Abstract 340: Early Invasive Hemodynamics and Outcomes in Cardiac Arrest Survivors Undergoing Targeted Temperature Management

• Published in: Circulation (New York, N.Y.) Vol. 138; no. Suppl_2
• Main Authors: Schenone, Aldo L, Chen, Kevin, Gheyath, Bashaer, Borges, Nyal, Li, Manshi, Wang, Xiaofeng, Duggal, Abhijit, Menon, Venu
• Format: Journal Article
• Language: English
• Published: 06-11-2018
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.138.suppl_2.340

Abstract only
Introduction:
Clinical and electrical determinants of survival following cardiac arrest (CA) have been well defined. The prognostic role of early invasive hemodynamics (iHDs) remains unknown.
Hypothesis:
Early iHDs following CA in survivors undergoing TTM predicts survival and neurological outcomes at hospital discharge.
Methods:
We reviewed prospectively collected data on CA survivors undergoing TTM in a quaternary CICU between Jan 15 and Jun 17. Patients included were required to have RHC derived iHDs at initiation of TTM. Subjects with cooling initiated before admission and temperature of <36°C prior to obtaining iHDs were excluded. Univariate and multivariate regression were conducted to test whether cardiac index (Fick-CI≥2.2 vs <2.2 liters/min per m
2
), pulmonary capillary wedge pressure (PCWP≥18 vs <18mmHg), systemic vascular resistance (SVR>1200 vs 800-1200 vs <800 dynes·sec·cm
-5
) or Forrester hemodynamic profiles were predictive of survival and favorable neurological outcomes at hospital discharge.
Results:
We identified 52 subjects and 26 (50%) survived to hospital discharge, with 21 (40%) achieving a favorable neurological outcome. Wide variability in invasive hemodynamic parameters was noted in this cohort. There was no association between Fick-CI (p=0.45 & p=0.10), PCWP (p=0.90 & p=0.60), SVR (0.95 & p=0.17) or Forrester hemodynamic profiles (p=0.40 & p=0.42) and survival or favorable neurological outcome at discharge.
Conclusion:
CA survivors undergoing TTM present with a wide spectrum of iHDs highlighting the heterogeneity of the post cardiac arrest syndrome. Early iHDs did not predict survival or neurological outcomes at hospital discharge.