Abstract 334: Slight Therapeutic Hypothermia (35°C) is Effective and Safe as a Post Cardiac Arrest Care for Low Left Cardiac Function PCAS Patients
Background: Mild therapeutic hypothermia (32-34°C, 24-48 hours: mild TH) for post cardiac arrest syndrome (PCAS) due to ventricular fibrillation (VF) has been recommended in the American Heart Association (AHA) Guidelines 2010 (class I) and the International Liaison Committee on Resuscitation (ILCOR). But it is still unknown what temperature is good for low left cardiac function patients including acute myocardial infarction (AMI) cases. Sometimes executing mild TH for patients with severe left ventricular dysfunction are difficult because of hypotension, arrhythmias, unstable vital signs and so on. So we studied whether slight therapeutic hypothermia (35°C: Slight TH) was effective and safe compare with mild TH for PCAS due to VF.
Methods: Consecutive PCAS patients who were witnessed, confirmed VF caused by cardiac or coronary events and introduced therapeutic hypothermia for the latest 58 months were sorted into the GroupM (Mild TH, 34°C, 24-48 hours) and the GroupS (Slight TH, 35°C, 24-48 hours).The primary end point was a favorable neurologic outcome (cerebral performance category: CPC 1 or 2) in 90th days after cardiac arrest. Secondary end points were the changes of cardiac index (CI) after introducing therapeutic hypothermia, the time required to reach target temperature and the rate of complications (infections, bleeding, arrhythmias etc.) within fourteen days.
Results: forty-eight patients (twenty-two AMI cases) were studied (GroupM 24 patients and GroupS 24 patients). The rate of favorable neurologic outcome was available and did not differ significantly between the two groups (13/24 54% vs. 17/24 71%, p=0.34). The time to reach target temperature was significantly shorter in the GroupS (5.4h vs. 1.6h, p<0.01). The decrease of CI was remarkable in the groupM (before TH/during TH, GroupM 2.8/2.1, p<0.01, GroupS 2.2/2.1, p=0.33). The rate of complications did not differ significantly between them and there were no major complications.
Conclusion: Slight therapeutic hypothermia for PCAS due to VF with low left cardiac function is effective and safe possibility.
- © 2013 by American Heart Association, Inc.