tailieunhanh - Báo cáo y học: " Capillary leakage in post-cardiac arrest survivors during therapeutic hypothermia - a prospective, randomised study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Capillary leakage in post-cardiac arrest survivors during therapeutic hypothermia - a prospective, randomised study | Heradstveit et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medi- cine 2010 18 29 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access Capi llary leakage in post-cardiac arrest survivors during therapeutic hypothermia - a prospective randomised study Bãrd E Heradstveit 1 Anne Berit Guttormsen1 2 J0rund Lang0rgen3 Stig-Morten Hammersborg1 Tore Wentzel-Larsen4 Rune Fanebust3 Elna-Marie Larsson5 and Jon-Kenneth Heltne1 6 Abstract Background Fluids are often given liberally after the return of spontaneous circulation. However the optimal fluid regimen in survivors of cardiac arrest is unknown. Recent studies indicate an increased fluid requirement in postcardiac arrest patients. During hypothermia animal studies report extravasation in several organs including the brain. We investigated two fluid strategies to determine whether the choice of fluid would influence fluid requirements capillary leakage and oedema formation. Methods 19 survivors with witnessed cardiac arrest of primary cardiac origin were allocated to either hypertonic saline with 6 poly O-2-hydroxyethyl starch solution HH or standard fluid therapy Ringer s Acetate and saline 9 mg ml control . The patients were treated with the randomised fluid immediately after admission and continued for 24 hours of therapeutic hypothermia. Results During the first 24 hours the HH patients required significantly less . fluid than the control patients 4750 ml versus 8010 ml p with comparable use of vasopressors. Systemic vascular resistance was significantly reduced from 0 to 24 hours p with no difference between the groups. Colloid osmotic pressure COP in serum and interstitial fluid p and p respectively decreased as a function of time in both groups with a more pronounced reduction in interstitial COP in the crystalloid group. Magnetic resonance imaging of the brain did not reveal vasogenic oedema. Conclusions Post-cardiac arrest patients have high