Document Detail


Postresuscitation myocardial dysfunction: correlated factors and prognostic implications.
MedLine Citation:
PMID:  17106656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the clinical factors correlated with postresuscitation myocardial dysfunction and the prognostic implication such dysfunction may have. DESIGN AND SETTING: Prospective observational study in a university medical center PATIENTS: 58 adult patients successfully resuscitated from nontraumatic out-of-hospital cardiac arrest over 2 years. MEASUREMENTS AND RESULTS: Echocardiographic evaluation of the left ventricular systolic and diastolic functions was performed 6 h postresuscitation and was analyzed in correlation to the clinical features and resuscitation factors. Univariate analysis revealed left ventricular ejection fraction (LVEF) to be significantly lower in patients with hypertension, past history of myocardial infarction, resuscitation duration longer than 20 min, defibrillation, and use of more than 5 mg epinephrine. Isovolumic relaxation time (IVRT) was significantly longer in patients with noncardiac cause and initial rhythm of nonventricular fibrillation/tachycardia. Multiple regression analysis showed epinephrine dose and past history of myocardial infarction to be independent factors for LVEF, while the cause of cardiac arrest was independently associated with IVRT. For prognosis, 27 patients survived to hospital discharge. Both LVEF under 40% and IVRT 100 ms or longer were associated with poor survival outcomes. In Cox regression analysis IVRT 100 ms or longer served as an independent factor predicting poor survival prognosis. CONCLUSIONS: Postresuscitation left ventricular dysfunction is correlated with a number of clinical factors, among which past history of myocardial infarction, epinephrine dose, and the cause of cardiac arrest play independent roles. Meanwhile, IVRT 100 ms or longer 6 h postresuscitation predicts poor survival outcomes and serves as a marker of poor prognosis.
Authors:
Wei-Tien Chang; Matthew Huei-Ming Ma; Kuo-Liong Chien; Chien-Hua Huang; Min-Shan Tsai; Fuh-Yuan Shih; Ann Yuan; Kuang-Chau Tsai; Fang-Yue Lin; Yuan-Teh Lee; Wen-Jone Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-11-15
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-15     Completed Date:  2007-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  88-95     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Chung-Shan South Road 7, 100, Taipei, Taiwan, R.O.C.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation*
Female
Heart / physiopathology*
Heart Arrest / therapy*
Humans
Male
Middle Aged
Myocardial Contraction
Prognosis
Prospective Studies
Stroke Volume

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


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