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Ned Tijdschr Geneeskd · Jan 2009
[Mild therapeutic hypothermia following resuscitation; experience and results in the first two years after introduction].
- Lenneke E M Haas, David H T Tjan, and Arthur R H van Zanten.
- Ziekenhuis Gelderse Vallei, afd. Intensive Care, Ede, The Netherlands.
- Ned Tijdschr Geneeskd. 2009 Jan 1;153:B315.
ObjectiveTo describe the results of mild therapeutic hypothermia (MTH) following resuscitation in the 'Gelderse Vallei' hospital, Ede, the Netherlands.DesignDescriptive, retrospective.MethodPatient data was collected from patients who had undergone MTH during the first two years following introduction of this treatment in the intensive care department of the 'Gelderse Vallei' hospital, Ede. Information used in the description included patient characteristics, heart arrest type (ventricular fibrillation or other arrhythmias), place of onset (in hospital or elsewhere), resuscitation data, side effects of the treatment, mortality and neurological outcome.Results67 patients were treated with MTH in the period April 2005 to July 2007. The hospital mortality rate within this group was 81%. The mortality rate in the subgroup presenting with ventricular fibrillation as initial arrhythmia was 76%, compared with 89% in the subgroup with other arrhythmias. The mortality rate of patients who were resuscitated outside the hospital was comparable with that for patients resuscitated in hospital (80% versus 83%). Patients who could be discharged from hospital had a good neurological outcome (average Cerebral Performance Category score 1.9; 95%-CI: 1.6-2.2). The most important complications during MTH were electrolyte imbalances and ventilator associated pneumonia.ConclusionThe introduction of MTH in the intensive care department of the "Gelderse Vallei" has taken place without major problems. Although the mortality rate following cardiopulmonary resuscitation was relatively high, the neurological outcome in those patients who were discharged from hospital alive was good.
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