Browse > Article
http://dx.doi.org/10.34250/jkccn.2021.14.3.128

Incidence of Peripheral Cyanosis in Patients with Therapeutic Hypothermia after Cardiac Arrest in the Acute Care Unit of a Tertiary General Hospital  

Bang, Soo Youn (Asan Medical Center)
Yi, Young Hee (Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Journal of Korean Critical Care Nursing / v.14, no.3, 2021 , pp. 128-140 More about this Journal
Abstract
Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.
Keywords
Peripheral cyanosis; Therapeutic hypothermia; Post-cardiac arrest syndrome;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Choi JH. Management of brain injury after post-cardiac arrest syndrome. Acute and Critical Care. 2009;24(1):1-3. http://doi.org/10.4266/kjccm.2009.24.1.1   DOI
2 Adeyinka A, Kondamudi NP. Cyanosis [Internet]. Treasure Island (FL): StatPearls publishing; 2021 [cited 2021 April 16]. Available from: https://www-ncbi-nlm-nih-gov-ssl.libproxy.amc.seoul.kr/books/NBK482247/
3 Hwang SO, Jung SP, Song KJ, Kim H, Rho TH, Park KN, et al. 2015 Korean guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Journal of the Korean Society of Emergency Medicine. 2016;27(4):1-8. file:///C:/Users/admin/Downloads/T201605550.pdf
4 Moon HK, Kim EG. Comparing validity of body mass index, waist to hip ratio, and waist circumference to cardiovascular disease risk factors in Korean elderly. Korean nutrition Society. 2005;38(6):445-54. https://www.koreascience.or.kr/article/JAKO200522219652599.pdf
5 Girotra S, Chan PS, Bradley SM. Post-resuscitation care following out-of-hospital and in-hospital cardiac arrest. Heart. 2015;101(24):1943-9. http://doi.org/10.1136/heartjnl-2015-307450   DOI
6 Foead AI, Mathialagan A, Varadarajan R, Larvin M. Management of symmetrical peripheral gangrene. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine. 2018;22(12):870-4. http://doi.org/10.4103/ijccm.IJCCM_379_18   DOI
7 Han MK. Therapeutic hypothermia. Journal of Neurocritical Care. 2009;2(2):62-7. https://www.ejnc.org/upload/pdf/200902S62.pdf
8 McMullen SM, Patrick W. Cyanosis. American Journal of Medicine. 2013;126(3):210-2. http://doi.org/10.1016/j.amjmed.2012.11.004   DOI
9 Omairi AM, Pandey S. Targeted hypothermia temperature management [Internet]. Treasure Island (FL): StatPearls publishing; 2021 [cited 2021 April 16]. Available from: https://www-ncbi-nlm-nih-govssl.libproxy.amc.seoul.kr/books/NBK556124/
10 Yang SY, Ham KK, Kim CK. Therapeutic hypothermia system after cardiac arrest. Journal of Korean Institute of Communications and Information Sciences. 2017;42(8):1708-17. http://doi.org/10.7840/kics.2017.42.8.1708   DOI
11 Deye N, Vincent F, Michel P, Ehrmann S, Da Silva D, Piagnerelli M, et al. Changes in cardiac arrest patients' temperature management after the 2013 "TTM" trial: results from an international survey. Annals of Intensive Care. 2016;6(1):1-9. http://doi.org/10.1186/s13613-015-0104-6   DOI
12 Stockmann H, Krannich A, Schroeder T, Storm C. Therapeutic temperature management after cardiac arrest and the risk of bleeding: systematic review and meta-analysis. Resuscitation. 2014;85(11):1494-503. http://doi.org/10.1016/j.resuscitation.2014.07.018   DOI
13 Korean Association of Cardiopulmonary Resuscitation (KACPR). Korean basic life support. 1st ed. Paju: Koonja; 2018. p. 5-14.
14 Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Journal of Haematology. 2009;145(1):24-33. http://doi.org/10.1111/j.1365-2141.2009.07600.x   DOI
15 Silverman MG, Scirica BM. Cardiac arrest and therapeutic hypothermia. Trends in Cardiovascular Medicine. 2016;26(4):337-44. http://doi.org/10.1016/j.tcm.2015.10.002   DOI
16 Chiang CW, Lin YJ, Huang YB. Terlipressin-induced peripheral cyanosis in a patient with liver cirrhosis and hepatorenal syndrome. American Journal of Ophthalmology Case Reports. 2019;20:5-9. http://doi.org/10.12659/AJCR.913150   DOI
17 Pesola GR, Bugal N. Pulse oximeter analysis of peripheral cyanosis distal to an AV fistula. The American Journal of Emergency Medicine. 1996;14(3):268-9. http://doi.org/10.1016/S0735-6757(96)90173-4   DOI
18 Neumar RW, Nolan JP, Adrie C, Aibiki M, Berg RA, Bottiger BW, et al. Post-cardiac arrest syndrome. Circulation. 2008;118(23):2452-83. http://doi.org/10.1161/CIRCULATIONAHA.108.190652   DOI
19 Hwang SO. Therapeutic hypothermia after cardiac arrest. International Journal of Arrhythmia. 2010;11(2):31-4. https://www.earrhythmia.org/journal/view.php?number=71
20 Taccone FS, Picetti E, Vincent JL. High quality targeted temperature management (TTM) after cardiac arrest. Critical Care. 2020;24(1):1-7. http://doi.org/10.1186/s13054-019-2721-1   DOI
21 Minn YG. Anatomy and physiology of thermoregulation. Journal of Pain and Autonomic Disorders. 2013;2(1):1-2. http://www.kspad.or.kr/files/journals/2013/01/01.pdf
22 Jeon SB. Therapeutic hypothermia in the intensive care unit. Korean Neurocritical Care Society. 2014;7(1):6-15. http://doi.org/10.18700/jnc.2014.7.1.6   DOI
23 Pahal P, Goyal A. Central and peripheral cyanosis [Internet]. Treasure Island (FL): StatPearls publishing; 2021 [cited 2021 July 7]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559167/
24 Baranoski GVG, Van Leeuwen SR, Chen TF. On the detection of peripheral cyanosis in individuals with distinct levels of cutaneous pigmentation. In 2019 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2017;4260-4. http://doi.org/10.1109/EMBC.2017.8037797   DOI
25 Arrich J, Holzer M, Havel C, Mullner M, Herkner H. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. The Cochrane Database of Systematic Reviews. 2016;15(2):CD004128. http://doi.org/10.1002/14651858.CD004128.pub4   DOI
26 Leong SHB, Chan E, Ho BCH, Yeo C, Lew S, Sewa DW, et al. Therapeutic temperature management (TTM): post-resuscitation care for adult cardiac arrest, with recommendations from the National TTM Workgroup. Singapore Medical Journal. 2017;58(7):408-10. http://doi.org/10.11622/smedj.2017067   DOI
27 Ko SB. Physiologic mechanism of therapeutic hypothermia. Korean Neurocritical Care Society. 2014;7(1):1-5. http://doi.org/10.18700/jnc.2014.7.1.1   DOI
28 Jain A, Gray M, Slisz S, Haymore J, Badjatia N, Kulstad E. Shivering treatments for targeted temperature management: a review. The Journal of Neuroscience Nursing. 2018;50(2):63-7. http://doi.org/10.1097/JNN.0000000000000340   DOI
29 Park JY, Leem JT, Park SK, Woo SK, Kwak SH, Jung WS, et al. The relationship between coldness of hands and feet and the erythrocyte deformability in stroke patients. Journal of Internal Korean Medicine. 2010;31(3):578-85. https://www.koreascience.or.kr/article/JAKO201020140556757.pdf