title: Therapeutic hypothermia after cardiac arrest in a real-life setting.
abstract: BACKGROUND
  In 2002, two landmark studies concluded that therapeutic hypothermia (TH) improves survival and neurologic outcome in patients with shockable rhythms and out-of-hospital cardiac arrest (OHCA). However, the evidence on whether TH also improves the prognosis in patients with non-shockable rhythms or in-hospital cardiac arrest (IHCA) is sparse. The aim of this study was to assess the prevalence and prognosis of patients with non-shockable rhythms or IHCA after implementation of TH in a real-life setting.
  
  
  METHODS
  The study included 72 consecutive, unconscious patients that were admitted to Holbaek Hospital after cardiac arrest and successful resuscitation. Patients were included regardless of initial cardiac rhythms and location of the cardiac arrest. All patients were cooled to a temperature of 32-34 °C. The primary outcome was survival with a favourable neurologic outcome within six months.
  
  
  RESULTS
  Almost two thirds (63%) of the included patients had non-shockable rhythms or IHCA and only 8.7% of these patients survived with a favourable neurologic outcome. Nearly a third (29%) of the included patients had OHCA with an initial non-shockable rhythm and none (0%) of these patients survived with a favourable neurologic outcome.
  
  
  CONCLUSIONS
  In a real-life setting, the majority of resuscitated patients receiving TH do not fulfil the criteria of the original studies upon which the current guidelines are based. Furthermore, these patients have a poor outcome, indicating that not all patients may benefit from TH.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: klewser@gmail.com.
authors.forename: Søren
authors.initials: S
authors.lastname: Hoffmann
authors.forename: Rikke
authors.initials: R
authors.lastname: Ersgaard
authors.forename: Mette Lind
authors.initials: ML
authors.lastname: Kristensen
authors.forename: Anders
authors.initials: A
authors.lastname: Beck
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Bülow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D004554:Electric Countershock; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D015995:Prevalence; D011379:Prognosis; D015996:Survival Rate