative O2 therapy, mild hypercapnia and the optimal ventilator settings to use post-ROSC period will be confirmed or refuted in clinical trials.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Individualized blood pressure targets during postcardiac arrest intensive
           care
    • Authors: Skrifvars; Markus B.; Åneman, Anders; Ameloot, Koen
      Abstract: imagePurpose of review To discuss recent findings relevant to optimizing blood pressure targets in adult, postcardiac arrest (PCA) patients and whether to tailor these based on specific patient, cardiac arrest or treatment characteristics.Recent findings Observational data suggest that mean arterial pressure (MAP) below 65–75 mmHg in PCA patients is associated with worse outcome. A higher MAP could be beneficial in patients with chronic hypertension who more frequently have a right shift of the cerebral autoregulation curve. Two recent randomized pilot trials compared lower and higher MAP targets during PCA care and found no significant effect on biomarkers of neurological injury. The haemodynamic interventions in those studies did not use any cerebral perfusion endpoints beyond a static MAP targets during ICU stay. Individualized, dynamic MAP targets based on assessments of cerebral perfusion and tailored to the specifics of the patient, cardiac arrest circumstances and treatment responses may be more conducive to improved outcomes. Pilot data suggest that near infrared spectroscopy monitoring may be used to determine the cerebral autoregulatory capacity and an optimal MAP, but this approach is yet to be tested in clinical trials.Summary Current evidence suggests targeting a MAP of at least 65–75 mmHg in PCA patients. Future studies should focus on whether certain patient groups could benefit from higher and dynamic MAP targets.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Monitoring coherence between the macro and microcirculation in septic
           shock
    • Authors: Bakker; Jan; Ince, Can
      Abstract: imagePurpose of review Currently, the treatment of patients with shock is focused on the clinical symptoms of shock. In the early phase, this is usually limited to heart rate, blood pressure, lactate levels and urine output. However, as the ultimate goal of resuscitation is the improvement in microcirculatory perfusion the question is whether these currently used signs of shock and the improvement in these signs actually correspond to the changes in the microcirculation.Recent findings Recent studies have shown that during the development of shock the deterioration in the macrocirculatory parameters are followed by the deterioration of microcirculatory perfusion. However, in many cases the restoration of adequate macrocirculatory parameters is frequently not associated with improvement in microcirculatory perfusion. This relates not only to the cause of shock, where there are some differences between different forms of shock, but also to the type of treatment.Summary The improvement in macrohemodynamics during the resuscitation is not consistently followed by subsequent changes in the microcirculation. This may result in both over-resuscitation and under-resuscitation leading to increased morbidity and mortality. In this article the principles of coherence and the monitoring of the microcirculation are reviewed.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Automated quantification of tissue red blood cell perfusion as a new
           resuscitation target
    • Authors: Hilty; Matthias P.; Ince, Can
      Abstract: imagePurpose of review Identification of insufficient tissue perfusion is fundamental to recognizing circulatory shock in critically ill patients, and the primary target to restore adequate oxygen delivery. However, the concept of tissue perfusion remains ill-defined and out-of-reach for clinicians as point-of-care resuscitation target. Even though handheld vital microscopy (HVM) provides the technical prerequisites to collect information on tissue perfusion in the sublingual microcirculation, challenges in image analysis prevent quantification of tissue perfusion and manual analysis steps prohibit point-of-care application. The present review aims to discuss recent advances in algorithm-based HVM analysis and the physiological basis of tissue perfusion-based resuscitation parameters.Recent findings Advanced computer vision algorithm such as MicroTools independently quantify microcirculatory diffusion and convection capacity by HVM and provide direct insight into tissue perfusion, leading to our formulation a functional parameter, tissue red blood cell (RBC) perfusion (tRBCp). Its definition is discussed in terms of the physiology of oxygen transport to the tissue and its expected effect as a point-of-care resuscitation target. Further refinements to microcirculatory monitoring include multiwavelength HVM techniques and maximal recruitable microcirculatory diffusion and convection capacity.Summary tRBCp as measured using algorithm-based HVM analysis with an automated software called MicroTools, represents a promising candidate to assess microcirculatory delivery of oxygen for microcirculation-based resuscitation in critically ill patients at the point-of-care.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Regional perfusion monitoring in shock
    • Authors: Noitz; Matthias; Szasz, Johannes; Dünser, Martin W.
