https://scholars.lib.ntu.edu.tw/handle/123456789/455827
標題: | Postresuscitation myocardial dysfunction: Correlated factors and prognostic implications | 作者: | WEI-TIEN CHANG MATTHEW HUEI-MING MA KUO-LIONG CHIEN CHIEN-HUA HUANG MIN-SHAN TSAI FUH-YUAN SHIH ANG YUAN Tsai K.-C. Lin F.-Y. Lee Y.-T. WEN-JONE CHEN |
公開日期: | 2007 | 卷: | 33 | 期: | 1 | 起(迄)頁: | 88-95 | 來源出版物: | Intensive Care Medicine | 摘要: | Objective: To evaluate the clinical factors correlated with postresuscitation myocardial dysfunction and the prognostic implication such dysfunction may have. Design and setting: Prospective observational study in a university medical center Patients: 58 adult patients successfully resuscitated from nontraumatic out-of-hospital cardiac arrest over 2 years. Measments and results: Echocardiographic evaluation of the left ventricular systolic and diastolic functions was performed 6 h postresuscitation and was analyzed in correlation to the clinical features and resuscitation factors. Univariate analysis revealed left ventricular ejection fraction (LVEF) to be significantly lower in patients with hypertension, past history of myocardial infarction, resuscitation duration longer than 20 min, defibrillation, and use of more than 5 mg epinephrine. Isovolumic relaxation time (IVRT) was significantly longer in patients with noncardiac cause and initial rhythm of nonventricular fibrillation/tachycardia. Multiple regression analysis showed epinephrine dose and past history of myocardial infarction to be independent factors for LVEF, while the cause of cardiac arrest was independently associated with IVRT. For prognosis, 27 patients survived to hospital discharge. Both LVEF under 40% and IVRT 100 ms or longer were associated with poor survival outcomes. In Cox regression analysis IVRT 100 ms or longer served as an independent factor predicting poor survival prognosis. Conclusions: Postresuscitation left ventricular dysfunction is correlated with a number of clinical factors, among which past history of myocardial infarction, epinephrine dose, and the cause of cardiac arrest play independent roles. Meanwhile, IVRT 100 ms or longer 6 h postresuscitation predicts poor survival outcomes and serves as a marker of poor prognosis. ? 2006 Springer-Verlag. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/455827 | DOI: | 10.1007/s00134-006-0442-9 | SDG/關鍵字: | adrenalin; adult; aged; article; clinical feature; correlation analysis; defibrillation; echocardiography; female; heart arrest; heart infarction; heart left ventricle ejection fraction; heart rhythm; hospital discharge; human; hypertension; major clinical study; male; multiple regression; myocardial disease; prediction; prognosis; resuscitation; statistical significance; survival; tachycardia; univariate analysis; university hospital; Aged; Aged, 80 and over; Cardiopulmonary Resuscitation; Female; Heart; Heart Arrest; Humans; Male; Middle Aged; Myocardial Contraction; Prognosis; Prospective Studies; Stroke Volume |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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