Abstract 4037: Microcirculatory Changes Due To Cooling Therapy In Patients After Cardiac Arrest
Introduction: Upon cardiac arrest, perfusion is restored with inotropic or vasorpressor support. Ischemia reperfusion or even inotropic or vasopressor support might result in microcirculation disturbance. the effect of colling therapy on microcircualtion is unknown. OPS vessel microscopy (orthogonal polarized spectral imaging) is a new method to visualize microcirculation.
Methods: In this study 20 Patients with cardiogenic shock after cardiac arrest and cooling therapy caused by a myocardial infarction were followed after their PCI. Five areas in the oral vestibule were recorded and averaged each 24 hours for three days. Data were transferred on a PC and analysed the average of diameters, of flow and the cell blood velocity (CBV) were recorded. In this way, we compared all data recorded at temperatures lower than 34 °C to data recorded at higher temperatures (more than 38°C) and to data recorded at normal temperatures from 36 –38 °C.
Results: At temperatures below 36°C we found lower CBV (295,5μm/s vs. 527,6μm/s; p= 0,0027) and flow (308 ×10±9ml/s vs. 740 ×10±9ml/s; p=0,018) in patients with cardiogenic shock and cooling therapy compared to normal temperatures. It is remarkable, that medium vessel diameter is relatively constant and independent from temperature changes(32,5μm vs. 31,9μm vs. 31,1μm; p=0,96 und 0,83). The biggest flow and CBV were found at normal temperatures.
Conclusion: This data may suggest a decrease of organ perfusion in the microcirculation under hypothermia. It shows that OPS technology is a useful tool to follow heart patients on the intensive care unit in order to estimate influences of cooling therapy on microcirculation.