      Abstract: imagePurpose of review Despite restoration of adequate systemic blood flow in patients with shock, single organs may remain hypoperfused. In this review, we summarize the results of a literature research on methods to monitor single organ perfusion in shock. We focused on methods to measure heart, brain, kidney, and/or visceral organ perfusion. Furthermore, only methods that can be used in real-time and at the bedside were included.Recent findings We identified studies on physical examination techniques, electrocardiography, echocardiography, contrast-enhanced ultrasound, near-infrared spectroscopy, and Doppler sonography to assess single organ perfusion.Summary Physical examination techniques have a reasonable negative predictive value to exclude single organ hypoperfusion but are nonspecific to detect it. Technical methods to indirectly measure myocardial perfusion include ECG and echocardiography. Contrast-enhanced ultrasound can quantify myocardial perfusion but has so far only been used to detect regional myocardial hypoperfusion. Near-infrared spectroscopy and transcranial Doppler sonography can be used to assess cerebral perfusion and determine autoregulation thresholds of the brain. Both Doppler and contrast-enhanced ultrasound techniques are novel methods to evaluate renal and visceral organ perfusion. A key limitation of most techniques is the inability to determine adequacy of organ blood flow to meet the organs’ metabolic demands.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Monitoring mitochondrial PO2: the next step
    • Authors: Mik; Egbert G.; Balestra, Gianmarco M.; Harms, Floor A.
      Abstract: imagePurpose of review To fully exploit the concept of hemodynamic coherence in resuscitating critically ill one should preferably take into account information about the state of parenchymal cells. Monitoring of mitochondrial oxygen tension (mitoPO2) has emerged as a clinical means to assess information of oxygen delivery and oxygen utilization at the mitochondrial level. This review will outline the basics of the technique, summarize its development and describe the rationale of measuring oxygen at the mitochondrial level.Recent findings Mitochondrial oxygen tension can be measured by means of the protoporphyrin IX-Triplet State Lifetime Technique (PpIX-TSLT). After validation and use in preclinical animal models, the technique has recently become commercially available in the form of a clinical measuring system. This system has now been used in a number of healthy volunteer studies and is currently being evaluated in studies in perioperative and intensive care patients in several European university hospitals.Summary PpIX-TSLT is a noninvasive and well tolerated method to assess aspects of mitochondrial function at the bedside. It allows doctors to look beyond the macrocirculation and microcirculation and to take the oxygen balance at the cellular level into account in treatment strategies.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Focused ultrasonography for septic shock resuscitation
    • Authors: Nikravan; Sara; Song, Pingping; Bughrara, Nibras; Díaz-Gómez, José L.
      Abstract: imagePurpose of review Severe sepsis with septic shock is the most common cause of death among critically ill patients. Mortality has decreased substantially over the last decade but recent data has shown that opportunities remain for the improvement of early and targeted therapy. This review discusses published data regarding the role of focused ultrasonography in septic shock resuscitation.Recent findings Early categorization of the cardiovascular phenotypes with echocardiography can be crucial for timely diagnosis and targeted therapy of patients with septic shock. In the last few years, markers of volume status and volume responsiveness have been investigated, serving as valuable tools for targeting volume therapy in the care of both spontaneously breathing and mechanically ventilated patients. In tandem, investigators have highlighted findings of extravascular volume with ultrasonographic evaluation to compliment de-escalation of resuscitation efforts when appropriate. Furthermore, special attention has been given to resuscitation efforts of patients in septic shock with right ventricular failure.Summary Severe sepsis with septic shock is an insidious disease process that continues to take lives. In more recent years, data have emerged suggesting the utility of bedside ultrasonography for early cardiovascular categorization, goal directed resuscitation, and appropriate cardiovascular support based on its changing phenotypes.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • This is your toolkit in hemodynamic monitoring
    • Authors: Kaufmann; Thomas; van der Horst, Iwan C.C.; Scheeren, Thomas W.L.
