The effects of mild induced hypothermia on the myocardium: a systematic review.
Mild induced hypothermia improves neurological outcome and reduces mortality among initially comatose survivors of out-of-hospital cardiac arrest. Similar pathological processes occur in the heart and the brain, namely ischaemia followed by reperfusion injury. Animal data indicate that mild induced hypothermia results in improved myocardial salvage, reduced infarct size, reduced left ventricular remodelling and better long-term left ventricular function. Several small human studies suggest that infarct size may be reduced by mild induced hypothermia, although this has not reached significance in any human study to date. There are variable reports of harm to the myocardium caused by mild induced hypothermia, including reduced myocardial contractility and cardiac output, electrocardiographic changes and arrhythmias, especially bradycardia. These harmful effects are reversible with rewarming.
Kelly
Fiona E
FE
Department of Anaesthesia and Intensive Care Medicine, Frenchay Hospital, Bristol, UK. fiona.kelly@doctors.org.uk
Nolan
J P
JP
D000818:Animals; D001145:Arrhythmias, Cardiac / Q000209:etiology; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D009203:Myocardial Infarction / Q000473:pathology / Q000517:prevention & control*