Does mild therapeutic hypothermia have the same influence on patients’ neurological outcome following in-hospital and out-of-hospital resuscitation due to shockable and non-shockable rhythms?
Authors:
Fiala Hynek 1; Berta Emil 2; Gabrhelík Tomáš 1; Šafránek Petr 1
Authors‘ workplace:
Klinika anesteziologie, resuscitace a intenzivní medicíny Fakultní nemocnice Olomouc
1; Dept. of Anesthesia and Intensive Care, Ringerike Hospital (Vestre Viken HF), Hønefoss, Norway
2
Published in:
Anest. intenziv. Med., 22, 2011, č. 4, s. 216-226
Category:
Intensive Care Medicine - Original Paper
Overview
Objective:
To assess the impact of therapeutic hypothermia on patients’ neurological outcome after out-of- and in-hospital cardiopulmonary resuscitation for shockable and non-shockable rhythms.
Design:
A comparative, non-randomized study.
Setting:
A University Hospital ICU.
Methods:
We compared a group of patients admitted to the ICU following cardiopulmonary resuscitation in 2010 to a group of patients admitted in 2006. Both groups were further divided into two subgroups: resuscitated for shockable and non-shockable rhythms respectively. Neurological outcome was assessed on discharge from the ICU or the hospital by the Glasgow Outcome Scale.
Results:
Compared to 2006, mortality increased in the 2010 subgroups and the number of patients with favourable neurological outcome decreased. In the subgroup of patients receiving out-of-hospital CPR due to VF the mortality increased by 21% and 17% fewer patients were discharged with GOS 4–5. In the subgroup of patients receiving CPR due to asystole the mortality increased by 59% and 11% fewer patients were discharged with GOS 4-5. After in-hospital CPR due to shockable and non-shockable rhythms the mortality increased by 43% and 38% respectively. Regardless of rhythm, 19% fewer patients were discharged with GOS 4–5.
Conclusion:
In contrast to studies by other authors we did not find a benefit of therapeutic hypothermia on the neurological outcome of patients after resuscitation for shockable rhythm. It was confirmed that the neurological outcome of patients after resuscitation for non-shockable rhythm was either unchanged or worse in 2010. This effect may have been influenced by mistakes made when performing therapeutic hypothermia.
Keywords:
cardiopulmonary resuscitation – shockable rhythm – non-shockable rhythm – herapeutic hypothermia – body temperature – neurological outcome
Sources
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Poděkování: Děkujeme paní Mgr. Kateřině Langové, Ph.D., z Ústavu biofyziky Lékařské fakulty Univerzity Palackého v Olomouci za statistické zpracování dat.
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2011 Issue 4
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