• Tomasz Darocha, Paweł Podsiadło, Maciej Polak, Hubert Hymczak, Łukasz Krzych, Janusz Skalski, Anna Witt-Majchrzak, Ewelina Nowak, Krzysztof Toczek, Szymon Waligórski, Aleksandra Kret, Dominik Drobiński, Barbara Barteczko-Grajek, Wojciech Dąbrowski, Romuald Lango, Beata Horeczy, Tomasz Romaniuk, Tomasz Czarnik, Mateusz Puślecki, Krzysztof Jarmoszewicz, Tomasz Sanak, Robert Gałązkowski, Rafał Drwiła, and Sylweriusz Kosiński.
• Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland. Electronic address: tomekdarocha@wp.pl.
• J. Cardiothorac. Vasc. Anesth. 2020 Feb 1; 34 (2): 365-371.

ObjectiveExtracorporeal rewarming is the treatment of choice for patients who had hypothermic cardiac arrest, allowing for best neurologic outcome. The authors' goal was to identify factors associated with survival in nonasphyxia-related hypothermic cardiac arrest patients undergoing extracorporeal rewarming.DesignAll 38 cardiac surgery departments in Poland were encouraged to report consecutive hypothermic cardiac arrest patients treated with extracorporeal life support. All variables collected were analyzed in order to compare survivor and nonsurvivor groups. The parameters available at the initiation of extracorporeal rewarming were considered as potential predictors of survival in a logistic regression model. The primary outcome was survival to discharge from the intensive care unit. The secondary outcome was neurologic status.SettingMulticenter retrospective study.ParticipantsNinety-eight cases in the final analysis.InterventionsAll patients in nonasphyxia-related hypothermic cardiac arrest rewarmed with extracorporeal life support.Measurements And Main ResultsThe survival rate was 53.1%, and 94.2% of survivors had favorable neurologic outcome. The lowest reported core temperature with cerebral performance category scale 1 was 11.8°C. A univariate analysis identified 3 variables associated with survival, namely: age, initial arterial pH, and lactate concentration. In a multivariate analysis, 2 independent predictors of survival were age (0.957; 95% confidence interval [CI] 0.924-0.991) and lactates (0.871; 95% CI 0.789-0.961). The area under the receiver operating characteristics curve for this fitted model was 0.71; 95% CI 0.602-0.817.ConclusionsFavorable survival with good neurologic outcome in nonasphyxiated hypothermic patients treated with extracorporeal life support was reported. Age and initial lactate level are independently associated with survival.Copyright © 2019 Elsevier Inc. All rights reserved.

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