Improved prognosis after using mild hypothermia to treat cardiorespiratory arrest due to a cardiac cause: comparison with a control group.
OBJECTIVE
Patients who survive a cardiac arrest have a poor short-term prognosis in terms of mortality and neurological function. The use of mild hypothermia has been investigated in only a few randomized studies, but appears to be effective for treating these patients. The aim of this study was to investigate the effect of this treatment on survival and neurological outcomes.


METHODS
We compared mild hypothermia and usual treatment in patients who had experienced a prolonged cardiac arrest due to ventricular fibrillation or tachycardia and who showed signs of neurological damage. Patient were divided into two groups: a control group of 28 patients and a group of 41 patients who were treated with hypothermia. Patients were assessed at discharge and at 6 months.


RESULTS
There was no significant difference between the two groups in baseline characteristics, including those of the cardiac arrest, or in the time to treatment. At discharge, neurological status was good in 18 patients (43.9%) in the hypothermia group but in only five (17.9%) in the control group (risk ratio=2.46; 95% confidence interval, 1.11-3.98; P=.029). At 6 months after discharge, neurological status was found to be good in 19 patients (46.3%) in the treatment group and six (21.4%) in the control group (risk ratio=2.16; 95% confidence interval, 1.05-3.36; P=.038). The effect of hypothermia may have been affected by various confounding factors.


CONCLUSIONS
Our findings demonstrate that hypothermic treatment after cardiac arrest prolonged by ventricular fibrillation or tachycardia helps improve the prognosis of anoxic encephalopathy.
Castrejón
Sergio
S
Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. castrejonxp@yahoo.es
Cortés
Marcelino
M
Salto
María L
ML
Benittez
Luiz C
LC
Rubio
Rafael
R
Juárez
Miriam
M
López de Sá
Esteban
E
Bueno
Héctor
H
Sánchez
Pedro L
PL
Fernández Avilés
Francisco
F
D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies