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Safety, Feasibility, and Hemodynamic Effects of Mild Hypothermia in Transcatheter Aortic Valve Replacement: The TAVR-CHILL Trial.

Sparv, David LU ; Hyllen, Snejana LU ; Harnek, Jan LU ; Nozohoor, Shahab LU ; Bjursten, Henrik LU and Götberg, Matthias LU (2015) In Therapeutic hypothermia and temperature management 5(4). p.209-216
Abstract
The safety, feasibility, and hemodynamic effects of mild hypothermia (MH) induced by transnasal cooling were studied in transcatheter aortic valve replacement (TAVR). MH is a common therapy following cardiac arrest and seems to have favorable effects in myocardial infarction and on hemodynamic stability. In TAVR, hemodynamic instability is common during rapid pacing. Twenty subjects undergoing TAVR were randomized 1:1 to hypothermia or normothermia. Hemodynamic endpoints were mean arterial blood pressure and required dosage of vasoactive and inotropic drugs. Patients were followed up at 6 months. All patients in the MH group (n=10) reached the target temperature of 34°C before first rapid pacing. Tympanic and urinary bladder temperature... (More)
The safety, feasibility, and hemodynamic effects of mild hypothermia (MH) induced by transnasal cooling were studied in transcatheter aortic valve replacement (TAVR). MH is a common therapy following cardiac arrest and seems to have favorable effects in myocardial infarction and on hemodynamic stability. In TAVR, hemodynamic instability is common during rapid pacing. Twenty subjects undergoing TAVR were randomized 1:1 to hypothermia or normothermia. Hemodynamic endpoints were mean arterial blood pressure and required dosage of vasoactive and inotropic drugs. Patients were followed up at 6 months. All patients in the MH group (n=10) reached the target temperature of 34°C before first rapid pacing. Tympanic and urinary bladder temperature remained significantly lower in the MH group during the procedure. No adverse effects of cooling were observed. Mean arterial pressure was higher in the MH group (90±20 mm Hg) than in the control group (71±13 mm Hg) at the start of the procedure, at first rapid pacing (94±19 vs. 80±16 mm Hg), and at balloon aortic valvuloplasty (90±17 vs. 73±14 mm Hg). Less norepinephrine was administered to the hypothermia group. Transnasal cooling during TAVR was safe and well tolerated. We observed a more stable hemodynamic profile in the MH group, indicated by higher blood pressure and lower levels of vasoactive drugs required. A larger study of patients with severe ventricular dysfunction is required to more comprehensively investigate the hemodynamic effects of transnasal cooling in TAVR. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Therapeutic hypothermia and temperature management
volume
5
issue
4
pages
209 - 216
publisher
Mary Ann Liebert, Inc.
external identifiers
  • pmid:26222725
  • wos:000369362500007
  • scopus:84989803795
ISSN
2153-7933
DOI
10.1089/ther.2015.0011
language
English
LU publication?
yes
id
e5157c7c-3876-43f6-b350-7ef6b9a12ef9 (old id 7703445)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26222725?dopt=Abstract
date added to LUP
2015-08-11 12:37:55
date last changed
2017-01-01 03:25:12
@article{e5157c7c-3876-43f6-b350-7ef6b9a12ef9,
  abstract     = {The safety, feasibility, and hemodynamic effects of mild hypothermia (MH) induced by transnasal cooling were studied in transcatheter aortic valve replacement (TAVR). MH is a common therapy following cardiac arrest and seems to have favorable effects in myocardial infarction and on hemodynamic stability. In TAVR, hemodynamic instability is common during rapid pacing. Twenty subjects undergoing TAVR were randomized 1:1 to hypothermia or normothermia. Hemodynamic endpoints were mean arterial blood pressure and required dosage of vasoactive and inotropic drugs. Patients were followed up at 6 months. All patients in the MH group (n=10) reached the target temperature of 34°C before first rapid pacing. Tympanic and urinary bladder temperature remained significantly lower in the MH group during the procedure. No adverse effects of cooling were observed. Mean arterial pressure was higher in the MH group (90±20 mm Hg) than in the control group (71±13 mm Hg) at the start of the procedure, at first rapid pacing (94±19 vs. 80±16 mm Hg), and at balloon aortic valvuloplasty (90±17 vs. 73±14 mm Hg). Less norepinephrine was administered to the hypothermia group. Transnasal cooling during TAVR was safe and well tolerated. We observed a more stable hemodynamic profile in the MH group, indicated by higher blood pressure and lower levels of vasoactive drugs required. A larger study of patients with severe ventricular dysfunction is required to more comprehensively investigate the hemodynamic effects of transnasal cooling in TAVR.},
  author       = {Sparv, David and Hyllen, Snejana and Harnek, Jan and Nozohoor, Shahab and Bjursten, Henrik and Götberg, Matthias},
  issn         = {2153-7933},
  language     = {eng},
  number       = {4},
  pages        = {209--216},
  publisher    = {Mary Ann Liebert, Inc.},
  series       = {Therapeutic hypothermia and temperature management},
  title        = {Safety, Feasibility, and Hemodynamic Effects of Mild Hypothermia in Transcatheter Aortic Valve Replacement: The TAVR-CHILL Trial.},
  url          = {http://dx.doi.org/10.1089/ther.2015.0011},
  volume       = {5},
  year         = {2015},
}