Heart Rate and the Post Cardiac Arrest Syndrome

Bascom, Karen E.; Riker, Richard R.; Seder, David B.

doi:10.1097/ccm.0000000000001495

Cited by 3 publications

(2 citation statements)

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“…In a recently published editorial regarding the importance of heart rate and its relation to the post cardiac arrest syndrome, the authors correctly point out that residual confounding may be present in the multivariable models used in our and other studies, simply due to the fact that they have not been conceptualized or due to unavailability (20). One of the important limitations to our studies is the lack of prearrest medication including beta-blockers, though patients with pre-arrest indications for such medications had a trend towards higher and not lower mortality.…”

Section: Mechanisms Behind the Heart Rate Lowering Effectmentioning

confidence: 86%

What can a simple measure of heart rate during temperature management tell us on the physiology and prognosis of comatose cardiac arrest patients?

2016

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Section: Mechanisms Behind the Heart Rate Lowering Effectmentioning

confidence: 86%

What can a simple measure of heart rate during temperature management tell us on the physiology and prognosis of comatose cardiac arrest patients?

2016

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“…These factors may have biased the outcomes of our study. Second, confounders of HR response, such as the use of preinjury beta-blockers [1, 36, 37], vasopressor support, amount of bleeding and fluids, and urine volume, were not examined, owing to unavailability of the dataset. However, hemodynamic status was monitored and maintained based strictly on the study protocol.…”

Section: Discussionmentioning

confidence: 99%

Mild decrease in heart rate during early phase of targeted temperature management following tachycardia on admission is associated with unfavorable neurological outcomes after severe traumatic brain injury: a post hoc analysis of a multicenter randomized controlled trial

et al. 2018

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BackgroundThe association between isolated admission heart rate (HR) and prognosis has been discussed, but not that between gross HR change and neurological outcome in patients with severe traumatic brain injury (TBI). In the acute phase of severe TBI, HR is influenced by several factors (e.g., pain, sympathetic activation, hypovolemia, fever, body temperature). Therefore, admission HR and gross HR change should be examined in patients with TBI treated with a well-designed protocol, such as was done in the Brain Hypothermia (B-HYPO) Study.MethodsThis was a post hoc analysis of the B-HYPO Study, which was conducted as a prospective, multicenter, randomized controlled trial in patients with severe TBI receiving mild therapeutic hypothermia (MTH; 32.0 °C–34.0 °C) or fever control (35.5 °C–37.0 °C) in Japan. Patients with MTH were examined, and HR change (%HR) in the early MTH phase was calculated as follows: [admission HR – HR at day 1]/admission HR × 100. Patients were divided into six groups, using admission HR (< 80, 80–99, ≤ 100) and median of %HR; i.e., group (Admission HR < 80 and %HR ≥ 18.6); group (Admission HR < 80 and %HR < 18.6); group (Admission HR 80–99 and %HR ≥ 18.6); group (Admission HR 80–99 and %HR < 18.6); group (Admission HR ≥100 and %HR ≥ 18.6); and group (Admission HR ≥100 and %HR < 18.6). The primary outcome was an adjusted predicted probability of unfavorable neurological outcome at 6 months after TBI according to Glasgow Outcome Scale score, which is a measure of functional recovery and defined as severe disability, persistent vegetative state, and death.ResultsOverall, 79 patients with MTH (52.7% of the original trial) were examined; among these, unfavorable neurological outcomes were observed in 53.2%. Among all the groups, group (Admission HR ≥100 and %HR < 18.6) exhibited the highest proportion of unfavorable outcomes, and 82.3% of patients had an adjusted predicted probability of unfavorable outcomes, whereas those in group (Admission HR < 80 and %HR ≥ 18.6) developed only 22.8% (p = 0.04).ConclusionsMild HR decrease during the early phase of targeted temperature management following tachycardia at admission can be associated with unfavorable neurological outcomes after severe TBI.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2276-6) contains supplementary material, which is available to authorized users.

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The Impact of Heart Rate Response During 48-Hour Rewarming Phase of Therapeutic Hypothermia on Neurologic Outcomes in Out-of-Hospital Cardiac Arrest Patients

Inoue

Yonemoto

Kuroda

et al. 2018

Critical Care Medicine

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Heart Rate and the Post Cardiac Arrest Syndrome

Cited by 3 publications

References 13 publications

What can a simple measure of heart rate during temperature management tell us on the physiology and prognosis of comatose cardiac arrest patients?

What can a simple measure of heart rate during temperature management tell us on the physiology and prognosis of comatose cardiac arrest patients?

Mild decrease in heart rate during early phase of targeted temperature management following tachycardia on admission is associated with unfavorable neurological outcomes after severe traumatic brain injury: a post hoc analysis of a multicenter randomized controlled trial

The Impact of Heart Rate Response During 48-Hour Rewarming Phase of Therapeutic Hypothermia on Neurologic Outcomes in Out-of-Hospital Cardiac Arrest Patients

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