Abstract 10921: Optimal Prolongation of Therapeutic Hypothermia Improves Neurologic and Cardiac Outcomes in Prolong Cardiac Arrests
Background Therapeutic hypothermia improves neurologic prognosis and survival in cardiac arrest survivors. However, whether prolong duration of hypothermia in prolong cardiac arrest survivors can improve neurologic outcomes and survival more has not been clarified.
Hypothesis Optimal prolongation of therapeutic hypothermia can improve neurologic and cardiac outcomes in prolong cardiac arrests.
Methods The animals were equally randomized to 5H2, 7H1, 7H2 and 7H4 groups. VF was induced and untreated for 5 minutes (5H2) or 7 minutes (7H1, 7H2, 7H4), followed by 1 minutes of CPR, and then one electrical shock of 5 J. Therapeutic hypothermia was initiated at simultaneously at the start of CPR with intravenous administration of 4°C saline and fan. After ROSC, hypothermia was maintained for 1hour (7H1), 2 hours (5H2, 7H2) and 4 hours (7H4), respectively.
Results All animals in the 5H2 group survived 72 hours following ROSC, and the 72 hour-survival rates in the 7H1, 7H2 and 7H4 groups were 30%, 70%, 80% respectively. The 5H2 and 7H4 groups had significantly better neurologic outcomes at the 72nd hour than the 7H1 groups (Table1). The 5H2 and 7H4 groups also showed less neuron death in the CA1 area of hippocampus when compared with the 7H1 groups. At the 4th hour following ROSC, the cardiac output and dp/dt40 were better in the 5H2 and 7H4 groups than in the 7H1 groups (Table1). The myocytolysis was less in the 5H2 and 7H4 groups than in the 7H1 groups.
Conclusion Optimal prolongation of therapeutic hypothermia can improve neurologic and cardiac outcomes in prolong cardiac arrests.
- © 2012 by American Heart Association, Inc.