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Schmidt-Schweda, S; Ohler, A; Post, H; Pieske, B.
Moderate hypothermia for severe cardiogenic shock (COOL Shock Study I and II).
Resuscitation. 2013; 84(3):319-325 Doi: 10.1016/j.resuscitation.2012.09.034
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Co-Autor*innen der Med Uni Graz
Pieske Burkert Mathias
Post Heiner
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Abstract:
Aim of the study: Hypothermia exerts profound protection from neurological damage and death after resuscitation from circulatory arrest. Its application during concomitant cardiogenic shock has been discussed controversially, and still hypothermia is used with reserve when haemodynamic parameters are impaired. On the other hand hypothermia improves force development in isolated human myocardium. Thus, we hypothesized that hypothermia could beneficially affect cardiac function in patients during cardiogenic shock. Methods: 14 Patients, admitted to Intensive Care Unit for cardiogenic shock under inotropic support, were enrolled and moderate hypothermia (33 degrees C) was induced for either one (n = 5, short-term) or twenty-four (n = 9, mid-term) hours. Results: 12 patients suffered from ischaemic cardiomyopathy, 2 were female, and 6 were included after cardiac arrest and resuscitation. Body temperature was controlled by an intravascular cooling device. Short-term hypothermia consistently decreased heart rate, and increased stroke volume, cardiac index and cardiac power output. Metabolic and electrocardiographic parameters remained constant during cooling. Improved cardiac function persisted during mid-term hypothermia, but was reversed during re-warming. No severe or persistent adverse effects of hypothermia were observed. Conclusion: Moderate Hypothermia is safe and feasable in patients during cardiogenic shock. Moreover, hypothermia improved parameters of cardiac function, suggesting that hypothermia might be considered as a positive inotropic intervention rather than a risk for patients during cardiogenic shock. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Aged, 80 and over -
Body Temperature - physiology
Female -
Follow-Up Studies -
Heart Arrest - etiology
Humans -
Hypothermia, Induced - methods
Male -
Middle Aged -
Myocardial Contraction -
Myocardial Ischemia - complications
Prospective Studies -
Severity of Illness Index -
Shock, Cardiogenic - complications
Treatment Outcome -

Find related publications in this database (Keywords)
Hypothermia
Cardiogenic shock
Heart failure
Patients
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