| Goal-directed hemodynamic optimization in the post-cardiac arrest syndrome: a systematic review. | |
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MedLine Citation:
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PMID: 18164117 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: The treatment recommendations from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science (hosted by the American Heart Association) advocate a goal-directed treatment strategy for hemodynamic optimization after return of spontaneous circulation (ROSC) in post-cardiac arrest care. We performed a systematic review to (1) examine the available evidence for goal-directed hemodynamic support in the post-cardiac arrest syndrome, (2) determine the effect of such a treatment strategy on survival, and (3) define the specific hemodynamic goals, if any, that have been tested in clinical trials of post-cardiac arrest patients. METHODS: We conducted a systematic review of the Cochrane Library, MEDLINE, CINAHL, conference proceedings, clinical practice guidelines, and other sources using a comprehensive strategy to identify randomized controlled trials and quasi-experimental studies of goal-directed hemodynamic optimization in patients with ROSC after cardiac arrest. RESULTS: The comprehensive search yielded a total of 1184 potential publications and after a relevance screen, five studies were eligible for full article review. None of the studies were eligible for inclusion in the final analysis. CONCLUSIONS: To date, no clinical trials have examined hemodynamic optimization in post-cardiac arrest patients. Although clinical acumen may support the concept that hemodynamic derangements after ROSC should be normalized, there is currently no evidence available to indicate the best strategy for goal-directed hemodynamic support. The current study indicates the need for future clinical investigations designed to determine both the efficacy of hemodynamic optimization in post-cardiac arrest patients and the best endpoints to target as part of a goal-directed strategy. |
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Authors:
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Alan E Jones; Nathan I Shapiro; J Hope Kilgannon; Stephen Trzeciak; |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review Date: 2007-12-27 |
Journal Detail:
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Title: Resuscitation Volume: 77 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-07 Completed Date: 2008-07-22 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 26-9 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, United States. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiopulmonary Resuscitation
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adverse effects*,
methods* Chi-Square Distribution Heart Arrest / mortality, physiopathology, therapy* Hemodynamics* Humans Iatrogenic Disease Practice Guidelines as Topic Randomized Controlled Trials as Topic Syndrome |
| Grant Support | |
ID/Acronym/Agency:
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1P50GM076659-01/GM/NIGMS NIH HHS; K23GM76652/GM/NIGMS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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