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J Intensive Care Med · Oct 2016
The Outcome and Predictors of Mortality in Patients Therapeutically Cooled Postcardiac Arrest.
- John Botha, Yvette O'Brien, Saada Malouf, Elizabeth Cole, Erum Sahid Ansari, Cameron Green, and Ravindranath Tiruvoipati.
- Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia Faculty of Medicine, Nursing and Health Sciences, School of Public Health, Monash University, Melbourne, Victoria, Australia.
- J Intensive Care Med. 2016 Oct 1; 31 (9): 603-10.
PurposeTo review the outcomes of patients postcardiac arrest admitted to a metropolitan intensive care unit (ICU) where therapeutic hypothermia is practiced.Materials And MethodsPatients admitted from 2004 to 2012 were reviewed. The management protocol included cooling to 33°C for 24 hours. The primary outcome assessed was hospital mortality. Secondary outcome measures included mortality in patients admitted to ICU after in-hospital cardiac arrest (IHCA) when compared to those with out-of-hospital cardiac arrest (OHCA) and to review initial cardiac rhythm as an indicator of mortality.ResultsA total of 330 patients were included. The overall hospital mortality was 58.1%. Hospital mortality was significantly higher in patients who had OHCA when compared to IHCA (62.5% vs 51%; P = .04). Patients who had asystole and pulseless electrical activity (PEA) had a higher mortality when compared to ventricular tachycardia/ventricular fibrillation (VT/VF) arrest (81.7% vs 67.8% vs 41.9%, respectively; P < .01).ConclusionPatients admitted to ICU postcardiac arrest after therapeutic cooling have a high mortality. An initial rhythm of VT/VF confers a mortality benefit when compared to asystole and PEA.© The Author(s) 2015.
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