Survival and neurological outcome in out-of-hospital cardiac arrests due to shockable rhythms treated with mild therapeutic hypothermia

• Published in: Medicina intensiva Vol. 38; no. 9; p. 541
• Main Authors: Magaldi, M, Fontanals, J, Moreno, J, Ruiz, A, Nicolás, J M, Bosch, X
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.12.2014
• Subjects: Female; Humans; Hypothermia, Induced; Male; Middle Aged; Nervous System Diseases - etiology; Out-of-Hospital Cardiac Arrest - complications; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - therapy; Prognosis; Prospective Studies; Survival Rate; Tachycardia, Ventricular - complications; Treatment Outcome; Ventricular Fibrillation - complications; Shockable rhythms; Post-resuscitation care; Out-of-hospital cardiac arrest; Mild therapeutic hypothermia; Hipotermia terapéutica moderada; Parada cardiorrespiratoria extrahospitalaria; Neurological outcome; Survival; Ritmos desfibrilables; Supervivencia; Cuidados postresucitación; Pronóstico neurológico
• ISSN: 1578-6749
• DOI: 10.1016/j.medin.2014.03.003

To analyze survival and neurological outcome at short and medium term in patients treated with mild therapeutic hypothermia (HTM) in our hospital after suffering an out-of-hospital cardiac arrest (CA) secondary to a shockable rhythm. Prospective, observational study from September 1, 2010 to December 31, 2012, with a follow up of 6 months. Tertiary hospital. All patients who suffer an out-of-hospital CA due to shockable rhythms. non-shockable rhythms, resuscitation >45 minutes without pulse recovery, septic shock, previous coagulopathy, terminal illness or order for withholding treatment. Mild hypothermia (33°C) and postresuscitation care on the basis of standardized protocols. Demographic and epidemiological data, CA data and survival and neurological outcome at hospital discharge and after 6 months. To assess the patients' neurological status, Cerebral Performance Categories (CPC) scale was used. A total of 54 patients were analyzed. 37 patients were discharged to hospital, representing a survival at discharge of 68.5%, which remains 6 months later because no discharged patient died during the follow up period. Regarding neurological outcome, 44.4% of patients were alive and with CPC 1-2 at discharge and up to 54.71% at 6 months. The results of survival and neurological functional status obtained in our center after implementation of HTM are comparable to those published in the literature.