Cardiac Arrest Clinical Trial
Official title:
Anti-inflammatory Effect of Therapeutic Hypothermia in Out-hospital Cardiac Arrest Patients With Cardiogenic Shock Via Interleukin-6 Trans-signaling
Acute myocardial infarction complicated with cardiogenic shock trigger IL-6, the strong
inflammatory response, result in multiple organ failure, even death.
While therapeutic hypothermia,to expect the possibility of anti-inflammatory effect via IL-6
bi-phasic effect and IL-10 , to improve the multiple organ failure, to increase survival rate
and well cerebral performance.
Despite emergency coronary revascularization coupled with medical stabilization, intra-aortic
balloon pump have significantly improved survival in patients with cardiogenic shock
complicating acute myocardial infarction, mortality still remains excessively high, being
actually about 30-50%. Future research should focus on new therapeutic strategies, aimed to
further decrease mortality rate of these patients or improve possible hospitalization and
prognosis.
Heart pumping failure result in cardiogenic shock. Increased LA filling pressure result in
acute pulmonary edema, hypoxemic respiratory failure, even congestive kidney and congestive
liver. Decreased stroke volume result in hypoperfusion obviously direct induce acute renal
failure, disturbance consciousness and lactate accumulation, even, shock liver. Multiple
organ failure is the major mortality in the patients suffered from cardiogenic shock after
acute myocardial infarction.
Cardiogenic shock remains the leading cause of death in patients hospitalized for myocardial
infarction . Systemic inflammation , especially endovascular Interleukin-6, triggered by
Tumor necrosis factor-alfa and Interleukin-1 beta result in inappropriate vasodilatation is
observed in many patients with cardiogenic shock and may contribute to an excess mortality
rate. In recent study, interleukin-6 represented a reliable independent early prognostic
marker of 30-day mortality.
Therapeutic hypothermia (34℃) increase stroke volume, reduce muscle oxygen consumption and
enhance anti-inflammatory action . The mechanism of anti-inflammatory effect for therapeutic
hypothermia in cardiogenic shock is still unclear, need to further study in clinical trial.
Furthermore, this study will provide new strategy to increase survival rate in cardiogenic
shock.
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