Cooling after successful resuscitation in cardiac surgery patients.
BACKGROUND
Despite many years of intensive research sudden cardiac death is one of the most common causes of death all over the world. The European Resuscitation Council (ERC) recommends the use of moderate therapeutic hypothermia for 12-24 hours to improve neurological outcome. However, the beneficial effect of this therapy on outcomes for cardiac surgery patients with In- Hospital- Resuscitation (IHR) has not been well studied.The purpose of this single center analysis was to investigate our first experience in a non - selected IHR population, where hypothermia was induced independent from initial heart rhythm disturbance.


METHODS
A total of 20 resuscitated patients who were treated in our institution between January 2010 and December 2011 formed the study cohort.


RESULTS
In all patients post- resuscitation course was significantly prolonged with severe low cardiac output syndrome in six patients (30%). Overall four patients (20%) sustained septicemia with the need for high dose inotropic support. The 30 day mortality was 30% (six of twenty). However, stroke with severe neurological impairment appeared in only four patients (20%) after resuscitation with subsequent therapeutic hypothermia.


CONCLUSIONS
With our observation study we could demonstrate the benefits for neurological outcome due to therapeutic hypothermia in cardiac surgery patients after successful resuscitation. However post- resuscitation treatment should focus on sufficient therapeutic strategies to avoid the distinctive short term morbidity and mortality.
Department of Cardiac Surgery, Heart Center Leipzig University, Struempellstrasse 39, 04289, Leipzig, Germany. marcel-vollroth@gmx.de.
Marcel
M
Vollroth
Knut
K
Roehrich
Carlos
C
Correia
Joerg
J
Seeburger
Thilo
T
Noack
Philipp
P
Kiefer
Michael
M
Hoebartner
Martin
M
Misfeld
Farhad
F
Bakhtiary
Martin
M
Kostelka
Friedrich Wilhelm
FW
Mohr
D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome