Treatment of cardiac patients and complications on the ICU

Remco Bergman

    Research output: ThesisThesis fully internal (DIV)

    1032 Downloads (Pure)

    Abstract

    Over the past decade there have been many improvements in the management of patients after cardiac arrest. This thesis investigated what these changes were and what their effect on outcome was for all patients after cardiac arrest.
    The hemodynamic effects of cooling therapy were examined. This showed decreased cardiac output and increased lactate levels while mixed venous oxygen levels were normal. Hyperlactataemia may be related to hypothermia and is not deleterious or prognostic per se as hyperlactataemia has also been described during hypothermia in cardiac surgery patients. Lactate levels tracked directly after cardiac arrest showed lactate clearance after OHCA was much faster than the 10%/hour reduction reported in successfully recovered septic patients and also above the 10%/hour suggested in the setting of cardiac arrest.
    Survival and neurological outcome in patients resuscitated after VF and treated with PCI within this STEMI network was remarkably good. These observations underscore the fact that the current chain of treatment allows optimal patient survival. A more liberal application of angiography and coronary intervention may be considered in experienced acute cardiac referral centres. Concerning elderly patients, outcome after OHCA is worse with a hospital survival rate that is approximate half that of younger patients. However, the majority of elderly patients who survived have a good neurological outcome and a life span that compared favourably with the general population at this age.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    Supervisors/Advisors
    • Absalom, Tony, Supervisor
    • van der Naalt, Joukje, Supervisor
    • van der Horst, Iwan, Co-supervisor
    Award date30-Oct-2017
    Place of Publication[Groningen]
    Publisher
    Print ISBNs978-94-6233-728-2
    Electronic ISBNs978-94-6233-729-9
    Publication statusPublished - 2017

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