Abstract 18847: Neurological Outcomes in Patients With Non-Shockable Cardiac Arrest Undergoing Therapeutic Hypothermia in a Tertiary Cardiac Center
Background: The benefit of Therapeutic Hypothermia (TH) on neurological outcomes in post cardiac arrest patients is well established. Most of these studies have demonstrated better neurological outcomes in patients with shockable rhythms (Ventricular fibrillation and Pulseless Ventricular Tachycardia) rather than non shockable rhythms (Pulseless Electrical Activity and Asystole). We hypothesize that at least some patients with non shockable cardiac arrest may benefit from TH.
Methods: A prospectively collected database of all post cardiac arrest patients undergoing TH from 2007 to the current year, were evaluated and patients with non-shockable cardiac arrest rhythms were included in the study. Using the Pittsburgh Cerebral Performance Category (CPC) scales, patients were considered to have either good (CPC scale of 1 and 2) or bad (CPC scale of 3 to 5) neurological outcomes. Pearson's Chi-Square analysis was used to determine the proportion of these patients with good neurological outcomes.
Results: out of the 77 post cardiac arrest patients who underwent th, 39 had a non-shockable rhythm with 18 having had pea, 21 having had asystole. the 39 patients had a mean age of 61 years, and were mostly caucasian (59.7%) and male (80%). good neurological outcomes were demonstrated in 8 out of the 21 patients with pea (38%; p=0.03) and 4 out of 18 patients (22%; p=0.38) with asystole. the cohort as a whole with non-shockable rhythms, 30% (p=0.023) had good neurological outcomes.
conclusion: Therapeutic hypothermia should be considered for patients after successful resuscitation from cardiac arrest with PEA, but data are not as compelling after cardiac arrest with Asystole.
- © 2010 by American Heart Association, Inc.