None listed
Conditions
Brief summary
During cardiac arrest, blood doesn't flow to the organs of the body. The brain may also not get enough blood. The lack of blood flow can cause lasting damage to the brain. The person may be unable to regain consciousness. Lowering the body temperature right away after cardiac arrest can reduce damage to the brain. Targeted temperature management (TTM) is a type of therapeutic treatment that improves neurological outcome and reduces mortality in patients with global cerebral ischemia, such as cardiac arrest patients. TTM therapy prevents brain damage through inhibition of multiple pathways such as oxidative stress, inflammatory responses, metabolic disruption, and cell death signals. TTM should be induced as early as possible to achieve maximum neuroprotection and edema blocking effect. Cell death is typically discussed dichotomously as either apoptosis or necrosis. In recent years, there are new studies on pyroptosis expressed as a new cell death. This cell death pathway is uniquely linked to caspase-1. A link between pyroptosis and hypothermia is currently unknown. If this link can be illuminated, the treatment approach can be formed. In this sudy we aimed to investigate The Effect of Targeted Temperature Management Therapy on Pyroptosis in Patients with return of Spontaneous Circulation post Cardiac Arrest Caused by Acute Myocardial Infarction.
Interventions
Target-Oriented Temperature Therapy, with spontaneous circulation after cardiac arrest caused by Acute Myocardial Infarction, patients over 18 years of age were included.
Patients under 18 years of age and those who died during 48 hours of hypothermia were excluded.
*Patients will be evaluated by the Cardiology department before the hypothermia procedure and cardiac examination of the patient will be performed.
* Hypothermia process will start within the first 6 hours after the arrest by inten
Target-Oriented Temperature Therapy, with spontaneous circulation after cardiac arrest caused by Acute Myocardial Infarction, patients over 18 years of age were included. Patients under 18 years of age and those who died during 48 hours of hypothermia were excluded. *Patients will be evaluated by the Cardiology department before the hypothermia procedure and cardiac examination of the patient will be performed. * Hypothermia process will start within the first 6 hours after the arrest by intensive care team. External targeted temperature therapy will be applied to the patients with the help of cold pads at 34°C for 48 hours. Samples will be stored at -80 °C after taking venous blood from the patients three times at the beginning of the cooling treatment (0.hour), at the 24th hour of the treatment and at the end of the treatment (48.hour) and centrifuged appropriately. *Patients will be re-evaluated by the cardiology department after the hypothermia procedure ends. * After reaching the number of patients, NLRP3, caspase1, gasdermin and IL-1Beta proteins will be measured by ELISA method and pyroptosis levels will be measured and recorded.
Sponsors
harran university medical faculty
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
The criteria for inclusion were a witnessed cardiac arrest, a presumed cardiac origin of the arrest, an age of 18 to 70 years, an estimated interval of 5 to 15 minutes from the patient's collapse to the first attempt at resuscitation by emergency medical personnel, and an interval of no more than 60 minutes from collapse to restoration of spontaneous circulation.
Exclusion criteria
Patients were excluded if they met any of the following criteria: esophageal temperature below 30 ° C at admission, coma before cardiac arrest due to administration of drugs that suppress the central nervous system, pregnancy, then response to verbal commands, return of spontaneous circulation, and before randomization, spontaneous Evidence of hypotension (mean arterial pressure less than 60 mm Hg), evidence of hypoxaemia (arterial oxygen saturation less than 85 percent) after return of circulation and more than 30 minutes prior to randomization, after return of spontaneous circulation and more than 15 minutes prior to randomization a fatal illness that occurred prior to arrest, factors unlikely to participate in follow-up, enrollment in another study, or a known pre-existing coagulopathy.
Outcome results
None listed