Therapeutic hypothermia as a treatment option after out-of hospital cardiac arrest: our experience
- Amer Iglica
(Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Bosnia and Herzegovina)
- Amina Godinjak (Clinical Centre University of Sarajevo, Sarajevo, Clinic for Emergency Medicine, Bosnia and Herzegovina)
- Edin Begić (General Hospital ‘’Prim.dr. Abdulah Nakaš’’, Sarajevo, Department of Cardiology, Bosnia and Herzegovina)
- Enisa Hodžić (Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Bosnia and Herzegovina)
- Faris Zvizdić (Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Bosnia and Herzegovina)
- Nihad Kukavica (Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Bosnia and Herzegovina)
- Kenana Aganović (Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Bosnia and Herzegovina)
- Nirvana Šabanović-Bajramović (Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Intensive Care Unit, Bosnia and Herzegovina)
- Adis Kukuljac (General Hospital ‘’Prim.dr. Abdulah Nakaš’’ Sarajevo, Sarajevo, Department of Orthopaedics, Bosnia and Herzegovina)
- Refet Gojak (Clinical Centre University of Sarajevo, Sarajevo, Clinic for Infectious diseases, Bosnia and Herzegovina)
Abstract
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.
Keywords: intensive care unit, treatment, ventricular fibrillation
How to Cite:
Iglica, A., Godinjak, A., Begić, E., Hodžić, E., Zvizdić, F., Kukavica, N., Aganović, K., Šabanović-Bajramović, N., Kukuljac, A. & Gojak, R., (2019) “Therapeutic hypothermia as a treatment option after out-of hospital cardiac arrest: our experience”, Medicinski glasnik 16(2), 179-184. doi: https://doi.org/10.17392/1040-19
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