      Abstract: imagePurpose of review To appraise the basic and more advanced methods available for hemodynamic monitoring, and describe the definitions and criteria for the use of hemodynamic variables.Recent findings The hemodynamic assessment in critically ill patients suspected of circulatory shock follows a step-by-step algorithm to help determine diagnosis and prognosis. Determination of accurate diagnosis and prognosis in turn is crucial for clinical decision-making. Basic monitoring involving clinical examination in combination with hemodynamic variables obtained with an arterial catheter and a central venous catheter may be sufficient for the majority of patients with circulatory shock. In case of uncertainty of the underlying cause or to guide treatment in severe shock may require additional advanced hemodynamic technologies, and each is utilized for different indications and has specific limitations. Future developments include refining the clinical examination and performing studies that demonstrate better patient outcomes by targeting hemodynamic variables using advanced hemodynamic monitoring.Summary Determination of accurate diagnosis and prognosis for patients suspected of circulatory shock is essential for optimal decision-making. Numerous techniques are available, and each has its specific indications and value.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • How to assess ventriculoarterial coupling in sepsis
    • Authors: Pinsky; Michael R.; Guarracino, Fabio
      Abstract: imagePurpose of review We will highlight the role of ventriculoarterial coupling in the pathophysiology of sepsis and how to assess it.Recent findings Most septic patients show a ventriculoarterial uncoupling at the time of diagnosis with arterial elastance (Ea) greater than left ventricle (LV) end-systolic elastance (Ees), often despite arterial hypotension. Ventriculoarterial coupling levels predict the cardiovascular response to resuscitation in this heterogeneously responding population.Summary Ventriculoarterial coupling is quantified as the ratio of Ea to Ees. The efficiency of the cardiovascular function is optimal when Ea/Ees is near one. When the hydraulic load of the arterial system is excessive either from increased vasomotor tone, decreased LV contractility or both, Ea/Ees becomes greater than 1 (i.e. ventriculoarterial decoupling), and cardiac efficiency decreases leading to heart failure, loss of volume responsiveness, and if sustained, increased mortality. Noninvasive echocardiographic techniques when linked with arterial pressure monitoring allow for the bedside estimates of both Ea and Ees. Studies using this approach have documented the key role ventriculoarterial coupling has defining initial cardiovascular state, response to therapy and outcome from critical illness. Sequential monitoring of ventriculoarterial coupling at the bedside offers a unique opportunity to assess relevant cardiovascular determinants in septic patients requiring resuscitation.
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
  • Parameters of fluid responsiveness
    • Authors: Shi; Rui; Monnet, Xavier; Teboul, Jean-Louis
      Abstract: imagePurpose of review On the basis of recent literature, we summarized the new advances on the use of available dynamic indices of fluid responsiveness.Recent findings Reliability of passive leg raising to assess fluid responsiveness is well established provided that a real-time haemodynamic assessment is available. Recent studies have focused on totally noninvasive techniques to assess its haemodynamic effects with promising results. Presence of intra-abdominal hypertension is associated with false-negative cases of passive leg raising. Use of pulse pressure and stroke volume variations is limited and other heart–lung interaction tests have been developed. The tidal volume challenge may overcome the limitation of low tidal volume ventilation. Preliminary data suggest that changes in pulse pressure variation during this test well predict fluid responsiveness. Growing evidence confirms the good predictive performance of the end-expiratory occlusion test. All these dynamic tests allow selecting appropriate fluid responders and preventing excessive fluid administration. Performance of a mini-fluid challenge may help for the decision-making process of fluid management if other tests are not available.Summary Several new dynamic variables and monitoring techniques to predict fluid responsiveness were investigated in the past years. Nevertheless, further research investigating their reliability and feasibility in larger cohorts is warranted.Video abstract http://links.lww.com/COCC/A32
      PubDate: Mon, 01 Jun 2020 00:00:00 GMT-
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 3.235.75.174
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-