Therapeutic hypothermia is associated with improved neurologic outcome and survival in cardiac arrest survivors of non-shockable rhythms

Therapeutic hypothermia improves neurologic outcomes in patients resuscitated from cardiac arrest due to ventricular fibrillation. However, its role in patients with cardiac arrest due to non-shockable rhythms (pulseless electrical activity (PEA) and asystole) is unclear. We hypothesized that therap...

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Veröffentlicht in:Resuscitation Jg. 83; H. 2; S. 202 - 207
Hauptverfasser: Lundbye, Justin B., Rai, Mridula, Ramu, Bhavadharini, Hosseini-Khalili, Alireza, Li, Dadong, Slim, Hanna B., Bhavnani, Sanjeev P., Nair, Sanjeev U., Kluger, Jeffrey
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Ireland Elsevier Ireland Ltd 01.02.2012
Schlagworte:
Aged
Asystole
Cardiac arrest
Cardiopulmonary Resuscitation - methods
Coma - etiology
Coma - physiopathology
Coma - therapy
Emergency
Female
Follow-Up Studies
Heart Arrest - complications
Heart Arrest - mortality
Heart Arrest - therapy
Humans
Hypothermia
Hypothermia, Induced - methods
Male
Middle Aged
Pulseless electrical activity
Retrospective Studies
Survival Rate - trends
Survivors - statistics & numerical data
United States - epidemiology
United States
Asystole
Cardiac arrest
Pulseless electrical activity
Hypothermia
ISSN:0300-9572, 1873-1570, 1873-1570
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Zusammenfassung:Therapeutic hypothermia improves neurologic outcomes in patients resuscitated from cardiac arrest due to ventricular fibrillation. However, its role in patients with cardiac arrest due to non-shockable rhythms (pulseless electrical activity (PEA) and asystole) is unclear. We hypothesized that therapeutic hypothermia favorably impacts neurologic outcome and survival in patients resuscitated from cardiac arrest due to non-shockable rhythms. Retrospectively collected data on consecutive adult patients admitted to Hartford Hospital from 1/1/2004 to 11/1/2010 who survived a cardiac arrest due to PEA or asystole were analyzed. Patients who underwent therapeutic hypothermia (1/1/2007–11/1/2010) formed the hypothermia group while patients admitted prior to the institution of therapeutic hypothermia (1/1/2004–1/1/2007) at Hartford Hospital formed the control group. The primary end-point was measured using the Pittsburgh cerebral performance category (CPC) scale and patients were assessed for a good (CPC 1 and 2) or poor (CPC 3–5) neurological outcome prior to discharge from hospital. A secondary end-point was measured as survival at discharge from hospital. Of 100 post-cardiac arrest patients included in the study, 15/52 (29%) patients in the hypothermia group had a good neurologic outcome as compared to 5/43 (10%) patients in the control group (P=0.021). On multivariate analysis, the odds ratio for good neurologic outcome and survival at discharge from the hospital with therapeutic hypothermia as compared to control were 4.35 (95% CI 1.10–17.24, P=0.04) and 5.65 (CI 1.66–19.23, P=0.006) respectively. Therapeutic hypothermia is associated with favorable neurologic outcome and survival in patients resuscitated after cardiac arrest due to non-shockable rhythms.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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ISSN:0300-9572
1873-1570
1873-1570
DOI:10.1016/j.resuscitation.2011.08.005