Does cooling the wrong patients heat up the costs?

Background and goals

Mild induced hypothermia (MIH) improves neurological recovery and survival after cardiac arrest for patients in whom the initial rhythm is ventricular fibrillation (VF) [1]. Other initial rhythms and cardiac arrest due to noncoronary causes may also benefit from such treatment [2].

Materials and methods

We evaluated 10 patients who received MIH after non-VF-(asystole, pulsless electric activity) out-of-hospital cardiac arrest (NVF-OHCA) and compared them with a historic control (n = 9) of NVF-OHCA who as not treated with MIH. The ICU and hospital length of stays as well as the incidence of bad outcome were compared. Bad outcome was defined as cerebral performance category (CPC) ≥ 3 or death [3].

Results

Data are presented in Table 1.

Table 1

Conclusion

The tendency towards prolongation of length of stay at even poor outcome suggests that a liberal MIH inclusion policy may result in a dissatisfactory cost–benefit ratio. Further research and larger patient numbers are needed to verify these results.