Abstract 135: Impacts of Rewarming Speed Differences on Outcomes of Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest: an Analysis in J-Pulse Hypo-Registry, a Multicenter Hypothermia Registry in Japan
Background: Although it has been reported that therapeutic hypothermia (TH) improves neurological outcomes of patients with out-of-hospital cardiac arrest, procedures of TH remain to be established. Particularly rewarming speed that maximizes protection afforded by TH has not been identified.
Methods: Five years (2005–2009) data from the 452 patients treated with TH in the multicenter registry in Japan (J-Pulse-Hypo registry) were available, for the purpose to investigate the efficacy of TH in out-of-hospital cardiac arrest patients. Selection of cooling procedure, target body temperatures, cooling duration, and rewarming speed were left to each institution. Four hundred twenty-nine patients completed TH were retrospectively divided into the three groups according to rewarming speed: 129 patients with rewarming speed ≥ 2.0 degrees C/day (fast, F group), 188 patients with rewarming speed 1.0–1.9 degrees C /day (moderate, M group), and 118 patients with rewarming speed < 1.0 degree C/day (slow, S group). We compared the clinical characteristics and the favorable neurological outcomes (FNO), cerebral performance category 1 and 2 rate at 30 days between 3 study groups.
Results: In baseline characteristics, there were no significant inter-group differences in gender, age, the presence of bystanders, rate of bystander cardiopulmonary resuscitation, rate of return of spontaneous circulation before admission, target temperature and mean cooling duration, but S group had a lower frequency of ventricular fibrillation in initial ECG and a lower incidence of complication during hypothermia compared with the other 2 group. The 30-day mortality of M group was significantly lower than that of the other groups (23.0% for F, 12.3% for M, 17.8% for S, p=0.036). There were no significant difference in FNO rate between 3 groups (59.4% for F, 56.4% for M, 56.8% for S, p=0.87).
Conclusions: The results suggest that FNO of patients treated with TH might be not affected by rewarming speed, but faster or slower rewarming might cause increase of the mortality.
- © 2010 by American Heart Association, Inc.