title: Comparison of Outcomes Between Patients Treated by Therapeutic Hypothermia for Cardiac Arrest Due to Cardiac or Respiratory Causes.
abstract: Outcome for patients experiencing out-hospital cardiac arrest (OHCA) due to respiratory causes is poor, even with treatment by therapeutic hypothermia (TH). The purpose of this study is to clarify difference in outcome and respiratory state during resuscitation between cases due to respiratory causes versus those due to cardiac causes, to establish alternative strategies for the patient. This study was conducted as a retrospective analysis of patients with post CA syndrome who underwent TH. Patients were divided into two groups according to cause of CA: cardiac (C group) or respiratory (R group). Utstein Style data, outcome, and arterial blood gas (ABG) findings after emergency room admission of the two groups were compared. Of 74 patients treated with TH during the 2-year study period, 49 were placed in the C group and 19 in the R group. The rates of ventricular fibrillation/pulseless ventricular tachycardia at initial rhythm were significantly higher in the C group than in the R group. The rate of favorable neurological outcome was significantly higher in the C group (15/49: 30.6%) than in the R group (1/19: 5.3%) 30 days after resuscitation. In the ABG findings, PaCO2 was significantly higher in the R group than in the C group. For patients experiencing OHCA from respiratory causes, TH was less effective and PaCO2 accumulated immediately after admission. From this, interpretation of the significance of PaCO2 in these patients at the early stage after return of spontaneous circulation should be seriously considered.
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakurai
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Kosaku
authors.initials: K
authors.lastname: Kinoshita
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Tomohide
authors.initials: T
authors.lastname: Komatsu
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Junko
authors.initials: J
authors.lastname: Yamaguchi
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Atsunori
authors.initials: A
authors.lastname: Sugita
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine , Tokyo, Japan .
authors.forename: Shingo
authors.initials: S
authors.lastname: Ihara
mesh_terms: D000368:Aged; D001639:Bicarbonates / Q000097:blood; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000150:complications; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood / Q000628:therapy*; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D010343:Patient Admission; D012140:Respiratory Tract Diseases / Q000097:blood / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001639:Bicarbonates; D002245:Carbon Dioxide; D010100:Oxygen