Targeted therapeutic mild hypercapnia after cardiac arrest
نویسندگان
چکیده
Cardiac arrest (CA) causes ischaemic brain injury and persistent cerebral hypoperfusion and cerebral hypoxia during the early post-resuscitation period. PaCO2 is the major physiological regulator of cerebral blood flow, is a modifiable component of care and mild hypercapnia may lead to improved neurological outcomes for resuscitated CA survivors. In order to evaluate the potential therapeutic role of PaCO2, we will conduct the TAME Cardiac Arrest trial. If TTMH therapy, which is cost free, is shown to be effective, the lives of countless CA survivors will be improved, clinical practice will be transformed, and major financial and human cost savings will be realised.
منابع مشابه
Targeted therapeutic mild hypercapnia after cardiac arrest: a part of the bundle of care for mitigating secondary injury after cardiac arrest
In the July 31 issue of Critical Care, Eastwood and colleagues [1] discussed the discordant results of the potential therapeutic role of mild hypercapnia in the early post-resuscitation period observed by Sekhon and colleagues [2]. These two previous studies [1, 2] underlined the importance of preventing secondary cerebral injury after cardiac arrest and the role of arterial carbon dioxide on c...
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BACKGROUND Cardiac arrest causes ischaemic brain injury. Arterial carbon dioxide tension (PaCO2) is a major determinant of cerebral blood flow. Thus, mild hypercapnia in the 24 h following cardiac arrest may increase cerebral blood flow and attenuate such injury. We describe the Carbon Control and Cardiac Arrest (CCC) trial. METHODS/DESIGN The CCC trial is a pilot multicentre feasibility, saf...
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In animal trials clinical outcome and histopathological damage of the brain tissue due to hypoxia after cardiac arrest was found to be reduced by mild therapeutic hypothermia.(1,2) The clinical milestone trials in 2002 also have found mild therapeutic hypothermia at 32°-34 °C for 12-24 hours to be neuroprotective in treatment of the post-cardiac arrest syndrome.(3-5) The last update of the inte...
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Aim. To evaluate whether the introduction of a therapeutic hypothermia (TH) protocol consisting of cold saline infusion and surface cooling would be effective in targeting mild therapeutic hypothermia (32-34°C). Additionally, to evaluate if TH would improve survival after cardiac arrest. Design. Before-after design. Setting. General Intensive Care Unit (ICU) at an urban general hospital with 47...
متن کاملResponse to letter regarding article, "association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post-cardiac arrest syndrome".
BACKGROUND Partial pressure of arterial CO2 (Paco(2)) is a regulator of cerebral blood flow after brain injury. Recent guidelines for the management of cardiac arrest recommend maintaining Paco(2) at 40 to 45 mm Hg after successful resuscitation; however, there is a paucity of data on the prevalence of Paco(2) derangements during the post-cardiac arrest period and its association with outcome. ...
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