[Therapeutic hypothermia after cardiac arrest].
BACKGROUND
The objective of the present paper was to examine the association between cerebral status at discharge in patients treated with therapeutic hypothermia (TH) and: 1) time form collapse to initiation of TH, 2) time form collapse to target temperature (32-34 degrees C), 3) time from initiation of TH to target temperature and 4) time to awakening after attainment of normal temperature. We also investigated the significance of age, over and under 70, and precipitating arrhythmia in relation to cerebral status at discharge.


METHODS
A total of 55 resuscitated but continuously comatose cardiac arrest patients who had received TH.


METHODS
cerebral status at discharge and 30-day mortality.


RESULTS
No significant association was found between cerebral score at discharge and 1) time span from collapse to initiation of TH, 2) time form collapse to target temperature or 3) time from initiation of TH to target temperature. It was found, however, that a longer time to awakening after attainment of normal temperature was associated with a poorer cerebral outcome (p = 0.000). There is a non-significant tendency towards a worse cerebral outcome and higher 30-day mortality in patients aged over 70 years, and in patients with asystole as precipitating arrhythmia.


CONCLUSIONS
Among the factors investigated, only time from attainment of normal body temperature to awakening was significantly associated with cerebral outcome.
Aarhus Universitet, Det Sundhedsvidenskabelige Fakultet og Arhus Universitetshospital, Skejby.
Louise Pape
LP
Larsen
Klaus Veng
KV
Kristensen
Hans
H
Kirkegaard
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D003128:Coma / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult