PhD Scientific Days 2022

Clinical Medicine II.

Investigation of prognostic factors for out-of-hospital cardiac arrest and targeted temperature management of post-cardiac arrest syndrome

Előadó neve

Nagy, Bettina

Előadó munkahelye

Heart and Vascular Center, Semmelweis University, Budapest, Hungary

Előadó telefonszáma

0036707038933

Előadó e-mail címe

nagy.betta@gmail.com

Az előadás címe

Investigation of prognostic factors for out-of-hospital cardiac arrest and targeted temperature management of post-cardiac arrest syndrome

Szerző(k) neve és munkahelye

Bettina Nagy, Heart ans Vascular Center, Semmelweis University, Budapest Hungary
Boldizsár Kiss, MD, Heart ans Vascular Center, Semmelweis University, Budapest Hungary

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine II.

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Sudden cardiac death is one of the most common causes of cardiovascular death. If the patient has undergone prolonged cardiopulmonary resuscitation or has remained in a coma, targeted temperature management (TTM) is used to treat hypoxic damage to the brain and prevent secondary damage.
Aim: Our aim was to create a score system that accurately estimates the outcome within the first 24 hours after cardiac arrest in TTM patients based on simple and easily measurable parameters.
Methods: In our retrospective study, we processed data from 103 consecutive patients who were successfully resuscitated and received TTM at our clinic between 2016 and 2020. Parameters: demographic data, initial rhythm, heart rate (HR), blood pressure, catecholamine requirement, echocardiographic-, laboratory-, and blood gas values. Our data were evaluated using simple descriptive statistics, ROC-, and Kaplan-Meier analysis.
Results: Based on early mortality, two groups were created: survivor (S)/non-survivor (NS). The best prognostic markers selected for the score system based on AUC for 30-day mortality were HR above 70 beats/min, systolic blood pressure below 110 mmHg, GFR below 45 ml/min /1.73 m2, TAPSE below 15 mm and BE below -8.5 mmol/l. Mortality-enhancing variables are also non-shockable rhythm (S:24.4%, NS: 8.6%, p=0.03) and noradrenaline (NA) requirement (S:0.167 µg/kg/min, NS: 0.034 µg/kg/min, p=0.029). If the studied variable exceeded the diagnostic threshold, the patient developed NA demand or had non-shockable initial rhythm received 1 point. The maximum score was 7. The mortality is 9% at 0 points and 85% at 7 points.
Conclusion: It can be concluded that the scoring system we have developed may be suitable for early risk assessment of patients receiving TTM as part of primary post-resuscitation care. As the score increases, so does the 30-day mortality.
Funding: The lack of expected decrease in HR correlates with lower expected survival. It was shown that the arterial blood pressure recorded during TTM also plays a central role in determining the outcome, so it may be a bases of a new “target-oriented therapeutic objective” during intensive care after resuscitation.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine

Supervisor

Prof. Endre Zima

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6861

Start

15:30

End

15:45

Authors (legacy)

Bettina Nagy, Heart ans Vascular Center, Semmelweis University, Budapest Hungary
Boldizsár Kiss, MD, Heart ans Vascular Center, Semmelweis University, Budapest Hungary