Therapeutic hypothermia after out of hospital cardiac arrest improve 1-year survival rate for selective patients

Abstract

Background Therapeutic Hypothermia (TH) is a standard of care after out-of-hospital cardiac arrest (OHCA). Previous reports failed to prove a significant benefit for survival or neurological outcomes. We examined whether the proper selection of patients would enhance treatment efficacy. Method We conducted a retrospective cohort study. Data was collected from January 2000 and August 2018. Patients were enrolled after OHCA and classified into two groups, patients treated with TH and patients who were not treated with TH. Results A total of 92 patients were included in the study. 57 (63%) patients were in the TH Group and 34 (37%) in the Non-TH group. There was no statistical difference in favorable neurological outcomes between the groups. Patients presenting with ventricular fibrillation had a higher 1-year survival rate from TH, while patients with asystole were found to benefit only if they were younger than 65 years (p < .007, p < .02, respectively).

The prognostic impact of therapeutic hypothermia after a sudden cardiac arrest in the course of myocardial infarction

“…Koren et al [28] highlight the need to take the age and the SCA-inducing arrhythmia into account when qualifying patients for TH. The present study proves the importance of appropriate qualification of patients for MTH.…”

“…Other studies have presented divergent results concerning survival and neurological status assessment of post-SCA patients depending on the obtained target temperature (between 33°C and 36°C) and fever control (i.e., avoiding the temperature of > 37.7°C [27,28]). It remains unclear whether following a different MTH protocol in patients aged ≥ 60 years would have resulted in greater benefits, including reducing the frequency of bleeding complications.…”

General Critical Care, Temperature Control, and End-of-Life Decision Making in Patients Resuscitated from Cardiac Arrest

“…The overall prognosis of patients following cardiac arrest remains poor, with only half of them surviving to discharge [ 173 , 195 ]. Early prognostication can be difficult, and clinical examination should be initially performed after ROSC and thereafter on a daily basis to assess the neurological status and guide decision making.…”