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Primary percutaneous coronary intervention and mild induced hypothermia in comatose survivors of ventricular fibrillation with ST-elevation acute myocardial infarctionKnafelj, Rihard ...Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST-elevation acute myocardial infarction (STEMI). In comatose survivors of cardiac arrest, mild induced ... hypothermia (MIH) improves neurological recovery. In the present study, we investigated feasibility and safety of combining primary PCI and MIH in comatose survivors of ventricular fibrillation with signs of STEMI after reestablishment of spontaneous circulation. Forty consecutive patients undergoing primary PCI and MIH from November 1, 2003 to December 31, 2005 were compared to 32 consecutive patientswho underwent primary PCI but no MIH between January 1, 2000 and November 1, 2003. There were no significant differences between the MIH and noMIH groups in general characteristics, cardiac arrest circumstances and angiographic features. Except for decreases in heart rate during hypothermia interval, there was no difference between the MIH and no MIH groups in arterial pressure, peak arterial lactate (5.1 mmol/l versus 5.7 mmol/l; p = .56), need for vasopressors (65% versus 53%; p = .44), inotropes (48% versus 59%; p = .44), aortic balloon counterpulsation (20% versus 22%; p = .92), repeat cardioversion/defibrillation (30% versus 34%; p=.89) and use of antiarrhythmics (33% versus 53%; p = .13). There was also no difference in inspired oxygen requirements during mechanical ventilation and in renal function. Hospital survival with cerebral performance category 1 and 2 was significantly better in MIH group (55% versus 16%; p=.001). Our preliminary experience indicates that primary PCI and MIH are feasible and may be combinedsafely in comatose survivors of ventricular fibrillation with signs ofSTEMI. Such a strategy may improve survival with good neurological recovery.Vir: Resuscitation. - ISSN 0300-9572 (Letn. 74, št. 2, 2007, str. 227-234)Vrsta gradiva - članek, sestavni delLeto - 2007Jezik - angleškiCOBISS.SI-ID - 24131033
Avtor
Knafelj, Rihard |
Radšel, Peter |
Ploj, Tom |
Noč, Marko, 1963-
Teme
Angioplasty, Transluminal, Percutaneous Coronary |
Hypothermia, Induced |
Cardiopulmonary Resuscitation |
Case-Control Studies |
Chi-Square Distribution |
Coma |
Physiopathology |
Feasibility Studies |
Myocardial Infarction |
Physiopathology |
Therapy |
Risk Factors |
Treatment Outcome |
Ventricular Fibrillation |
Therapy |
Physiopathology |
Angioplastika transluminalna, perkutana, koronarna |
Hipotermija inducirana |
Izvedljivost , študije |
Hi-kvadratna distribucija |
Miokardni infarkt |
Kontrolirane študije |
Kardiopulmonalno oživljanje |
Koma |
Zdravljenje, izid |
Dejavniki tveganja |
Prekatna fibrilacija
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Knafelj, Rihard | 31413 |
Radšel, Peter | 25618 |
Ploj, Tom | 18367 |
Noč, Marko, 1963- | 01161 |
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