Abstract 137: Efficacy of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest in Patients With Non-Ventricular Fibrillation: J-PULSE-Hypo Registry
Background: Therapeutic hypothermia is effective for patients who remain comatose after resuscitation from out-of-hospital cardiac arrest due to ventricular fibrillation (VF). However, whether therapeutic hypothermia is effective for cardiac arrest without VF remains unclear.
Methods: We conducted a multicenter retrospective study (J-PULSE-Hypo registry) at 14 institutions to evaluate the effect of therapeutic hypothermia on out-of-hospital cardiac arrest between January 2005 and December 2009. Enrolled patients were divided into the VF group, pulseless electrical activity (PEA) group, and asystole group according to the initial rhythm. Neurologic outcomes at discharge from the hospital were compared with those of patients in the SOS-KANTO study who received standard advanced cardiovascular life support with no therapeutic hypothermia. The SOS-KANTO study was performed from 2002 through 2003 and registered 9,592 patients with out-of-hospital cardiac arrest, including 556 patients who were aged 18–74 years, comatose (Glasgow Coma Scale ≤6) on admission, and received no therapeutic hypothermia. A favorable outcome was defined as a Cerebral Performance Category (CPC) of 1–2.
Results: A total of 452 patients were enrolled in the J-PULSE-Hypo registry. The mean age was 59±13 years. Men accounted for 83% of all patients. The patients in the J-PULSE-Hypo registry and the SOS-KANTO study were divided into the VF group (n=353, n=215), the PEA group (n=63, n=97), and the asystole group (n=36, n=244) according to the initial rhythm. The rates of favorable outcomes in the VF group (63% vs. 25%, p<0.01), the PEA group (32% vs. 8%, p<0.01), and the asystole group (19% vs. 5%, p<0.01) were significantly higher in the J-PULSE-Hypo registry than in the SOS-KANTO study.
Conclusions: Although the times of the studies and background characteristics of the subjects differed, our results suggest that therapeutic hypothermia is effective not only for out-of-hospital cardiac arrest due to VF, but also for cardiac arrest due to causes other VF.
- © 2010 by American Heart Association, Inc.