Abstract 116: Relationship of Downtime and Cardiopulmonary Resuscitation Time to Neurologic Outcome in Patients with Nonshockable Rhythm Undergoing Therapeutic Hypothermia
Background: Neurologic outcome in patients undergoing therapeutic hypothermia after resuscitation from cardiac arrest due to non-shockable rhythms is heterogeneous. We hypothesized that downtime and cardiopulmonary resuscitation (CPR) time in these patients significantly influence neurologic outcomes.
Methods: Prospectively collected data on consecutive adult patients admitted to Hartford Hospital from 1/1/2007 to 11/1/2010 that survived a cardiac arrest due to PEA or asystole and underwent therapeutic hypothermia formed the hypothermia group. “Downtime (DT)” was considered to be time from cardiac arrest to initiation of CPR and was categorized as “DT ≤ 15 minutes” and “DT >15 minutes”. “CPR time” was the duration of CPR and was categorized as “CPR≤ 10 minutes” and “CPR > 10 minutes”. 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.
Results: Of the 64 post-cardiac arrest patients in the hypothermia group, 16/64(25%) patients had a good neurologic outcome. On further analysis of DT and CPR time of these patients, 41 % (12/29) of patients with DT ≤ 15minutes and 12 %(3/25) of patients with DT >15 minutes had CPR time≤ 10 minutes (P=0.016), while 22 % (2/9) patients with DT ≤ 15minutes and 0 % (0/1) patients with DT >15 minutes had a CPR time >10 minutes (P=0.598) (Figure 1).
Conclusion: Patients who have a good neurologic outcome after undergoing therapeutic hypothermia for cardiac arrest from a non-shockable rhythm are more likely to have a downtime ≤ 15minutes and a CPR time ≤ 10 minutes.
- © 2011 by American Heart Association, Inc.