Lazzeri Chiara, Sori Andrea, Bernardo Pasquale, Chiostri Marco, Tommasi Eleonora, Zucchini Mery, Romano Salvatore Mario, Gensini Gian Franco, Valente Serafina
Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy.
Acute Card Care. 2014 Jun;16(2):67-73. doi: 10.3109/17482941.2014.889310. Epub 2014 Mar 21.
Data on the hemodynamic and cardiovascular effects of hypothermia in patients with cardiac arrest are scarce. The aim of this study was to evaluate the hemodynamic changes induced by hypothermia by means of Most Care(®) (pressure recording analytical method, PRAM methodology), a beat-to-beat hemodynamic monitoring method.
We enrolled 20 patients with cardiac arrest (CA) consecutively admitted to our intensive cardiac care unit and treated with mild hypothermia (TH).
While non-survivors showed no changes in haemodynamic variables throughout the study period, survivors exhibited a significant increase in systemic vascular resistance indexed during hypothermia and a trend towards lower values of heart rate and higher levels of mean arterial pressure.
According to our data, PRAM methodology proved to be a feasible and clinically useful tool in CA patients treated with TH since it provides continuous beat-to-beat haemodynamic monitoring that is based on assessment of several haemodynamic variables. Moreover, we observed that survivors showed a different haemodynamic behaviour during hypothermia in respect to patients who died. However, further studies, performed in larger cohorts, are needed to better elucidate the haemodynamic effects of hypothermia in CA patients by means of PRAM methodology.
关于心脏骤停患者低温治疗的血流动力学和心血管效应的数据稀缺。本研究的目的是通过Most Care（®）（压力记录分析方法，PRAM方法），一种逐搏血流动力学监测方法，评估低温诱导的血流动力学变化。
我们连续纳入了20例入住我们重症心脏监护病房并接受轻度低温治疗（TH）的心脏骤停（CA）患者。
在整个研究期间，非幸存者的血流动力学变量没有变化，而幸存者在低温期间全身血管阻力指数显著增加，心率值有降低趋势，平均动脉压水平有升高趋势。
根据我们的数据，PRAM方法被证明是在接受TH治疗的CA患者中一种可行且临床有用的工具，因为它提供基于多个血流动力学变量评估的连续逐搏血流动力学监测。此外，我们观察到幸存者在低温期间的血流动力学行为与死亡患者不同。然而，需要在更大的队列中进行进一步研究，以通过PRAM方法更好地阐明低温对CA患者的血流动力学影响。
