Document Detail


Community-based application of mild therapeutic hypothermia for survivors of cardiac arrest.
MedLine Citation:
PMID:  20224484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To demonstrate that the application of therapeutic hypothermia is technically feasible in a community-based setting. BACKGROUND: Implementation of therapeutic hypothermia for survivors of cardiac arrest in the United States has been slow, at least partially because of the perception that this therapy is technically difficult, especially at the community level. STUDY DESIGN: Retrospective cohort study with historical controls. METHODS: At our three community hospitals and after return of spontaneous circulation (ROSC), survivors of cardiac arrest were treated with therapeutic hypothermia using ice and cooling blankets or suits in order to cool patients to 32 degrees C-34 degrees C within 4 hours to achieve goal temperature within 8 hours and to maintain goal temperature for 24 hours. RESULTS: Beginning in 2004, 44 survivors of cardiac arrest were managed with therapeutic hypothermia. The mean time from ROSC to initiation of therapeutic hypothermia was 2.8 hours (range, 0.2-7.8 hours), the mean time from ROSC to goal temperature was 7.2 hours (range, 0.8-15.1 hours), and the mean time maintained at goal temperature was 24.5 hours (range, 9-28 hours). Once patients achieved goal temperature, 4.4% of the temperature readings were above 34 degrees C, reflecting undercooling, while 16.4% of the readings were below 32 degrees C, indicative of overcooling. Overall survival until hospital discharge with good neurologic outcome was 43%, compared to only 13% (P < 0.001) among selected controls. There were no major complications directly attributable to the induction of hypothermia or rewarming. CONCLUSION: A simple protocol of mild therapeutic hypothermia using locally available resources is technically feasible and safe in a community-based setting.
Authors:
John Prior; Mary Lawhon-Triano; David Fedor; Vincent J Vanston; Roger Getts; Raymond A Smego
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Southern medical journal     Volume:  103     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  295-300     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Mercy Hospital, Commonwealth Medical College, Scranton, PA, USA. JPrior@tcmedc.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Brain Ischemia / rehabilitation*
Cardiopulmonary Resuscitation*
Cohort Studies
Feasibility Studies
Female
Heart Arrest / therapy*
Hospitals, Community*
Humans
Hypothermia, Induced / methods*
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Retrospective Studies
Young Adult
Comments/Corrections
Comment In:
South Med J. 2010 Apr;103(4):283-5   [PMID:  20224491 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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