title: Mild therapeutic hypothermia is associated with favourable outcome in patients after cardiac arrest with non-shockable rhythms.
abstract: OBJECTIVE
  Mild therapeutic hypothermia (32-34°C) improves neurological recovery and reduces the risk of death in comatose survivors of cardiac arrest when the initial rhythm is ventricular fibrillation or pulseless ventricular tachycardia. The aim of the presented study was to investigate the effect of mild therapeutic hypothermia (32-34°C for 24h) on neurological outcome and mortality in patients who had been successfully resuscitated from non-ventricular fibrillation cardiac arrest.
  
  
  METHODS
  In this retrospective cohort study we included cardiac arrest survivors of 18 years of age or older suffering a witnessed out-of-hospital cardiac arrest with asystole or pulseless electric activity as the first documented rhythm. Data were collected from 1992 to 2009. Main outcome measures were neurological outcome within six month and mortality after six months.
  
  
  RESULTS
  Three hundred and seventy-four patients were analysed. Hypothermia was induced in 135 patients. Patients who were treated with mild therapeutic hypothermia were more likely to have good neurological outcomes in comparison to patients who were not treated with hypothermia with an odds ratio of 1.84 (95% confidence interval: 1.08-3.13). In addition, the rate of mortality was significantly lower in the hypothermia group (odds ratio: 0.56; 95% confidence interval: 0.34-0.93).
  
  
  CONCLUSIONS
  Treatment with mild therapeutic hypothermia at a temperature of 32-34°C for 24h is associated with improved neurological outcome and a reduced risk of death following out-of-hospital cardiac arrest with non-shockable rhythms.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria. fritz.sterz@meduniwien.ac.at
authors.forename: Christoph
authors.initials: C
authors.lastname: Testori
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Behringer
authors.forename: Moritz
authors.initials: M
authors.lastname: Haugk
authors.forename: Thomas
authors.initials: T
authors.lastname: Uray
authors.forename: Andrea
authors.initials: A
authors.lastname: Zeiner
authors.forename: Andreas
authors.initials: A
authors.lastname: Janata
authors.forename: Jasmin
authors.initials: J
authors.lastname: Arrich
authors.forename: Michael
authors.initials: M
authors.lastname: Holzer
authors.forename: Heidrun
authors.initials: H
authors.lastname: Losert
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004554:Electric Countershock / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D020127:Recovery of Function; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome