BACKGROUND: Although the benefits of mild therapeutic hypothermia (MTH) in selected patients after out-of-hospital cardiac arrest have been consistently demonstrated, no controlled trial of MTH in selected patients after in-hospital cardiac arrest (IHCA) has been published. We sought to assess the benefit of MTH after IHCA in patients meeting our institutions IHCA MTH inclusion criteria. METHODS: A retrospective, historical control study was performed. During the 3-year period before and after the 2006 MTH protocol implementation at our institution, we identified a total of 118 patients admitted to our Medical Intensive Care Unit after resuscitation from an IHCA. Two blinded investigators identified all patients meeting our institutions MTH protocol inclusion criteria and the patients in each time period were compared. The primary outcome was discharge with good neurological function. RESULTS: 33 IHCA patients met MTH protocol inclusion criteria; 16 patients were admitted prior to MTH protocol implementation and thus were not treated with MTH post arrest while 17 patients were admitted after implementation and were all treated with MTH post arrest. 91% of patients had an arrest rhythm of asystole or pulseless electrical activity. Good neurological function at discharge was found in 24% of MTH patients and 31% of controls (P = .62). CONCLUSIONS: No difference in neurological outcome at discharge was detected in predominantly non-shockable IHCA patients treated with MTH. This finding, if confirmed with further study, may define a population of patients for whom this costly and resource intensive therapy should be withheld.
BACKGROUND: Although the benefits of mild therapeutic hypothermia (MTH) in selected patients after out-of-hospital cardiac arrest have been consistently demonstrated, no controlled trial of MTH in selected patients after in-hospital cardiac arrest (IHCA) has been published. We sought to assess the benefit of MTH after IHCA in patients meeting our institutions IHCA MTH inclusion criteria. METHODS: A retrospective, historical control study was performed. During the 3-year period before and after the 2006 MTH protocol implementation at our institution, we identified a total of 118 patients admitted to our Medical Intensive Care Unit after resuscitation from an IHCA. Two blinded investigators identified all patients meeting our institutions MTH protocol inclusion criteria and the patients in each time period were compared. The primary outcome was discharge with good neurological function. RESULTS: 33 IHCA patients met MTH protocol inclusion criteria; 16 patients were admitted prior to MTH protocol implementation and thus were not treated with MTH post arrest while 17 patients were admitted after implementation and were all treated with MTH post arrest. 91% of patients had an arrest rhythm of asystole or pulseless electrical activity. Good neurological function at discharge was found in 24% of MTHpatients and 31% of controls (P = .62). CONCLUSIONS: No difference in neurological outcome at discharge was detected in predominantly non-shockable IHCA patients treated with MTH. This finding, if confirmed with further study, may define a population of patients for whom this costly and resource intensive therapy should be withheld.
Authors: J P Nolan; P T Morley; T L Vanden Hoek; R W Hickey; W G J Kloeck; J Billi; B W Böttiger; P T Morley; J P Nolan; K Okada; C Reyes; M Shuster; P A Steen; M H Weil; V Wenzel; R W Hickey; P Carli; T L Vanden Hoek; D Atkins Journal: Circulation Date: 2003-07-08 Impact factor: 29.690
Authors: Andrew H Travers; Thomas D Rea; Bentley J Bobrow; Dana P Edelson; Robert A Berg; Michael R Sayre; Marc D Berg; Leon Chameides; Robert E O'Connor; Robert A Swor Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: Jon C Rittenberger; Francis X Guyette; Samuel A Tisherman; Michael A DeVita; Rene J Alvarez; Clifton W Callaway Journal: Resuscitation Date: 2008-11 Impact factor: 5.262
Authors: Katherine M Berg; Anne V Grossestreuer; Amy Uber; Parth V Patel; Michael W Donnino Journal: Resuscitation Date: 2017-07-24 Impact factor: 5.262
Authors: Romergryko G Geocadin; Eelco Wijdicks; Melissa J Armstrong; Maxwell Damian; Stephan A Mayer; Joseph P Ornato; Alejandro Rabinstein; José I Suarez; Michel T Torbey; Richard M Dubinsky; Jason Lazarou Journal: Neurology Date: 2017-05-10 Impact factor: 9.910
Authors: Lauren E Thompson; Paul S Chan; Fengming Tang; Brahmajee K Nallamothu; Saket Girotra; Sarah M Perman; Somnath Bose; Stacie L Daugherty; Steven M Bradley Journal: Resuscitation Date: 2017-11-02 Impact factor: 5.262
Authors: Timothy J Mader; Brian H Nathanson; William E Soares; Ryan A Coute; Bryan F McNally Journal: Ther Hypothermia Temp Manag Date: 2014-03-01 Impact factor: 1.286
Authors: Pedro A Villablanca; Mohammed Makkiya; Evann Einsenberg; David F Briceno; Christia Panagiota; Mark Menegus; Mario Garcia; Daniel Sims; Harish Ramakrishna Journal: Ann Card Anaesth Date: 2016 Jan-Mar