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Therapeutic Hypothermia is Associated with Improved Neurologic Outcome and Survival in Cardiac Arrest Survivors of Non-Shockable Rhythms.
MedLine Citation:
PMID:  21864480     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: 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. METHODS: Prospectively 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 to 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 to 5) neurological outcome prior to discharge from hospital. A secondary end-point was measured as survival at discharge from hospital. RESULTS: 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. CONCLUSION: Therapeutic hypothermia is associated with favorable neurologic outcome and survival in patients resuscitated after cardiac arrest due to non-shockable rhythms.
Authors:
Justin B Lundbye; Mridula Rai; Bhavadharini Ramu; Alireza Hosseini-Khalili; Dadong Li; Hanna B Slim; Sanjeev P Bhavnani; Sanjeev U Nair; Jeffrey Kluger
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-19
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Affiliation:
Division of Cardiology, Hartford Hospital, Hartford, CT; University of Connecticut Health Center, Farmington, CT.
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