Bringing research to the bedside: the role of induced hypothermia in cardiac arrest.
Despite progress in resuscitative practices, there has been little improvement in mortality and neurologic morbidity outcomes after cardiac arrest. Updated resuscitative guidelines were published in 2005, and included changes in resuscitation measures and recommendations in postresuscitation interventions including induced hypothermia. Treatment with induced hypothermia after cardiac arrest for up to 24 hours has been shown to significantly improve the neurologic outcomes and mortality in patients with primary cardiac arrest who remain comatose after return of spontaneous circulation. St. Luke's Episcopal Hospital, a private, not-for-profit teaching hospital licensed for 949 beds located at the Texas Medical Center in Houston, Tex, has incorporated this research into practice. A multidisciplinary team led by a neurointensivist was formed to develop and implement a protocol to support induced hypothermia after cardiac arrest. Twenty-five patients have received induced hypothermia with a 74% survival rate. Of those who survived, 47% went home for a regular discharge, 29% transferred to acute rehabilitation, and 23% transferred to a long-term care facility.
Cushman
Lisa
L
St. Luke's Episcopal Hospital, Houston, Texas 77030, USA. lcushman@sleh.com
Warren
Mary Lou
ML
Livesay
Sarah
S
D000368:Aged; D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D019317:Evidence-Based Medicine; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006784:Hospitals, Teaching; D006788:Hospitals, Voluntary; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods* / Q000451:nursing; D008297:Male; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D016730:Program Development; D015397:Program Evaluation; D012151:Resuscitation / Q000379:methods* / Q000451:nursing; D015996:Survival Rate; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome