Universität zu Köln

Adler, C., Pfister, R., Baldus, S. and Reuter, H. (2017). Mild therapeutic hypothermia in cardiogenic shock. Retrospective analysis of 80 patients with preclinical cardiac arrest due to cardiac causes. Med. Klin.-Intensivmed Notfallmed., 112 (1). S. 24 - 30. NEW YORK: SPRINGER. ISSN 2193-6218

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Abstract

The mortality in patients with cardiogenic shock after out-of-hospital cardiac arrest (OHCA) remains high despite advances in resuscitation and early revascularization strategies. The use of mild therapeutic hypothermia (MTH) for improvement of survival and neurological outcome in patients with cardiogenic shock is currently subject to renewed discussion. The aim of this study was the detection of risk factors for mortality and morbidity in patients under MTH in cardiogenic shock following preclinical resuscitation for OHCA. A total of 80 consecutive patients in cardiogenic shock after successful resuscitation (mean age 60 +/- 3.2 years) treated with MTH were retrospectively analyzed. Patients were cooled to 33 A degrees C for 24 h using an endovascular cooling device. Neurological outcome was assessed after 2 months based on the Glasgow-Pittsburgh cerebral performance category (CPC) and correlated with various blood parameter values. After 2 months 31 patients (39 %) showed a good neurological recovery with CPC scores of 1-2, 20 patients (25 %) had a poor neurological outcome with CPC scores of 3-4 and 29 (36 %) patients enrolled in the trial died (CPC 5). Patients with a poor outcome showed significantly higher mean serum levels for lactate, creatinine and urea. In addition, these patients showed a continuous increase of serum neuron-specific enolase (NSE) values in contrast to patients with a good outcome (a dagger NSE from admission to day 1, CPC 1 and 2: - 10.6 +/- 3 A mu g/l and CPC 3-5: 33 +/- 12 A mu g/l, p = 0.02). Changes in the course of serum creatinine, urea and NSE levels within the first 72 h after OHCA could provide valuable additional information for the early assessment of the neurological prognosis in patients treated with MTH.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Adler, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-241185
DOI:	10.1007/s00063-015-0122-z
Journal or Publication Title:	Med. Klin.-Intensivmed Notfallmed.
Volume:	112
Number:	1
Page Range:	S. 24 - 30
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	2193-6218
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TARGETED TEMPERATURE MANAGEMENT; NEURON-SPECIFIC ENOLASE; CARDIOPULMONARY-RESUSCITATION; MYOCARDIAL-INFARCTION; COMATOSE SURVIVORS; PREDICTION; GUIDELINES; COHORT Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24118