tailieunhanh - Báo cáo y học: "Pre-hospital cooling of patients following cardiac arrest is effective using even low volumes of cold saline"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pre-hospital cooling of patients following cardiac arrest is effective using even low volumes of cold saline. | Skulec et al. Critical Care 2010 14 R231 http content 14 6 R231 KS CRITICAL CARE RESEARCH Open Access Pre-hospital cooling of patients following cardiac arrest is effective using even low volumes of cold saline 5 2 Roman Skulec 1 Anatolij Truhlár Jana Seblová Pavel Dostál Vladimir Cerný Abstract Introduction Pre-hospital induction of therapeutic mild hypothermia TH may reduce post-cardiac arrest brain injury in patients resuscitated from out-of-hospital cardiac arrest. Most often it is induced by a rapid intravenous administration of as much as 30 ml kg of cold crystalloids. We decided to assess the pre-hospital cooling effectivity of this approach by using a target dose of 15-20 ml kg of4 C cold normal saline in the setting of the physician-staffed Emergency Medical Service. The safety and impact on the clinical outcome have also been analyzed. Methods We performed a prospective observational study with a retrospective control group. A total of 40 patients were cooled by an intravenous administration of 15-20 ml kg of 4 C cold normal saline during transport to the hospital TH group . The pre-hospital decrease of tympanic temperature TT was analyzed as the primary endpoint. Patients in the control group did not undergo any pre-hospital cooling. Results In the TH group administration of ml kg of 4 C cold normal saline was followed by a prehospital decrease of TT of C in min p . The most effective cooling was associated with a transport time duration of 38-60 min and with an infusion of 17 ml kg of cold saline. In the TH group a trend toward a reduced need for catecholamines during transport was detected vs. p . There were no differences in demographic variables comorbidities parameters of the cardiopulmonary resuscitation and in other post-resuscitation characteristics. The coupling of pre-hospital cooling with subsequent in-hospital TH predicted a favorable neurological outcome at hospital .

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