Document Detail

Haemodynamic Variables and Functional Outcome in Hypothermic Patients Following Out-of-Hospital Cardiac Arrest.
MedLine Citation:
PMID:  23092896     Owner:  NLM     Status:  Publisher    
AIM OF THE STUDY: To evaluate the association between haemodynamic variables during the first 24hours after intensive care unit (ICU) admission and neurological outcome in out-of-hospital cardiac arrest (OHCA) victims undergoing therapeutic hypothermia. METHODS: In a multi-disciplinary ICU, records were reviewed for comatose OHCA patients undergoing therapeutic hypothermia. The hourly variable time integral of haemodynamic variables during the first 24hours after admission was calculated. Neurologic outcome was assessed at day 28 and graded as favourable or adverse based on the Cerebral Performance Category of 1-2 and 3-5. Bi- and multivariate regression models adjusted for confounding variables were used to evaluate the association between haemodynamic variables and functional outcome. RESULTS: 67/134 patients (50%) were classified as having favourable outcome. Patients with adverse outcome had a higher mean heart rate (73 [62-86] vs. 66 [60-78] bpm; p=0.04) and received noradrenaline more frequently (n=17 [25.4%] vs. n=9 [6%]; p=0.02) and at a higher dosage (128 [56-1004] vs. 13 [2-162] μg/h; p=0.03) than patients with favourable outcome. The mean perfusion pressure (mean arterial blood pressure minus central venous blood pressure) (OR=1.001, CI 95=1-1.003; p=0.04) and cardiac index time integral (OR=1.055, CI 95=1.003-1.109; p=0.04) were independently associated with adverse outcome at day 28. CONCLUSION: Mean perfusion pressure and cardiac index during the first 24hours after ICU admission were weakly associated with neurological outcome in an OHCA population undergoing therapeutic hypothermia. Further studies need to elucidate whether norepinephrine-induced increases in perfusion pressure and cardiac index may contribute to adverse neurologic outcome following OHCA.
Christian Torgersen; Jurka Meichtry; Christian A Schmittinger; Stefan Bloechlinger; Stephan M Jakob; Jukka Takala; Martin W Dünser
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-20
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Department of Intensive Care Medicine, Inselspital-University Hospital Bern, Bern, Switzerland. Electronic address:
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