title: Therapeutic hypothermia in adult cardiac arrest because of drowning.
abstract: BACKGROUND
  Therapeutic hypothermia in adult victims who suffer cardiac arrest following drowning has been applied in only a small number of cases. In the last 4 years, we have employed therapeutic hypothermia to decrease hypoxia-induced brain injury in these patients. The purpose of the present study was to report the results of the treatment of these patients.
  
  
  METHODS
  This study investigated the utilisation of therapeutic hypothermia on consecutive patients with cardiac arrest because of drowning between 2005 and 2008. The study was conducted retrospectively, collecting data by reviewing medical records. Hypothermia, with a target temperature of 32-34°C, was induced for 24 h. Neurological outcomes were classified using the cerebral performance categories (CPCs). The primary outcome was neurological function at discharge.
  
  
  RESULTS
  Twenty patients were treated with therapeutic hypothermia. Four patients (20%) exhibited a favourable neurological outcome (CPC 1-2). Two patients (10%) remained in a vegetative state at discharge (CPC 4), and 14 patients (70%) died (CPC 5). The most common complications during therapeutic hypothermia were pancreatitis and rhabdomyolysis. A longer duration of advanced cardiac life support (P = 0.035), an absence of motor response to pain after 3 days (P = 0.003), an abnormal brain imaging (P = 0.005) and a lack of cortical response to somatosensory evoked potential (P = 0.008) were related to an unfavourable outcome (CPC 3-5).
  
  
  CONCLUSIONS
  The present study did not demonstrate an advantage of therapeutic hypothermia in adult cardiac arrest after drowning compared with previous studies treated with conventional therapy. Further prospective studies are needed to evaluate the effects of therapeutic hypothermia.
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: S P
authors.initials: SP
authors.lastname: Choi
authors.forename: C S
authors.initials: CS
authors.lastname: Youn
authors.forename: K N
authors.initials: KN
authors.lastname: Park
authors.forename: J H
authors.initials: JH
authors.lastname: Wee
authors.forename: J H
authors.initials: JH
authors.lastname: Park
authors.forename: S H
authors.initials: SH
authors.lastname: Oh
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D022561:Advanced Cardiac Life Support; D000368:Aged; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000628:therapy*; D009422:Nervous System Diseases / Q000209:etiology; D009460:Neurologic Examination; D011379:Prognosis; D012640:Seizures / Q000209:etiology; D013534:Survival; D016896:Treatment Outcome; D055815:Young Adult