治疗性低温对心脏骤停后QT间期的影响。

IF 0.8 4区 医学 Q4 CRITICAL CARE MEDICINE
Aydin Nadir, Mehmet Sari
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引用次数: 0

摘要

心脏骤停(PCA)综合征与高心血管发病率和死亡率相关。QT间期延长可导致危及生命的室性心律失常和心源性猝死。治疗性低温(TH)被广泛用于改善PCA患者的神经预后,但其对QT间期的影响仍是一个研究课题。本研究旨在评估TH对PCA患者校正QT间期的影响。本研究共纳入48例(平均年龄63.2±11.3岁)心脏骤停存活并行TH的患者。在TH前后评估标准12导联心电图(ECGs)和血清电解质水平。采用Bazett公式测定QT间期和QTc间期,并计算QT离散度(QTd)为最大和最小QT间期之差。TH后RR间隔明显增加(480.75±91.75 ms vs. 660.43±97.35 ms, p < 0.05)。QTc间隔由397.13±12.45 ms显著增加至449.25±21.40 ms (p < 0.05)。QTd由55.48±12.45 ms增加至67.41±13.42 ms (p < 0.05)。QT间期的延长与血清钾和钙水平的显著降低有关。总之,TH可显著延长QT和QTc间期,增加QTd。这些发现表明,密切的心电图监测对于接受TH的PCA患者至关重要,特别是那些有心律失常易感因素的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Therapeutic Hypothermia on the QT Interval in Postcardiac Arrest Cases.

Postcardiac arrest (PCA) syndrome is associated with high cardiovascular morbidity and mortality. Prolongation of the QT interval can lead to life-threatening ventricular arrhythmias and sudden cardiac death. Therapeutic hypothermia (TH) is widely used to improve neurological outcomes in PCA patients, but its effects on the QT interval remain a subject of investigation. This study aimed to evaluate the impact of TH on corrected QT (QTc) intervals in PCA patients. A total of 48 patients (mean age 63.2 ± 11.3 years) who survived cardiac arrest and underwent TH were included. Standard 12-lead electrocardiograms (ECGs) and serum electrolyte levels were assessed before and after TH. The QT and QTc intervals were measured using Bazett's formula, and QT dispersion (QTd) was calculated as the difference between the maximum and minimum QT intervals. Following TH, a significant increase in RR intervals was observed (480.75 ± 91.75 ms vs. 660.43 ± 97.35 ms, p < 0.05). QTc intervals increased significantly from 397.13 ± 12.45 ms to 449.25 ± 21.40 ms (p < 0.05). Similarly, QTd increased from 55.48 ± 12.45 ms to 67.41 ± 13.42 ms (p < 0.05). The prolongation of the QT interval was associated with a significant decrease in serum potassium and calcium levels. In conclusion, TH leads to a significant prolongation of the QT and QTc intervals and an increase in QTd. These findings suggest that close ECG monitoring is essential in PCA patients undergoing TH, particularly in those with predisposing factors for arrhythmias.

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来源期刊
CiteScore
2.50
自引率
8.30%
发文量
35
期刊介绍: Therapeutic Hypothermia and Temperature Management is the first and only journal to cover all aspects of hypothermia and temperature considerations relevant to this exciting field, including its application in cardiac arrest, spinal cord and traumatic brain injury, stroke, burns, and much more. The Journal provides a strong multidisciplinary forum to ensure that research advances are well disseminated, and that therapeutic hypothermia is well understood and used effectively to enhance patient outcomes. Novel findings from translational preclinical investigations as well as clinical studies and trials are featured in original articles, state-of-the-art review articles, protocols and best practices. Therapeutic Hypothermia and Temperature Management coverage includes: Temperature mechanisms and cooling strategies Protocols, risk factors, and drug interventions Intraoperative considerations Post-resuscitation cooling ICU management.
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