Document Detail


Feasibility and safety of combined percutaneous coronary intervention and therapeutic hypothermia following cardiac arrest.
MedLine Citation:
PMID:  20083333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
REVIEW: Mild therapeautic hypothermia (MTH) has been associated with cardiac dysrhythmias, coagulopathy and infection. After restoration of spontaneous circulation (ROSC), many cardiac arrest patients undergo percutaneous coronary intervention (PCI). The safety and feasibility of combined MTH and PCI remains unclear. This is the first study to evaluate whether PCI increases cardiac risk or compromises functional outcomes in comatose cardiac arrest patients who undergo MTH. METHODS: Ninety patients within a 6-h window following cardiac arrest and ROSC were included. Twenty subjects (23%) who underwent PCI following MTH induction were compared to 70 control patients who underwent MTH without PCI. The primary endpoint was the rate of dysrhythmias; secondary endpoints were time-to-MTH induction, rates of adverse events (dysrhythmia, coagulopathy, hypotension and infection) and mortality. RESULTS: Patients who underwent PCI plus MTH suffered no statistical increase in adverse events (P=.054). No significant difference was found in the rates of dysrhythmias (P=.27), infection (P=.90), coagulopathy (P=.90) or hypotension (P=.08). The PCI plus MTH group achieved similar neurological outcomes (modified Rankin Scale (mRS) <or=3 (P=.42) and survival rates (P=.40). PCI did not affect the speed of MTH induction; the target temperature was reached in both groups without a significant time difference (P=.29). CONCLUSION: Percutaneous coronary intervention seems to be feasible when combined with MTH, and is not associated with increased cardiac or neurological risk.
Authors:
Leonardo M Batista; Fabricio O Lima; James L Januzzi; Vivian Donahue; Colleen Snydeman; David M Greer
Related Documents :
23236323 - Pericardial effusion and pericardiocentesis: role of echocardiography.
18690563 - Early percutaneous intervention improves survival in elderly patients with acute myocar...
24350923 - Allogeneic adipose stem cell therapy in acute myocardial infarction.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-18
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  398-403     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Neurology, J Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114-3117, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Arrhythmias, Cardiac / etiology
Cohort Studies
Feasibility Studies
Female
Heart Arrest / mortality,  therapy*
Humans
Hypothermia, Induced* / adverse effects
Male
Middle Aged
Myocardial Infarction / therapy
Resuscitation / methods
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The importance of pre-trauma centre treatment of life-threatening events on the mortality of patient...
Next Document:  Monitoring in resuscitation: Comparison of cardiac output measurement between pulmonary artery cathe...