Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Arrich, Jasmin; Hölzer, Michael; Havel, Christof; Müllner, Marcus; Herkner, Harald

doi:10.1002/14651858.cd004128.pub3

Cited by 164 publications

(142 citation statements)

References 70 publications

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“…[9][10][11][12][13][14][15][16][17][18] However, its effects on mortality and neurological outcome remain unclear, especially in patients who cannot receive DC. Therefore, we conducted a RCT to address this issue.…”

Section: February 2016mentioning

confidence: 99%

“…However, the safety of mild hypothermia in patients with MCHI had been confirmed by many studies. [9][10][11][12][13][14][15][16][17][18] The complications associated with hypothermia included pneumonia, hyperglycemia, electrolyte disorders, and arrhythmia, among others. 39 However, no significant differences with normothermia treatment were recorded.…”

Section: Strokementioning

confidence: 99%

“…8 Additionally, a systematic review and meta-analysis of RCTs in patients with cardiopulmonary arrest have also shown that hypothermia treatment reduces mortality (risk ratios [RR]=1.35; 95% confidence interval [CI], 1.10-1.65) and improves neurological outcomes (RR=1.55; 95% CI, 1.22-1.96) compared with normothermia treatment. 9 Consequently, therapeutic hypothermia may be an option for patients with MCHI.…”

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confidence: 99%

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Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

Liu

Zhang

et al. 2016

Stroke

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Background and Purpose-We conducted this randomized controlled trial to investigate the effects of therapeutic hypothermia on mortality and neurological outcome in patients with massive cerebral hemispheric infarction. Methods-Patients within 48 hours of symptom onset were randomized to either a hypothermia group or a control group.Patients in the hypothermia group were given standard medical treatment plus endovascular hypothermia with a target temperature of 33 or 34°C. Hypothermia was maintained for a minimum of 24 hours. Patients in the control group were given standard medical treatment only with a target temperature of normothermia. The primary end points were mortality and the modified Rankin Scale score at 6 months. Results-There were 16 patients in the hypothermia group and 17 patients in the control group. At 6 months, 8 patients had died in the hypothermia group versus 7 patients in the control group (P=0.732). The main cause of death was fatal herniation caused by a pronounced rise in intracranial pressure. Seven patients (43.8%) had a modified Rankin Scale of 1 to 3 in the hypothermia group versus 4 patients (23.5%) in the control group (P=0.282). Additionally, of the survivors, patients in the hypothermia group achieved better neurological outcomes compared with those in the control group (7/8, 87.5% versus 4/10, 40.0%; P=0.066; odds ratio=10.5; 95% confidence interval, 0.9-121.4). Conclusions-Mild

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Section: February 2016mentioning

confidence: 99%

Section: Strokementioning

confidence: 99%

mentioning

confidence: 99%

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Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

Liu

Zhang

et al. 2016

Stroke

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“…Many studies showed a beneficial neurologic outcome of hypothermia closely related to its neuroprotective effect. It increased survival without major neurological sequelae for comatose patients after a CA following a ventricular fibrillation or tachycardia resuscitated successfully [6,7,11] . In this context, a protocol for cerebral protection by hypothermia after CA was introduced in the Intensive Care Unit (ICU) of Saint-Pierre University Hospital in 2004 and was updated regularly.…”

Section: Introductionmentioning

confidence: 99%

The therapeutic hypothermia after resuscitated cardiac arrest caused by ventricular fibrillation: a retrospective study in Saint Pierre University Hospital

Libert

Mols

Dechamps

et al. 2014

JHA

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Background: Therapeutic hypothermia is recommended as soon as possible for the neurological protection of comatose patients after cardiorespiratory arrest (CA) caused by pulseless ventricular fibrillation (VF) or tachychardia (VT). This retrospective study evaluates the adherence to the hypothermia protocol in Emergency Department and Intensive Care Units of Saint Pierre University Hospital (SPUH). Methods:Retrospective analyses of the database records from the 1st January 2005 to the 31st December 2010 concerning all the out-of-hospital arrests due to ventricular fibrillation admitted alive in the hospital. Transferred or NTBR patients were excluded. Results:Of the 72 patients studied, 68% were discharged alive from the hospital, of which 84% were free of neurological sequelae. Hypothermia was used in 44 patients, unjustified in 5 cases. There were also 5 cases for which it was needed, but not applied. Hypothermia (32°C -34°C) was achieved in a median time of 9.5 hours (range: 1.5 hours -39 hours) and lasted a median 21 hours (range: 7 hours -31 hours). Hypothermic patient survival was 72.7%, with 81% good neurological outcome. Conclusion:The protocol application in our small study gives as good figures as previous studies. Few errors of inclusion and exclusion are still present. Implementation of a common protocol for Emergency Medical Service (EMS), Emergency Department (ED) and Intensive Care Unit (ICU) would shorten the time to obtain the target temperature. The creation and implementation of a specific register with CA patients who received hypothermia would lead to a better medical follow-up for the patient and improve the current knowledge related to this technique.

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“…Indeed, cooling or mild therapeutic hypothermia (MTH) is based on extensive laboratory evidence and clinical studies that highlight the beneficial effect of cooling to a core temperature of 33-34°C to secondarily mitigate brain damage, and hence to improve the neurological outcome [9][10][11].…”

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confidence: 99%

Hypothermia or normothermia after cardiac arrest? Do not throw the baby out with the bath water?

2014

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Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Abstract: Conventional cooling methods to induce mild therapeutic hypothermia seem to improve survival and neurologic outcome after cardiac arrest. Our review supports the current best medical practice as recommended by the International Resuscitation Guidelines.

Cited by 164 publications

References 70 publications

Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

Improved Neurological Outcome With Mild Hypothermia in Surviving Patients With Massive Cerebral Hemispheric Infarction

The therapeutic hypothermia after resuscitated cardiac arrest caused by ventricular fibrillation: a retrospective study in Saint Pierre University Hospital

Hypothermia or normothermia after cardiac arrest? Do not throw the baby out with the bath water?

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