title: Therapeutic hypothermia application vs standard support care in post resuscitated out-of-hospital cardiac arrest patients.
abstract: BACKGROUND
  Survival after cardiac arrest remains poor, especially when it occurs outside of hospital. In recent years, therapeutic hypothermia has been used to improve outcomes in patients who have experienced cardiac arrest, however, application to out-of-hospital cardiac arrest (OHCA) patients remains controversial.
  
  
  METHODS
  A total of 175 OHCA patients underwent therapeutic hypothermia (TH), which was performed using large volume ice crystalloid fluid (LVICF) infusions after ICU admission. Ice packs and conventional cooling blankets were used to maintain a core body temperature of 33°C, according to standard protocol for 36 hours. Patients in the control group received standard supportive care without TH. Hospital survival and neurologic outcomes were compared.
  
  
  RESULTS
  There was no significant difference between the groups with regards to patient characteristics, underlying etiologies, and length of hospital stays. The duration of cardiac pulmonary resuscitation (CPR) was also similar. In the 51 patients that received TH, 14 were alive at hospital discharge. In the 124 patients belonging to the supportive care group, only 15 were alive at hospital discharge (27.5% vs. 12.1%, p = 0.013). Approximately 7.9% of patients in the TH group had good neurologic outcomes (4 of 51) compared with the 1.7% (2 of 124) of patients in the supportive group (p = 0.04). There were no specific treatment-related complications.
  
  
  CONCLUSIONS
  Therapeutic hypothermia can be safely applied to OHCA patients and can improve their outcome. Further large scale studies are needed to verify our results.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chieh-Jen
authors.initials: CJ
authors.lastname: Wang
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Yang
authors.forename: Chiao-Hsien
authors.initials: CH
authors.lastname: Lee
authors.forename: Rong-Luh
authors.initials: RL
authors.lastname: Lin
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Peng
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome