Document Detail


Reversible myocardial dysfunction after cardiopulmonary resuscitation.
MedLine Citation:
PMID:  16053943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Myocardial stunning frequently has been described in patients with an acute coronary syndrome. Recently, it has also been described in critically ill patients without ischaemic heart disease. It is possible that the most severe form of any syndrome, leading to cardio-respiratory arrest, may cause myocardial stunning. Myocardial stunning appears to have been demonstrated in experimental studies, though this phenomenon has not been sufficiently studied in human models. The aim of the present work has been to study and describe the possible development of myocardial dysfunction in patients resuscitated after cardio-respiratory arrest, in the absence of acute or previous coronary artery disease. DESIGN: Descriptive study of a case series. SETTING: The intensive care unit (ICU) of a provincial hospital. PATIENTS AND PARTICIPANTS: The study period was from April 1999 to June 2001. All patients admitted to the ICU with critical, non-coronary artery pathology, with no past history of cardiac disease, and those who were resuscitated after cardio-respiratory arrest, were included in the study. MEASUREMENTS AND RESULTS: Transthoracic and transoesophageal echocardiography was used to assess left ventricular ejection fraction (LVEF) and disturbances of segmental contractility. This study was carried out within the first 24h after admission, during the first week, during the second or third week, after 1 month, and between 3 and 6 months. Twenty-nine patients with a median age of 65 years (range 24--76) were included in the study. Twelve patients died. Twenty patients developed myocardial dysfunction; the initial LVEF in these patients was 0.28 (0.12--0.51), showing improvement over time in the patients who survived. All of these patients presented disturbances of segmental contractility which also became normal over time. CONCLUSIONS: After successful CPR, reversible myocardial dysfunction, consisting of systolic myocardial dysfunction and disturbances of segmental contractility, may occur.
Authors:
Manuel Ruiz-Bailén; Eduardo Aguayo de Hoyos; Silvia Ruiz-Navarro; Miguel Angel Díaz-Castellanos; Luis Rucabado-Aguilar; Francisco Javier Gómez-Jiménez; Sergio Martínez-Escobar; Rafael Melgares Moreno; Javier Fierro-Rosón
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  66     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-01     Completed Date:  2005-12-09     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  175-81     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Critical Care and Emergency Department, Hospital Universitario Médico-Quirúrgico, Complejo Hospitalario de Jaén, Spain. mrb1604@terra.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Cardiopulmonary Resuscitation / adverse effects*,  methods
Cohort Studies
Electrocardiography
Female
Follow-Up Studies
Heart Arrest / diagnosis,  therapy*
Heart Function Tests
Hemodynamics / physiology*
Humans
Incidence
Intensive Care Units
Male
Middle Aged
Myocardial Stunning / diagnosis,  epidemiology*,  etiology*
Probability
Risk Assessment
Severity of Illness Index
Sex Distribution
Survival Rate

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


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