The Effects of In-Hospital Intravenous Cold Saline in Postcardiac Arrest Patients Treated with Targeted Temperature Management
| Autor: | Justin Lundbye, Gregory A. Panza, Shreyas Gowdar, Ramya Jayaraman, Kamala Ramya Kallur, Sena Kilic, Nissi Suppogu, Antonio B. Fernandez |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Targeted temperature management Sodium Chloride Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Hypothermia Induced medicine Emergency medical services Humans Cardiopulmonary resuscitation Registries Saline Aged Retrospective Studies Brain Diseases business.industry Glasgow Coma Scale 030208 emergency & critical care medicine Rearrest Middle Aged Pulmonary edema medicine.disease Surgery Heart Arrest Connecticut Anesthesiology and Pain Medicine Anesthesia Cohort Administration Intravenous Female business |
| Zdroj: | Therapeutic hypothermia and temperature management. 8(1) |
| ISSN: | 2153-7933 |
| Popis: | Recent data suggest that rapid infusion of intravenous (IV) cold saline for Targeted Temperature Management (TTM) after cardiac arrest is associated with higher rates of rearrest, pulmonary edema, and hypoxia, with no difference in neurologic outcomes or survival when administered by Emergency Medical Services. We sought to determine the effects of IV cold saline administration in the hospital setting in postcardiac arrest patients to achieve TTM and its effect on clinical parameters and neurologic outcomes.A cohort of 132 patients who completed TTM after cardiac arrest in a single institution was retrospectively studied. Patients who did not receive cold saline were matched by age, gender, Glasgow coma scale, downtime, and presenting rhythm to patients who received cold saline. Demographics, cardiac rearrest, diuretic use, time to target temperature, and Cerebral Performance Category (CPC) scores were recorded among other variables. Patients who received cold saline achieved target temperature sooner (280 vs. 345 minutes, p = 0.05), had lower lactate levels on day 1 (4.2 ± 3.5 mM vs. 6.0 ± 4.9 mM, p = 0.019) and day 2 (1.3 ± 2.2 mM vs. 2.2 ± 3.2 mM, p = 0.046), increased incidence of pulmonary edema (51.5% vs. 31.8%, p = 0.006), and increased diuretic utilization (63.6% vs. 42.4%, p = 0.014). There was no significant difference in cardiac rearrest, arterial oxygenation, and CPC scores (ps 0.05).Infusion of IV cold saline is associated with shorter time to target temperature, increased incidence of pulmonary edema, and diuretic use, with no difference in cardiac rearrest, survival, and neurologic outcomes. |
| Databáze: | OpenAIRE |
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