Clinical course and prognostic factors of patients in severe accidental hypothermia with circulatory instability rewarmed with veno-arterial ECMO - an observational case series study
| العنوان: | Clinical course and prognostic factors of patients in severe accidental hypothermia with circulatory instability rewarmed with veno-arterial ECMO - an observational case series study |
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| المؤلفون: | Kosiński, Sylweriusz, Darocha, Tomasz, Jarosz, Anna, Zeliaś, Aleksander, Ziętkiewicz, Mirosław, Podsiadło, Paweł, Sanak, Tomasz, Sałapa, Kinga, Piątek, Jacek, Konstanty-Kalandyk, Janusz, Gałązkowski, Robert, Krawczyk, Paweł, Krzych, Łukasz, Drwiła, Rafał |
| المصدر: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 25, Iss 1, Pp 1-7 (2017) |
| بيانات النشر: | BioMed Central, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Hemodynamics, Hypothermia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Extracorporeal, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Extracorporeal membrane oxygenation, Humans, Rewarming, Original Research, Aged, Aged, 80 and over, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Shock, lcsh:RC86-88.9, Middle Aged, Prognosis, Surgery, Heart Arrest, Critical care, Blood pressure, Shock (circulatory), Anesthesia, Accidents, Emergency Medicine, Arterial blood, Female, medicine.symptom, business, Case series |
| الوصف: | Background Recently, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become the rewarming treatment of choice in hypothermic cardiac arrest. The detailed indications for extracorporeal rewarming in non-arrested, severely hypothermic patients with circulatory instability have not been established yet. The primary purpose of the study was a preliminary analysis of all aspects of the treatment process, as well as initial identification of mortality risk factors within the group of severely hypothermic patients, treated with arteriovenous extracorporeal membrane oxygenation (VA-ECMO). The secondary aim of the study was to evaluate efficacy of VA-ECMO in initial 6-h period of treatment Methods From July 2013 to June 2016, thirty one hypothermic patients were accepted for extracorporeal rewarming at Severe Accidental Hypothermia Center, Cracow. Thirteen patients were identified with circulatory instability and were enrolled in the study. The evaluation took into account patients’ condition on admission, the course of therapy, and changes in laboratory and hemodynamic parameters. Results Nine out of 13 analyzed patients survived (69%). Patients who died were older, had lower both systolic and diastolic pressure, and had increased creatinine an potassium levels on admission. In surviving patients, arterial blood gases parameters (pH, BE, HCO3) and lactates would normalize more quickly. Their potassium level was lower on admission as well. The values of the core temperature on admission were comparable. Although normothermia was achieved in 92% of patients, none of them had been weaned-off VA-ECMO in the first 6 h of treatment. Discussion and Conclusions In our preliminary study more pronounced markers of cardiocirculatory instability and organ hypoperfusion were observed in non-survivors. Future studies on indications to extracorporeal rewarming in severely hypothermic, non-arrested patients should focus on the extent of hemodynamic disturbances. Short term ( |
| اللغة: | English |
| تدمد: | 1757-7241 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e07d4b81e8cc1f7177d3f364500aacebTest http://europepmc.org/articles/PMC5414327Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e07d4b81e8cc1f7177d3f364500aaceb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17577241 |
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