Premium
Therapeutic hypothermia in comatose patients after out‐of‐hospital cardiac arrest *
Author(s) -
Hay A. W.,
Swann D. G.,
Bell K.,
Walsh T. S.,
Cook B.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05262.x
Subject(s) - medicine , hypothermia , ventricular fibrillation , cardiopulmonary resuscitation , resuscitation , anesthesia , intensive care unit , clinical death , coma (optics) , hospital discharge , emergency medicine , physics , optics
Summary Our intensive care unit has been treating comatose patients, following an out‐of‐hospital cardiac arrest, with therapeutic hypothermia since 2002. In all, 139 out‐of‐hospital cardiac arrest patients were admitted in the 4‐year period 2002–5. Of these, 27% had a favourable outcome (discharged home or to rehabilitation). Forty‐one per cent of patients presenting with ventricular fibrillation (VF) and 7% of non‐VF patients had a favourable outcome. No patient with an estimated time from collapse to first attempt at cardiopulmonary resuscitation over 12 min survived to hospital discharge. Twenty‐two per cent of patients over 70 years were discharged home, suggesting age was not a barrier to surviving out‐of‐hospital cardiac arrest. The introduction of a therapeutic hypothermia clinical pathway, at the end of 2003 improved the efficiency of cooling. The percentage of patients cooled to below 34 °C within 4 h increased from 15 to 51% and those cooled for more than 12 h increased from 30 to 83%.