PhD Scientific Days 2018

Poster presentations: Cardiology

Changes in hemodynamic parameters and management of hemodynamics in comatose patients after successful resuscitation

Előadó neve

Dr. Kovács, Enikő, PhD

Előadó munkahelye

Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest

Előadó telefonszáma

+3630-991-4098

Előadó e-mail címe

kovacs.eniko2@med.semmelweis-univ.hu

Az előadás címe

Changes in hemodynamic parameters and management of hemodynamics in comatose patients after successful resuscitation

Szerző(k) neve és munkahelye

Enikő Kovács1, Zsigmond Jenei2, Alexa Fekete-Győr3, Zsófia Szakál-Tóth3, Dávid Pilecky3, János Gál1, Béla Merkely3, Endre Zima3

1 Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest
2 3rd Department of Internal Medicine, Semmelweis University, Budapest
3 Heart and Vascular Center, Semmelweis University, Budapest

Bemutatás módja

Szóbeli

Szekció

Poster presentations: Cardiology

Language of the presentation

Hungarian

Témacsoport

cardio-vascular sciences

Összefoglaló szövege

Introduction: Targeted temperature management (TTM) causes many complications in post-cardiac arrest patients, including hemodynamic instability.

Aims: We investigated the influence of TTM on hemodynamic parameters and the usefulness of Pulse index Contour Cardiac Output (PiCCO™) monitoring in survivors after cardiac arrest.

Method: Comatose post-cardiac arrest patients cooled to 32-34℃ with thermo-feedback device for 24 hours after successful resuscitation were divided into two groups: PiCCO (n=45; PiCCO™ monitor applied) and nonPiCCO group (n=23; without PiCCO™ monitoring). Changes in hemodynamic parameters and catecholamine consumption were assigned at initiation, 12th and 24th hour of cooling and after rewarming. Survival and in PiCCO group advanced hemodynamic parameters were also determined.

Results: The average heart rate was significantly lower at 12th (p<0.001) and 24th (p<0.001) hour of cooling than during normothermia. Systolic pressure was significantly lower after rewarming compared to the value at 12th hour of cooling (p=0.06). Diastolic pressure was also lower after rewarming compared to values at 12th (p=0.025) and 24th (p=0.008) hour of cooling.
Dopamine (p=0.038) and dobutamine (p=0.017) doses were significantly higher at initiation of cooling in PiCCO group. On the other hand dobutamine dose was significantly lower in PiCCO group at 12th (p=0.02) and 24th hour (p=0.03) of cooling and after rewarming (p=0.02). The same was found in adrenaline (p<0.001) and noradrenaline (p=0.025) doses at 24th hour of cooling and after rewarming (adrenaline: p<0.001; noradrenaline: p=0.04).
30-day survival was similar in both groups (p=0.25).
In PiCCO group cardiac index was significantly lower and systemic vascular resistance index significantly higher at 12th and 24th hour of cooling compared to values after rewarming (p<0.05).

Conclusion: We verified the deteriorating effects of TTM and post-cardiac arrest syndrome on hemodynamics. We showed that PiCCO™ guided therapy may be beneficial in the management of catecholamine treatment in post-cardiac arrest patients, however its use did not affect 30-day survival.

Data of the presenter

Doctoral School: Basic and Translational Medicine
Program: Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Supervisor: Endre Zima
E-mail: kovacs.eniko2@med.semmelweis-univ.hu

Kind

Szabad

Status

visszavonva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

2809

Authors (legacy)

Enikő Kovács1, Zsigmond Jenei2, Alexa Fekete-Győr3, Zsófia Szakál-Tóth3, Dávid Pilecky3, János Gál1, Béla Merkely3, Endre Zima3

1 Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest
2 3rd Department of Internal Medicine, Semmelweis University, Budapest
3 Heart and Vascular Center, Semmelweis University, Budapest