Effect of hypothermia therapy after outpatient cardiac arrest due to ventricular fibrillation

Ichiro Takeuchi, Hitoshi Takehana, Daisuke Satoh, Hidehira Fukaya, Yujin Tamura, Mototsugu Nishi, Hisahito Shinagawa, Hiroshi Imai, Toru Yoshida, Taiki Tojo, Takayuki Inomata, Naoyoshi Aoyama, Kazui Soma, Tohru Izumi
Circulation Journal: Official Journal of the Japanese Circulation Society 2009, 73 (10): 1877-80

BACKGROUND: Several investigators have emphasized the positive effect of hypothermia therapy on patients who have suffered from cardiac arrest. Salvaging patients from circulatory collapse is a pivotal task, but it is unclear whether additional hypothermia can practically contribute to an improvement in the neurological outcome.

METHODS AND RESULTS: Since December 2005, our hospital has been using hypothermia therapy. Forty-six comatose patients after recovery of spontaneous circulation were consecutively enrolled in the present study. Twenty-five of the enrolled patients received hypothermia therapy and 21 did not because they were treated prior to 2005. The time from collapse to spontaneous circulation (P=0.09), the rates of performance of bystander CPR (P=0.370) and presence of a witnessed collapse (P=0.067) were not significantly different between the recovery group (n=28) and the non-recovery group (n=18). The additional hypothermia therapy was an independent predictor of neurological recovery (P=0.005, OR 6.5, 95%CI 1.74-24.27). The recovery rate was significantly higher in patients who received hypothermia therapy (80%) compared to those who did not (38%).

CONCLUSIONS: Hypothermia therapy is very useful for treating patients who have had an out-of-hospital cardiac arrest; it should be induced rapidly and smoothly.

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