Abstract 258: The Effectiveness of Therapeutic Hypothermia in Patients Suffering From Asphyxia Cardiac Arrest
Introduction: Therapeutic hypothermia (TH) is recommended for comatose survivors of cardiac arrest; however, the effectiveness of TH provided to asphyxial cardiac arrest has not been studied. So, we aimed to describe the characteristics and outcome among patients with out-of-cardiac-arrest caused by asphyxia, who were treated with TH.
Patients and methods: We performed a multicenter retrospective registry-based study of adult OHCA patients treated with TH presenting to 24 hospitals across South Korea during the period from January 2007 to December 2012. Comatose survivors who were treated with TH after asphyxial cardiac arrest were included, but hanging and gas intoxication were excluded.
Results: Of a total of 930 OHCA patients entered in the registry, 111 patients were enrolled in this study. The mean age was 65.8±16.3 years and old age (≥65) was 68 cases (61.3%). Most cases (85, 76.6%) were witness cardiac arrest, but few were provided bystander CPR (26, 23.4%). First monitored rhythms were almost non-shockable (80, 72.1%), and 23 (20.7%) had previous lung disease. TH were started within 121.9 (±152.4) min after ROSC, target temperature were achieved in 168 (±173.3) min, and maintained 23.6 (±10.6) hr. Intravascular cooling technique was performed in 34 cases (30.6%). 52 patients (46.8%) were survived and good neurologic outcome (CPC 1, 2) was 6 cases (5.4%). Witnessed status, age, previous lung disease, bystander CPR and any time factor were not correlated with survival and good neurologic outcome except ROSC time from detection in favorable outcome (p=0.005).
Conclusion: The effectiveness of TH in axphyxial cardiac arrest was low, but quick achievement of ROSC would increase the favorable neurologic outcome proportion. proportion.
- © 2013 by American Heart Association, Inc.