Aim To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA). Methods The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33 o C (32.3-34.1 o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS). Results Multiple organ dysfunction syndrome (MODS) significantly affected survival (p=0.0001), as its presence reduced patients' survival by 96%. In addition, ventricular fibrillation (VF) as the presenting rhythm, also significantly affected survival (p=0.019). A degree of patient's coma, as measured by the GCS, significantly affected survival (p=0.011). For each increasing point on the GCS, the chance for survival increased twice. Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively). Conclusion In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.
Guen L, Nicolas-Robin M, Carreira A, Raux S, Leprince M, Riou P, et al. Extracorporeal life support following out-of-hospital refractory cardiac arrest. Crit Care. 2011.
2.
Lee J, Han S, Kim H, Hong K, Choi H, Park K, et al. Out-of-hospital cardiac arrest patients treated with cardiopulmonary resuscitation using extracorporeal membrane oxygenation: focus on survival rate and neurologic outcome. Scand J Trauma Resusc Emerg Med. 2016. p. 74.
3.
Maclean D, Stevenson R, Bata I, Green R. Therapeutic hypothermia for out-of-hospital cardiac arrest: An analysis comparing cooled and not cooled groups at a Canadian center. J Emerg Trauma Shock. 2012. p. 328–32.
4.
Bernard S, Gray T, Buist M, Jones B, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002. p. 557–63.
5.
Polderman K. Hypothermia and neurological outcome after cardiac arrest: State of the art. Eur J Anaesthesiol. 2008. p. 23–30.
6.
Gibson A, Andrews P. Therapeutic hypothermia, still. 2013. p. 26.
7.
Ecc Committee. American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005. p. 1–203.
8.
Scott B, Hogue T, Fixley M, Adamson P. Induced hypothermia following out-of-hospital cardiac arrest; initial experience in a community hospital. Clin Cardiol. 2006. p. 525–9.
9.
Callaway C, Donnino M, Fink E, Geocadin R, Geocadin R, Golan E, et al. Part 8: Post-cardiac arrest care: 2015 American Heart Association Guidelines Update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015. p. 465–82.
10.
Teasdale G, Maas A, Lecky F, Manley G, Stocchetti N, Murray G. The Glasgow Coma Scale at 40 years: standing the test of time. Lancet Neurol. 2014. p. 844–54.
11.
Nolan J, Soar J, Zideman D, Biarent D, Bossaert L, Deakin C, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010. p. 1219–76.
12.
Chan P, Mcnally B, Tang F, Kellermann A, Group CRS. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation. 2014. p. 1876–82.
13.
Girotra S, Nallamothu B, Spertus J, Li Y, Krumholz H, Chan P. American Heart Association Get with the Guidelines-Resuscitation Investigators. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012. p. 1912–20.
14.
Werling M, Thorén A, Axelsson C, Herlitz J. Treatment and outcome in post-resuscitation care after out-of-hospital cardiac arrest when a modern therapeutic approach was introduced. Resuscitation. 2007. p. 40–5.
15.
State-specific mortality from sudden cardiac death--United States. MMWR Morb Mortal Wkly Rep. 1999. p. 123–6.
16.
Kuisma M, Alaspää A. Out-of-hospital cardiac arrests of non-cardiac origin. Epidemiology and outcome. Eur Heart J. 1997. p. 1122–8.
17.
Chokengarmwong N, Ortiz L, Raja A, Goldstein J, Huang F, Yeh D. Outcome of patients receiving CPR in the ED of an urban academic hospital. Am J Emerg. 2016. p. 1595–9.
18.
Morrison L, Schmicker R, Weisfeldt M, Bigham B, Berg R, Topjian A, et al. Resuscitation Outcomes Consortium Investigators. Effect of gender on outcome of out of hospital cardiac arrest in the Resuscitation Outcomes Consortium. Resuscitation. 2016. p. 76–81.
19.
Poon S, Goodman S, Yan R, Bugiardini R, Bierman A, Eagle K, et al. Bridging the gender gap: Insights from a contemporary analysis of sex-related differences in the treatment and outcomes of patients with acute coronary syndromes. Am Heart J. 2011. p. 66–73.
20.
Safdar B, Stolz U, Stiell I, Cone D, Bobrow B, Deboehr M, et al. Differential survival for men and women from out-of-hospital cardiac arrest varies by age: results from the OPALS study. Acad Emerg Med. 2014. p. 1503–11.
21.
Nadolny K, Szarpak L, Gotlib J, Panczyk M, Sterlinski M, Ladny J, et al. An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest. Medicine (Baltimore). 2018. p. 11607.
22.
Luo S, Zhang Y, Zhang W, Zheng R, Tao J, Xiong Y. Prognostic significance of spontaneous shockable rhythm conversion in adult out-of-hospital cardiac arrest patients with initial non-shockable heart rhythms: A systematic review and meta-analysis. 2017. p. 1–8.
23.
Vargas M, Servillo G, Sutherasan Y, Rodríguez-González R, Brunetti I, Pelosi P. Effects of in-hospital low targeted temperature after out of hospital cardiac arrest: A systematic review with meta-analysis of randomized clinical trials. Resuscitation. 2015. p. 8–18.
24.
Wada T, Gando S, Ono Y, Maekawa K, Katabami K, Hayakawa M, et al. Disseminated intravascular coagulation with the fibrinolytic phenotype predicts the outcome of patients with out-of-hospital cardiac arrest. Thromb J. 2016. p. 43.
25.
Godinjak A, Jusufovic S, Rama A, Iglica A, Zvizdic F, Kukuljac A, et al. Hyperlactatemia and the importance of repeated lactate measurements in critically ill patients. Med Arch. 2017. p. 404–7.
26.
Abella B, Rhee J, Huang K, Hoek V, Becker T, L. Induced hypothermia is underused after resuscitation from cardiac arrest: a current practice survey. Resuscitation. 2005. p. 181–6.
27.
Varon J, Acosta P. Therapeutic hypothermia use among health care providers in 2 developing countries. Am J Emerg Med. 2008. p. 244.
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