title: Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study.
abstract: OBJECTIVE
  We aimed to evaluate post-resuscitation care, implementation of therapeutic hypothermia (TH) and outcomes of intensive care unit (ICU)-treated out-of-hospital cardiac arrest (OHCA) patients in Finland.
  
  
  METHODS
  We included all adult OHCA patients admitted to 21 ICUs in Finland from March 1, 2010 to February 28, 2011 in this prospective observational study. Patients were followed (mortality and neurological outcome evaluated by Cerebral Performance Categories, CPC) within 1 year after cardiac arrest.
  
  
  RESULTS
  This study included 548 patients treated after OHCA. Of those, 311 patients (56.8%) had a shockable initial rhythm (incidence of 7.4/100,000/year) and 237 patients (43.2%) had a non-shockable rhythm (incidence of 5.6/100,000/year). At ICU admission, 504 (92%) patients were unconscious. TH was given to 241/281 (85.8%) unconscious patients resuscitated from shockable rhythms, with unfavourable 1-year neurological outcome (CPC 3-4-5) in 42.0% with TH versus 77.5% without TH (p < 0.001). TH was given to 70/223 (31.4%) unconscious patients resuscitated from non-shockable rhythms, with 1-year CPC of 3-4-5 in 80.6% (54/70) with TH versus 84.0% (126/153) without TH (p = 0.56). This lack of difference remained after adjustment for propensity to receive TH in patients with non-shockable rhythms.
  
  
  CONCLUSIONS
  One-year unfavourable neurological outcome of patients with shockable rhythms after TH was lower than in previous randomized controlled trials. However, our results do not support use of TH in patients with non-shockable rhythms.
authors: Department of Surgery, Intensive Care Units, Helsinki University Hospital, Helsinki, Finland. jukka.vaahersalo@hus.fi
authors: Jukka
authors: J
authors: Vaahersalo
authors: Pamela
authors: P
authors: Hiltunen
authors: Marjaana
authors: M
authors: Tiainen
authors: Tuomas
authors: T
authors: Oksanen
authors: Kirsi-Maija
authors: KM
authors: Kaukonen
authors: Jouni
authors: J
authors: Kurola
authors: Esko
authors: E
authors: Ruokonen
authors: Jyrki
authors: J
authors: Tenhunen
authors: Tero
authors: T
authors: Ala-Kokko
authors: Vesa
authors: V
authors: Lund
authors: Matti
authors: M
authors: Reinikainen
authors: Outi
authors: O
authors: Kiviniemi
authors: Tom
authors: T
authors: Silfvast
authors: Markku
authors: M
authors: Kuisma
authors: Tero
authors: T
authors: Varpula
authors: Ville
authors: V
authors: Pettilä
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D057216:Propensity Score; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome