| The induction of mild hypothermia improves systolic function of the resuscitated porcine heart at no further sympathetic activation. | |
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MedLine Citation:
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PMID: 21658179 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aim: Mild hypothermia (MH) after cardiac arrest attenuates hypoxic brain injury and improves survival. As MH increases contractility in normal hearts, we hypothesized that MH improves cardiovascular function after cardiac arrest. Methods: In 16 anaesthetized pigs (64±2 kg), ventricular fibrillation was induced electrically for 5 min. At 10 min after resuscitation and return of spontaneous circulation (ROSC), pigs were assigned to normothermia (NT, 38 °C, n=8) or MH (33 °C, n=8, intravascular cooling). Results: At ROSC 6h vs. baseline, heart rate (HR) was unchanged in NT, but decreased in MH. Cardiac output (CO, l min(-1) ) decreased in MH (3.5±0.2 vs. 5.5±0.4, p<0.05) more than in NT (4.8±0.4 vs. 5.7±0.4, p=NS). Mixed venous oxygen saturation decreased in NT (56±2 vs. 66±3%, p<0.05), but remained constant in MH (64±2 vs. 65±2%) due to a 35% decrease of whole body oxygen consumption. Left ventricular (LV) dP/dtmax (mmHg s(-1) ) decreased in NT (1163±97 vs. 1665±134, p<0.05) but was preserved in MH (1602±102 vs. 1603±96), while LV relaxation was profoundly slowed during MH. Pressure-volume analysis confirmed improved LV systolic function during MH, but also demonstrated decreased LV end-diastolic distensibility, which was further potentiated by right atrial pacing at baseline HR. MH did not increase plasma catecholamine levels. Spectral analysis of heart rate variability revealed reduced sympathetic activation during MH. Conclusion: The induction of MH after cardiac resuscitation improves systolic myocardial function without further sympathetic activation. A reduced metabolism during MH outweighs a decreased CO and thereby acts favourably on systemic oxygen supply/demand balance. |
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Authors:
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Michael Schwarzl; Paul Steendijk; Stefan Huber; Martini Truschnig-Wilders; Barbara Obermayer-Pietsch; Heinrich Maechler; Burkert Pieske; Heiner Post |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-9 |
Journal Detail:
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Title: Acta physiologica (Oxford, England) Volume: - ISSN: 1748-1716 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101262545 Medline TA: Acta Physiol (Oxf) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Scandinavian Physiological Society. |
Affiliation:
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Dept. of Cardiology, Medical University of Graz Auenbruggerplatz 15, 8036 Graz, Austria Dept. of Cardiology, Leiden University Medical Center PO 9600, 2300 RC Leiden, The Netherlands Dept. of Cardiothoracic Surgery, Medical University of Graz Auenbruggerplatz 29, 8036 Graz, Austria Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz Auenbruggerplatz 15, 8036 Graz, Austria Dept. of Endocrinology and Nuclear Medicine, Medical University of Graz Auenbruggerplatz 15, 8036 Graz, Austria. |
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