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01-10-2009 | Original article

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

Auteurs: I. Andrade Ferreira, M. Schutte, E. Oosterloo, W. Dekker, B. W. Mooi, J. H. E. Dambrink, A. W. J. van ’t Hof

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2009

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.)

vorige artikel Influence of transoesophageal echocardiography on therapy and prognosis in young patients with TIA or ischaemic stroke

volgende artikel Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

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Titel: Therapeutic mild hypothermia improves outcome after out-of-hospital cardiac arrest
Auteurs: I. Andrade Ferreira
M. Schutte
E. Oosterloo
W. Dekker
B. W. Mooi
J. H. E. Dambrink
A. W. J. van ’t Hof
Publicatiedatum: 01-10-2009
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Netherlands Heart Journal / Uitgave 10/2009
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI: https://doi.org/10.1007/BF03086288

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