Effect of hypothermia therapy after outpatient cardiac arrest due to ventricular fibrillation

Circ J. 2009 Oct;73(10):1877-80. doi: 10.1253/circj.cj-09-0088. Epub 2009 Aug 7.

Abstract

Background: Several investigators have emphasized the positive effect of hypothermia therapy on patients who have suffered from cardiac arrest. Salvaging patients from circulatory collapse is a pivotal task, but it is unclear whether additional hypothermia can practically contribute to an improvement in the neurological outcome.

Methods and results: Since December 2005, our hospital has been using hypothermia therapy. Forty-six comatose patients after recovery of spontaneous circulation were consecutively enrolled in the present study. Twenty-five of the enrolled patients received hypothermia therapy and 21 did not because they were treated prior to 2005. The time from collapse to spontaneous circulation (P=0.09), the rates of performance of bystander CPR (P=0.370) and presence of a witnessed collapse (P=0.067) were not significantly different between the recovery group (n=28) and the non-recovery group (n=18). The additional hypothermia therapy was an independent predictor of neurological recovery (P=0.005, OR 6.5, 95%CI 1.74-24.27). The recovery rate was significantly higher in patients who received hypothermia therapy (80%) compared to those who did not (38%).

Conclusions: Hypothermia therapy is very useful for treating patients who have had an out-of-hospital cardiac arrest; it should be induced rapidly and smoothly.

MeSH terms

  • Aged
  • Brain / physiopathology*
  • Cardiopulmonary Resuscitation*
  • Coma / etiology
  • Coma / physiopathology
  • Coma / therapy*
  • Disability Evaluation
  • Emergency Medical Services*
  • Female
  • Heart Arrest / etiology
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced*
  • Intensive Care Units
  • Male
  • Middle Aged
  • Recovery of Function
  • Time Factors
  • Treatment Outcome
  • Ventricular Fibrillation / complications
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / therapy*