کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3027124 1182939 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Mild induced hypothermia: Effects on sepsis-related coagulopathy -results from a randomized controlled trial
ترجمه فارسی عنوان
هیپوترمی ناشی از خفیف: اثرات کواگولوپاتی مربوط به سپسیس - نتایج حاصل از یک کارآزمایی کنترل شده تصادفی یک ؟؟
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی


• Mild Induced Hypothermia (33 °C for 24 hours) improved sepsis-related coagulopathy
• Improvement of sepsis-related coagulopathy was sustained after rewarming
• Mild Induced Hypothermia may be a future intervention against sepsis

IntroductionCoagulopathy associates with poor outcome in sepsis. Mild induced hypothermia has been proposed as treatment in sepsis but it is not known whether this intervention worsens functional coagulopathy.Materials and methodsInterim analysis data from an ongoing randomized controlled trial; The Cooling And Surviving Septic shock (CASS) study. Patients suffering severe sepsis/septic shock are allocated to either mild induced hypothermia (cooling to 32-34 °C for 24 hours) or control (uncontrolled temperature). Trial registration: NCT01455116. Thrombelastography (TEG) is performed three times during the first day after study enrollment in all patients. Reaction time (R), maximum amplitude (MA) and patients’ characteristics are here reported.ResultsOne hundred patients (control n = 50 and intervention n = 50; male n = 59; median age 68 years) with complete TEG during follow-up were included. At enrollment, 3%, 38%, and 59% had a hypocoagulable, normocoagulable, and hypercoagulable TEG clot strength (MA), respectively.In the hypothermia group, functional coagulopathy improved during the hypothermia phase, measured by R and MA, in patients with hypercoagulation as well as in patients with hypocoagulation (correlation between ΔR and initial R: rho = -0.60, p < 0.0001 and correlation between ΔMA and initial MA: rho = -0.50, p = 0.0002). Similar results were not observed in the control group neither for R (rho = -0.03, p = 0.8247) nor MA (rho = -0.15, p = 0.3115).ConclusionMild induced hypothermia did seem to improve functional coagulopathy in septic patients. This improvement of functional coagulopathy parameters during the hypothermia intervention persisted after rewarming. Randomized trials are warranted to determine whether the positive effect on sepsis-related coagulopathy can be transformed to improved survival.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Thrombosis Research - Volume 135, Issue 1, January 2015, Pages 175–182
نویسندگان
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