Therapeutic hypothermia after prolonged cardiac arrest due to non-coronary causes.
Mild resuscitative hypothermia has been shown to improve neurological outcome after cardiac arrest presenting with ventricular fibrillation (VF) due to cardiac causes. We describe the experience of inducing mild hypothermia in three patients with non-cardiac causes of arrest and long delays before a return of spontaneous circulation (ROSC). In one patient, extreme metabolic acidosis due to inadvertent oesophageal intubation complicated therapy, and the role of point-of-care diagnostics in the prehospital setting is briefly discussed. All patients survived to discharge from hospital, and neuropsychological examinations revealed good recovery. It is concluded that mild resuscitative hypothermia may be beneficial also in patients with obvious non-coronary causes for cardiac arrest.
Silfvast
T
T
Department of Anaesthesia and Intensive Care Medicine, Meilahti Hospital, Helsinki University Central Hospital, FIN-00029, Helsinki, Finland. tom.silfvast@hus.fi
Tiainen
M
M
Poutiainen
E
E
Roine
R O
RO
D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003131:Combined Modality Therapy; D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009422:Nervous System Diseases / Q000517:prevention & control*; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome