Cardiac condition during cooling and rewarming periods of therapeutic hypothermia after cardiopulmonary resuscitation

BMC Anesthesiology

Serdar Demirgan¹  Kerem Erkalp¹  M Salih Sevdi¹  Meltem Turkay Aydogmus¹  Numan Kutbay¹  Aydin Firincioglu¹  Ali Ozalp¹  Aysin Alagol¹ 

[1] Department of Anesthesiology and Reanimation, Bagcilar Educational and Training Hospital, Şenlikköy Mah, İncir Sokak, No:1/3, Sarı Konaklar Sitesi, B-Blok, Daire:6, Florya/ Bakırköy, Istanbul, Turkey

关键词: Cardiac measurement;    Cardioprotection;    Cardiac function;    Therapeutic hypothermia;    Cardiac arrest;   

Others  :  1084415
DOI  :  10.1186/1471-2253-14-78

 received in 2014-02-24, accepted in 2014-09-11,  发布年份 2014

【 摘 要 】

Background

Hypothermia has been used in cardiac surgery for many years for neuroprotection. Mild hypothermia (MH) [body temperature (BT) kept at 32–35°C] has been shown to reduce both mortality and poor neurological outcome in patients after cardiopulmonary resuscitation (CPR). This study investigated whether patients who were expected to benefit neurologically from therapeutic hypothermia (TH) also had improved cardiac function.

Methods

The study included 30 patients who developed in-hospital cardiac arrest between September 17, 2012, and September 20, 2013, and had return of spontaneous circulation (ROSC) following successful CPR. Patient BTs were cooled to 33°C using intravascular heat change. Basal BT, systolic artery pressure (SAP), diastolic artery pressure (DAP), mean arterial pressure (MAP), heart rate, central venous pressure, cardiac output (CO), cardiac index (CI), global end-diastolic volume index (GEDI), extravascular lung water index (ELWI), and systemic vascular resistance index (SVRI) were measured at 36°C, 35°C, 34°C and 33°C during cooling. BT was held at 33°C for 24 hours prior to rewarming. Rewarming was conducted 0.25°C/h. During rewarming, measurements were repeated at 33°C, 34°C, 35°C and 36°C. A final measurement was performed once patients spontaneously returned to basal BT. We compared cooling and rewarming cardiac measurements at the same BTs.

Results

SAP values during rewarming (34°C, 35°C and 36°C) were lower than during cooling (P < 0.05). DAP values during rewarming (basal temperature, 34°C, 35°C and 36°C) were lower than during cooling. MAP values during rewarming (34°C, 35°C and 36°C) were lower than during cooling (P < 0.05). CO and CI values were higher during rewarming than during cooling. GEDI and ELWI did not differ during cooling and rewarming. SVRI values during rewarming (34°C, 35°C, 36°C and basal temperature) were lower than during cooling (P < 0.05).

Conclusions

To our knowledge, this is the first study comparing cardiac function at the same BTs during cooling and rewarming. In patients experiencing ROSC following CPR, TH may improve cardiac function and promote favorable neurological outcomes.

【 授权许可】

   
2014 Demirgan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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