Haemodynamic variables and functional outcome in hypothermic patients following out-of-hospital cardiac arrest

Bradycardia During Therapeutic Hypothermia Is Associated With Good Neurologic Outcome in Comatose Survivors of Out-of-Hospital Cardiac Arrest*

“…No other differences in patient characteristics, prehospital data, or treatment factors were found. In opposite to Torgersen et al (16), we found that norepinephrine was not a significant independent factor for outcome. However, only prospective studies with specific aims can properly answer the questions regarding the association between different vasopressors, optimal blood pressure, and outcome after cardiac arrest.…”

“…Cerebral hypoxia is not caused by reduced cardiac output but depends on perfusion pressure and mismatch between oxygen demand and delivery. Recently, Torgersen et al (16) reported that TH patients with poor outcome had higher mean heart rates the first 24 hours post-cardiac arrest than patients with good outcome (73 vs 66 bpm), both within the higher range compared with the present data from our study. Better outcome in patients with even lower heart rates in the present study indicates that cerebral perfusion achieved during bradycardia is usually sufficient during hypothermia with reduced oxygen demand (17).…”

“…Beylin et al (18) recently reported that higher MAP and less vasoactive agent requirements were associated with better outcomes in 168 cooled patients, whereas Torgersen et al (16), on the other hand, found that lower mean perfusion pressure and cardiac index time integral were independently associated with adverse outcome. We found no differences in MAP within the first 24 hours after ICU admission between the bradycardia and nonbradycardia patients, but more patients received catecholamines, had lower base excess, and higher lactate levels in the nonbradycardia group indicating more initial ischemia and/ or reperfusion injury.…”

International Study on Microcirculatory Shock Occurrence in Acutely Ill Patients*

“…Indeed, in a recent study in early normotensive sepsis, MFI was 3.00 (2.73-3.00) (35). The observed association between macrohemodynamic variables, lactate levels, and mortality confirms the present clinical paradigm (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). Notably, a single measurement of blood pressure or HR, irrespective of disease state and timeframe, provided predictive value.…”

Mean arterial pressure and vasopressor load after out-of-hospital cardiac arrest: Associations with one-year neurologic outcome

“…Since hemodynamic instability is common after ROSC, vasoactive agents are frequently used. 18,19 The causes of hypotension after OHCA are likely multifactorial. Post-cardiac arrest syndrome (PCAS), characterized by brain injury, systemic inflammation and myocardial dysfunction, has many features similar to sepsis, such as endothelial activation and release of inflammatory markers.…”