• J Emerg Trauma Shock · Oct 2012

    Therapeutic hypothermia for out-of-hospital cardiac arrest: An analysis comparing cooled and not cooled groups at a Canadian center.

    • D Alex Maclean, Robert S Stevenson, Iqbal Bata, and Robert S Green.
    • Dalhousie University; Halifax, Nova Scotia; Canada ; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia; Canada ; Department of Medicine, Division of Cardiology, Saint John, New Brunswick, Canada.
    • J Emerg Trauma Shock. 2012 Oct 1;5(4):328-32.

    BackgroundOut of hospital cardiac arrest is a devastating event and is associated with poor outcomes; however, therapeutic hypothermia (TH) is a novel treatment which may improve neurological outcome and decrease mortality. Despite this, TH is not uniformly implemented across Coronary Care and Intensive Care Units in Canada.ObjectiveThe purpose of this study was to compare cerebral recovery and mortality rates between patients in our Coronary Care Unit who received TH with a historical control group.Materials And MethodsA retrospective chart review was performed of patients admitted to a tertiary care center with out-of-hospital cardiac arrest. Twenty patients who were admitted and cooled after December 2006 were compared with 29 noncooled patients admitted in the 5 years prior as a historical control group. The primary outcomes of interest were in-hospital mortality and neurological outcome.ResultsEleven of 20 (11/20, 55%) patients who were cooled as per protocol survived to hospital discharge, all having a good neurological outcome. Eleven of 29 (11/29, 38%) noncooled patients survived to hospital discharge (Odds Ratio: 0.50, 95% CI: 0.16- 1.60, P=0.26). Eleven of 20 patients who were cooled had a good neurological outcome (CPS I-II, 11/20, 55%), versus 7 of 29 (7/29, 24%) of noncooled patients (Odds ratio: 3.84, 95% CI: 1.13- 13.1, P=0.03). One hundred percent (11/11) of survivors in the cooled group had a good neurological outcome.ConclusionIn our center, the use of TH in out-of-hospital cardiac arrest survivors was associated with improved neurological outcome.

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