title: Therapeutic hypothermia for out-of-hospital cardiac arrest: An analysis comparing cooled and not cooled groups at a Canadian center.
abstract: BACKGROUND
  Out of hospital cardiac arrest is a devastating event and is associated with poor outcomes; however, therapeutic hypothermia (TH) is a novel treatment which may improve neurological outcome and decrease mortality. Despite this, TH is not uniformly implemented across Coronary Care and Intensive Care Units in Canada.
  
  
  OBJECTIVE
  The purpose of this study was to compare cerebral recovery and mortality rates between patients in our Coronary Care Unit who received TH with a historical control group.
  
  
  METHODS
  A retrospective chart review was performed of patients admitted to a tertiary care center with out-of-hospital cardiac arrest. Twenty patients who were admitted and cooled after December 2006 were compared with 29 noncooled patients admitted in the 5 years prior as a historical control group. The primary outcomes of interest were in-hospital mortality and neurological outcome.
  
  
  RESULTS
  Eleven of 20 (11/20, 55%) patients who were cooled as per protocol survived to hospital discharge, all having a good neurological outcome. Eleven of 29 (11/29, 38%) noncooled patients survived to hospital discharge (Odds Ratio: 0.50, 95% CI: 0.16- 1.60, P=0.26). Eleven of 20 patients who were cooled had a good neurological outcome (CPS I-II, 11/20, 55%), versus 7 of 29 (7/29, 24%) of noncooled patients (Odds ratio: 3.84, 95% CI: 1.13- 13.1, P=0.03). One hundred percent (11/11) of survivors in the cooled group had a good neurological outcome.
  
  
  CONCLUSIONS
  In our center, the use of TH in out-of-hospital cardiac arrest survivors was associated with improved neurological outcome.
authors.affiliation: Dalhousie University; Halifax, Nova Scotia; Canada ; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia; Canada ; Department of Medicine, Division of Cardiology, Saint John, New Brunswick, Canada.
authors.forename: D Alex
authors.initials: DA
authors.lastname: Maclean
authors.forename: Robert S
authors.initials: RS
authors.lastname: Stevenson
authors.forename: Iqbal
authors.initials: I
authors.lastname: Bata
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green