| Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention. | |
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MedLine Citation:
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PMID: 19942784 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Therapeutic hypothermia for comatose survivors of out-of-hospital cardiac arrest has demonstrated neurological benefits. Although early cooling during cardiac arrest enhances efficacy in animal studies, few clinical studies are available. METHODS AND RESULTS: The 171 patients who failed to respond to conventional cardiopulmonary resuscitation were studied prospectively. Patients underwent emergency cardiopulmonary bypass (CPB) plus intra-aortic balloon pumping, with subsequent percutaneous coronary intervention (PCI) if needed. Mild hypothermia (34 degrees C for 3 days) was induced during cardiac arrest or after return of spontaneous circulation. Of the 171 patients, 21 (12.3%) had a favorable neurological outcome at hospital discharge. An unadjusted rate of favorable outcome decreased in a stepwise fashion for increasing quartiles of collapse-to-34 degrees C interval (P=0.016). An adjusted odds ratio for favorable outcome after collapse-to-CPB interval was 0.89 (95% confidence interval (CI) 0.82-0.97) and after CPB-to-34 degrees C interval, 0.99 (95%CI 0.98-0.99) when collapse-to-34 degrees C interval was divided into 2 components. Favorable neurological accuracy of a collapse-to-CPB interval at a cutoff of 55.5 min and CPB-to-34 degrees C interval at a cutoff of 21.5 min was 85.4% and 89.5%, respectively. CONCLUSIONS: Early attainment of a core temperature had neurological benefits for patients with out-of-hospital cardiac arrest who underwent CPB and PCI. (Circ J 2010; 74: 77 - 85). |
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Authors:
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Ken Nagao; Kimio Kikushima; Kazuhiro Watanabe; Eizo Tachibana; Yoshiteru Tominaga; Katsushige Tada; Mitsuru Ishii; Nobutaka Chiba; Asuka Kasai; Taketomo Soga; Masakazu Matsuzaki; Kei Nishikawa; Yutaka Tateda; Harumi Ikeda; Tsukasa Yagi |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-27 |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 74 ISSN: 1347-4820 ISO Abbreviation: Circ. J. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-25 Completed Date: 2010-04-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 77-85 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, Japan. kennagao@med.nihon-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Body Temperature / physiology Cardiopulmonary Bypass* Cardiopulmonary Resuscitation Extracorporeal Circulation Female Heart Arrest / complications, physiopathology, therapy* Humans Hypothermia, Induced* Male Middle Aged Nervous System Diseases / etiology, prevention & control* Odds Ratio Outpatients* Prospective Studies ROC Curve Retrospective Studies Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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