Primary percutaneous coronary intervention and mild induced hypothermia in comatose survivors of ventricular fibrillation with ST-elevation acute myocardial infarction

Knafelj, Rihard; Radšel, Peter; Ploj, Tom; Noč, Marko

doi:10.1016/j.resuscitation.2007.01.016

Cited by 244 publications

(126 citation statements)

References 17 publications

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“…There have also been several previous studies with historical controls [25][26][27] considered as GOE IV, and experimental studies. [28][29][30][31] Recently, several observational studies, with historical controls [32][33][34][35] (GOE IV), uncontrolled studies 36,37 (GOE V) and a European registry 39 (GOE V), all show that MTH is feasible, safe, has few side effects and seems to contribute toward improved survival.…”

Section: Resultsmentioning

confidence: 99%

“…Induction can easily be induced with ice-cold i.v. fluids (30-40 ml/kg) 35,[47][48][49][50] (GOE II-V) or removal of clothes and with the use of ice packs, placed in the groins, armpits and around the neck and head 33,51 (GOE IV and II). Although traditional external cooling has proven its feasibility 33,51,52 (GOE IV, V, II), its use may lead to overcooling 53 (GOE V).…”

Section: Methods For Mthmentioning

confidence: 99%

“…Diagnosing the cause of the cardiac arrest. Early coronary angiography with subsequent PCI should be recommended for primary resuscitated cardiacarrested patients suspected to have myocardial infarction or severe coronary heart disease [34][35][36] (GOE IV, V). MTH can be initiated and maintained during coronary angiography and PCI 34,63 (GOE IV) Pre-or in-hospital thrombolysis is recommended for patients with ST elevation if there are no facilities for immediate PCI.…”

Section: Timing Of Other Interventionsmentioning

confidence: 99%

“…Although MTH exerts various effects on several organ systems, clinical studies show that MTH does not increase the risk or the number of complications compared with similar patients not treated with MTH 22,34,35,39,82 (GOE I-V). Induction of hypothermia may affect haemodynamic stability.…”

Section: Adverse Effects and Complications Of Mthmentioning

confidence: 99%

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Scandinavian Clinical practice guidelines for therapeutic hypothermia and post‐resuscitation care after cardiac arrest

Castrèn¹,

Silfvast²,

Rubertsson³

et al. 2009

Acta Anaesthesiol Scand

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Background and aim: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several studies MTH has been proven to be safe, with few complications and improved survival, and is recommended by the International Liaison of Committee on Resuscitation. The aim of this paper is to recommend clinical practice guidelines for MTH treatment after cardiac arrest from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI).Methods: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus opinion was used when high‐grade evidence (Grade of Recommendation, GOR) was unavailable. A management strategy was developed as a consensus from the evidence and the protocols in the participating countries.Results and conclusion: Although proven beneficial only for patients with initial ventricular fibrillation (GOR A), the SSAITFTH also recommend MTH after restored spontaneous circulation, if active treatment is chosen, in patients with initial pulseless electrical activity and asystole (GOR D). Normal ethical considerations, premorbid status, total anoxia time and general condition should decide whether active treatment is required or not. MTH should be part of a standardized treatment protocol, and initiated as early as possible after indication and treatment have been decided (GOR E). There is insufficient evidence to make definitive recommendations among techniques to induce MTH, and we do not know the optimal target temperature, duration of cooling and rewarming time. New studies are needed to address the question as to how MTH affects, for example, prognostic factors.

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Section: Resultsmentioning

confidence: 99%

Section: Methods For Mthmentioning

confidence: 99%

Section: Timing Of Other Interventionsmentioning

confidence: 99%

Section: Adverse Effects and Complications Of Mthmentioning

confidence: 99%

See 2 more Smart Citations

Scandinavian Clinical practice guidelines for therapeutic hypothermia and post‐resuscitation care after cardiac arrest

Castrèn¹,

Silfvast²,

Rubertsson³

et al. 2009

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Es ist anerkannt, das Patienten nach einem Kreislaufstillstand mit ST-Hebungs-Infarktzeichen (STEMI) schnellstmöglich eine Koronarangiographie und eine PCI erhalten sollen. Da jedoch sowohl Thoraxschmerz als auch ST-Veränderungen bei den Patienten nach Kreislaufstillstand nur eingeschränkt korrekt einen akuten koronaren Verschluss voraussagen [660], soll bei allen Patienten nach Kreislaufstillstand, bei denen eine KHK angenommen werden kann, eine PCI in Erwägung gezogen werden [630,634,660,661,662,663,664,665,666]. Mehrere Studien weisen darauf hin, dass bei einem Patienten mit einem Kreislaufstillstand, der aufgrund eines ACS aufgetreten ist, die Kombination von Hypothermie und PCI machbar sowie sicher ist [630,634,639,666,667].…”

Section: Herz-kreislauf-systemunclassified