0020. Microcirculatory perfusion and vascular reactivity are altered in post cardiac arrest patients, irrespective of target temperature management to 33° vs 36° (substudy TTM)
نویسندگان
چکیده
Introduction After cardiopulmonary resuscitation (CPR), following an out of hospital cardiac arrest (OHCA) hemodynamic failure is common, due to a combination of heart failure and ischemia reperfusion injury. Comatose post-cardiac arrest patients are treated on the intensive care unit (ICU) with mild therapeutic hypothermia (33°), nowadays referred to as target temperature management (TTM) for an assumed neuroprotective effect.
منابع مشابه
Targeted temperature management at 33°C versus 36°C and impact on systemic vascular resistance and myocardial function after out-of-hospital cardiac arrest: a sub-study of the Target Temperature Management Trial.
BACKGROUND Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome, and hypothermia may pose additional impact on hemodynamics. The aim was to investigate systemic vascular resistance index (SVRI), cardiac index, and myocardial performance at a targeted temperature management of 33°C (TTM33) versus 36°C (TTM36). METHODS AND RESULTS ...
متن کاملTargeted temperature management for adult out-of-hospital cardiac arrest: current concepts and clinical applications.
Targeted temperature management (TTM) (primarily therapeutic hypothermia (TH)) after out-of-hospital cardiac arrest (OHCA) has been considered effective, especially for adult-witnessed OHCA with a shockable initial rhythm, based on pathophysiology and on several clinical studies (especially two randomized controlled trials (RCTs) published in 2002). However, a recently published large RCT compa...
متن کاملResults and generalizability of the Target Temperature Management Trial and future research for patients admitted to intensive care after cardiac arrest
The Target Temperature Management (TTM) Trial randomized 950 unconscious, adult patients with return of spontaneous circulation after out-of-hospital cardiac arrest (CA) of presumed cardiac cause to strict temperature management at either 33°C or 36°C. Temperature was managed with intravascular or surface cooling devices for 36 hours, while the patients were sedated and mechanically ventilated....
متن کاملTargeted temperature management after out-of-hospital cardiac arrest: who, when, why, and how?
OBJECTIVE To provide a succinct review of the evidence, framed for the emergency department clinician, for the application of targeted temperature management (TTM) for patients after out-of-hospital cardiac arrest (OHCA). SOURCES OF INFORMATION MEDLINE, EMBASE, and the Cochrane database were searched for prospective and retrospective studies relevant to the indications of TTM, optimal timing ...
متن کاملDysglycemia, glycemic variability and outcome after cardiac arrest and temperature management at 33 °C and 36 °C (a post-hoc analysis of the target temperature management trial)
OBJECTIVES Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. D...
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عنوان ژورنال:
دوره 2 شماره
صفحات -
تاریخ انتشار 2014