Cardiac function during mild hypothermia in pigs: increased inotropy at the expense of diastolic dysfunction

Post, Heiner; Schmitto, Jan D.; Steendijk, Paul; Christoph, Jan; Holland, R.; Wachter, Rolf; Schöndube, F.; Pieske, B.

doi:10.1111/j.1748-1716.2010.02083.x

Cited by 61 publications

(71 citation statements)

References 41 publications

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“…Improvement in systolic function with improved myocardial contractility with diastolic function being negatively affected during hypothermia has been reported in an animal model using conductance catheter. 20,21 The temperature-related changes in systolic or diastolic function could not be confirmed by echocardiographic-derived parameters in this study; however, echocardiography may be less sensitive compared with invasive methods.…”

Section: Discussioncontrasting

confidence: 67%

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Bro-Jeppesen

Hassager

Wanscher

et al. 2014

Circ: Cardiovascular Interventions

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emodynamic instability with low cardiac output and low to normal filling pressures is frequent in survivors after out-of-hospital cardiac arrest (OHCA), but may not always be apparent at hospital admission. 1 The hemodynamic profile suggestive of myocardial stunning and vasodilation is part of the postcardiac arrest syndrome, characterized by impaired vasoregulation, reduced cardiac output, and hypotension, which all contribute to decreased organ perfusion.2 Although application of targeted temperature management (TTM) in comatose survivors after OHCA is an established part of postresuscitation care, its effects on central hemodynamics may pose additional challenges to the treating physicians. Our current knowledge of the hemodynamic implications of TTM is limited because most descriptive studies are small or used noninvasive methods for hemodynamic evaluation, 3,4 whereas other studies were primarily designed for evaluating outcome. 5,6 A recent large randomized study, the Target Temperature Management after Cardiac arrest trial (TTM Trial), compared the beneficial effects of a target temperature of 33°C compared with 36°C after OHCA. Both regimens were equally efficacious in terms of mortality (50% versus 48%; P=0.51) and unfavorable neurological outcome (54% versus 52%; P=0.78). 7This study reports the impact on central hemodynamics in survivors after OHCA randomized to a TTM at 33°C or 36°CBackground-Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome, and hypothermia may pose additional impact on hemodynamics. The aim was to investigate systemic vascular resistance index (SVRI), cardiac index, and myocardial performance at a targeted temperature management of 33°C (TTM33) versus 36°C (TTM36

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Section: Discussioncontrasting

confidence: 67%

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Bro-Jeppesen

Hassager

Wanscher

et al. 2014

Circ: Cardiovascular Interventions

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“…Diastolic function in prearrest group was inferior to that in the Norm group when hypothermia was induced, but systolic function was less affected. This result is similar to previously published findings of Fischer et al [20] and Post et al [21]. However, diastolic function in prearrest and Norm group animals after ROSC did not differ even if the hypothermia effect it negatively, and systolic function was better in the prearrest rabbits at that time.…”

Section: Discussionsupporting

confidence: 92%

Prearrest hypothermia improved defibrillation and cardiac function in a rabbit ventricular fibrillation model

Jiang

Wang

et al. 2015

The American Journal of Emergency Medicine

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“…In hypothermia, bradycardia occurs normally and is associated with reduced systolic dysfunction in animal models. 57 Acute coronary syndrome is a common cause of cardiac arrest. In patients with ST-segment elevation or left bundle branch block on initial ECG after ROSC, the prevalence of an acute coronary lesion is more than 80%.…”

Section: Cbf and Metabolismmentioning

confidence: 99%

Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest

Nakashima

Hifumi

Kawakita

et al. 2017

Circ J

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The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.

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Cardiac function during mild hypothermia in pigs: increased inotropy at the expense of diastolic dysfunction

Abstract: MH negatively affects diastolic function, which, however, is compensated for by decreased spontaneous HR. Positive inotropy and a decrease in whole body oxygen consumption warrant further studies addressing the potential benefit of MH on the acutely failing heart.

Cited by 61 publications

References 41 publications

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Prearrest hypothermia improved defibrillation and cardiac function in a rabbit ventricular fibrillation model

Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest

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