title: Efficacy of therapeutic hypothermia after out-of-hospital cardiac arrest due to ventricular fibrillation.
abstract: OBJECTIVE
  We investigated implementation and efficacy of mild therapeutic hypothermia in the treatment of out-of-hospital cardiac arrest due to ventricular fibrillation.
  
  
  METHODS
  Two periods were compared, an historical one (36 patients) between 2000 and 2002 where therapeutic hypothermia was never used, and a recent period (32 patients) between 2003 and 2005 where therapeutic hypothermia (32-34 degrees C) was implemented prospectively in our unit. Cooling was obtained by simply using wet cloths and ice packs. Survival in the two groups and factors associated with survival were analysed, together with the neurological prognosis in discharged patients.
  
  
  RESULTS
  Survival was significantly higher in the hypothermia group (56% versus 36%), whereas no significant difference was observed in severity between the two periods. Only age, time from return to spontaneous circulation <20min, and therapeutic hypothermia were independently associated with survival. Therapeutic hypothermia was well tolerated and was associated with a significant improvement in neurological outcome. Whereas only 23% of patients actually reached the target temperature in 2003, 100% did in 2005.
  
  
  CONCLUSIONS
  Therapeutic hypothermia is efficient in significantly improving survival and neurological outcome of out-of-hospital cardiac arrest with ventricular fibrillation. By using a simple method, it can be implemented easily and quickly, without side effects.
authors.affiliation: Medical Intensive Care Unit, University Hospital Ambroise Paré, Assistance Publique Hôpitaux de Paris, 9 avenue Charles de Gaulle, 92104 Boulogne Cedex, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Belliard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Catez
authors.forename: Cyril
authors.initials: C
authors.lastname: Charron
authors.forename: Vincent
authors.initials: V
authors.lastname: Caille
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerter
authors.forename: Olivier
authors.initials: O
authors.lastname: Dubourg
authors.forename: François
authors.initials: F
authors.lastname: Jardin
authors.forename: Antoine
authors.initials: A
authors.lastname: Vieillard-Baron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000150:complications / Q000401:mortality / Q000628:therapy*