Abstract P98: Impact of Hemodynamic State in Mild Hypothermia Therapy after Cardiac Arrest
Background) Mild hypothermia therapy (MHT) was proven to be effective for the patients resuscitated from cardiac arrest survivors. However, the efficacy of hypothermia for the patients with shock after recovery of spontaneous circulation (ROSC) remains unclear.
Methods) From June 2001 to March 2008, included 71 patients of this study were 1) documented cardio-pulmonary arrest 2) without hemorrhagic disorder 3) persistent coma after ROSC 4) age under 80years. All patients were received coronary angiography immediately after ROSC and percutaneous coronary intervention (PCI) if needed. Mild hypothermia(MH) was performed with cooling temperature of 34°C for 24 – 48hours. Those 71 patients were divided into three groups: 1) hemodynamic stable after ROSC (Group S) 2) Stable after administration of vasopressor drugs (Group V) and 3) hemodynamic compromised state needed support devices, such as intra-aortic balloon counterpulsation (IABP) and percutaneous cardio-pulmonary bypass (PCPS) (Group R).
Results) Of those 71 pts, favorable neurologic outcome patients after MHT were seen in 32pts (43.7%). In-hospital mortality was 7.1% in group S, 37.5% in group V (p=0.0120, compared with group S) and 70.3% in group R patients (p<0.0001 compared with group S). Favorable neurologic outcome (Good recovery + Moderate disability) was found in 78.6% of group S, 31.2% of group V (p<0.0019, compared with group S) and in 14.8% of group R (p<0.0001 compared with group S).
Conclusion) Favorable neurologic outcome rate was 43.7% in all rhythm resuscitated patients. Hemodynamic compromised patients needed circulatory support devices were less beneficial than circulatory stable patients in MHT.