OA Critical Care

Review

Anaesthesiology, Perioperative & Critical Care Medicine

Lazzeri C, Valente S, Chiostri M, Spini V, Fatucchi S, Gensini GF. Theraputic hypothermia and hemodynamics after cardiac arrest: From animal to human studies. OA Critical Care 2014 Apr 14;2(1):6.

Abstract

Data on the  hemodynamic and cardiovascular effects of therapeutic hypothermia (TH)  in patients after cardiac arrest (CA)are scarce , even if nearly half of thesepatients are hemodynamically unstable and quite often require vasopressor agents.

          The present manuscript is aimed at summarizing the available evidence on the hemodynamic effects of  hypothermia after cardiac arrest in experimental studies and in investigations performed in humans.

           In the temperature recommended for therapeutic hypothermia (32-34°C),  in animal models, hypothermia has an inotropic effects most likely acts by sensitizing the myofilaments of calcium.

          In cardiac arrest patients, therapeutic hypothermia  is associated with a reduction in heart rate and an increase in systemic vascular resistance.

               Despite scarcity of data, TH seems to be feasible and well tolerated in CA patients with hemodynamic instability who presented a comparable incidence of complications in respect to stable patients and a good neurological outcome.

               Despite the fact the hemodynamic management is crucial in post-arrest care, concrete data to guide clinical treatment decisions are so far scarce andno consensus exist on the hemodynamic goals that a clinical should reach in the management of CA patients submitted to TH.  There is the clinical need of implementation investigations which could provide sufficient details which could be agreed upon by a consensus group of experts in post-arrest care.

Corresponding Author

Chiara Lazzeri - lazzeric@libero.it