NHẬN XÉT MỘT SỐ BIẾN CHỨNG CỦA PHƯƠNG PHÁP HẠ THÂN NHIỆT CHỈ HUY VỚI ĐÍCH 33°C TRONG ĐIỀU TRỊ BỆNH NHÂN HÔN MÊ SAU NGỪNG TUẦN HOÀN

Abstract

Purposes: To evaluate some complications of the method of conducting hypothermia with a target of 33°C in the treatment of comatose patients after out-of-hospital cardiac arrest. Subjects and methods: Interventional study on 68 comatose patients after out-of-hospital cardiac arrest who were successfully resuscitated and return of spontaneous circulation with target hypothermia of 33°C in the emergency department A9 Patient Bach Mai Hospital from October 2015 to January 2020. Results: Shivering was a complication encountered in 100% of patients in the hypothermic phase. Hypokalemia in the hypothermic phase (KT0 3,7 ± 0,8 vs KT351 3,5 ± 0,7; p = 0,011), hyperkalemia during the warming phase (KT2 3,8 ± 0,7 vs KT352 4,2 ± 0,8; p = 0,007). 72,1% of patients had hyperglycaemia, increasing trend during hypothermia. Thrombocytopenia is a common complication (TC T0 287,7 ± 72,2 compared with TC T4 163,1 ± 61,1; p < 0,001). Sinus bradycardia was found in 10.3% of patients. Conclusions: Shivering, disorder kalemia, hyperglycemia, and thrombocytopenia are common complications in the treatment of 33°C target hypothermia. In the treatment of hypothermia with a target of 33°C, close monitoring, detection and management of these complications are essential..