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Therapeutic mild hypothermia improves outcome after out-of-hospital cardiac arrest

Netherlands Heart Journal volume 17, pages 378–384 (2009)Cite this article

Abstract

Purpose. Therapeutic mild hypothermia (TMH) is indicated for comatose survivors of an out-ofhospital cardiac arrest (OHCA) to improve general outcome. Although widely used, there are not many reports on its use on a critical care unit (CCU) or on the comparison of cooling methods.

Methods. In a retrospective analysis covering January 2005 to December 2006, 75 consecutive comatose subjects post-OHCA due to ventricular fibrillation and nonventricular fibrillation rhythms (asystole/pulseless electrical activity) were studied in a single tertiary PCI centre. Subjects treated with conventional post-resuscitation care without TMH served as controls (n=26; Jan 2005–Sep 2005). Outcome from controls at hospital discharge was compared with subjects treated with TMH (n=49; Oct 2005–Dec 2006). During the study period, TMH was induced by either external (n=25; Oct 2005–Feb 2006) or endovascular (n=24; Mar 2006–Dec 2006) approach.

Results. Besides more females in the control group, there were no major differences in baseline characteristics present between all groups. TMH improved survival (OR 0.36 [0.13–0.95], p<0.05) and neurological outcome (OR 0.23 [0.07–0.70], p<0.01). After subanalysis, TMH-improved outcome did not differ between the two cooling methods used. However, the times to reach TMH and normothermia were shorter with the endovascular approach.

Conclusion. TMH induced on a CCU improves survival and neurological outcome after post-OHCA coma. TMH by endovascular approach was more feasible compared with external cooling, but the two cooling methods did not result in a different outcome. (Neth Heart J 2009;17:378–84.)

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  1. I. Andrade Ferreira

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  1. I. Andrade Ferreira
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  2. M. Schutte
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  3. E. Oosterloo
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  4. W. Dekker
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  5. B. W. Mooi
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  6. J. H. E. Dambrink
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  7. A. W. J. van ’t Hof
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Department of Cardiology, Isala Clinics, Zwolle, the Netherlands

Department of Thorax-Anaesthesiology, Isala Clinics, Zwolle, the Netherlands

A.W.J. van ’t Hof Department of Cardiology, Isala Clinics, PO Box 10500, 8000 GM Zwolle, the Netherlands

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Ferreira, I.A., Schutte, M., Oosterloo, E. et al. Therapeutic mild hypothermia improves outcome after out-of-hospital cardiac arrest. NHJL 17, 378–384 (2009). https://doi.org/10.1007/BF03086288

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  • DOI: https://doi.org/10.1007/BF03086288

  • resuscitation
  • heart arrest
  • hypothermia (induced)
  • treatment outcome