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

BMC Anesthesiology

Research Article

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

[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 arrest;    Therapeutic hypothermia;    Cardiac function;    Cardioprotection;    Cardiac measurement;   

DOI  :  10.1186/1471-2253-14-78

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

来源: Springer

【 摘 要 】

BackgroundHypothermia 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.MethodsThe 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.ResultsSAP 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).ConclusionsTo 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】

Unknown   
© Demirgan et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.