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Good outcome in noncoronary out-of-hospital cardiac arrest treated with mild induced hypothermia

Introduction

Mild induced hypothermia (MIH) has become a standard of care in comatose survivors of out-of-hospital cardiac arrest (OHCA) [1, 2]. Even though the initial randomised trails excluded victims with noncoronary causes of OHCA, MIH may still be useful to attenuate ischemic brain damage in this group of patients.

Methods

We retrospectively studied 172 coronary and 32 noncoronary OHCA survivors that were treated with MIH in our ICU from 2002 to 2008 with regard to cerebral performance category (CPC) at hospital discharge. Bad outcome was defined as severe disability (CPC3), vegetative state (CPC4) and death (CPC5).

Results

Bad outcome was significantly more frequent in patients with noncoronary cause of OHCA (chi-square P < 0.0001). The subgroups of noncoronary cardiac arrest differed substantially with regard to outcome. The outcome after coronary and noncoronary OHCA treated with MIH is displayed in Figure 1.

Figure 1
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abstract

Conclusion

No randomised controlled clinical trial supports the use of MIH in noncoronary OHCA. Although noncoronary OHCA seems to influence outcome negatively, further studies are warranted to examine the potential benefit of MIH in this category of patients.

References

  1. 1.

    Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al.: Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002, 346: 557-563. 10.1056/NEJMoa003289

  2. 2.

    Hypothermia after Cardiac Arrest Study Group: Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002, 346: 549-556. 10.1056/NEJMoa012689

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Busch, M. Good outcome in noncoronary out-of-hospital cardiac arrest treated with mild induced hypothermia. Crit Care 13, P72 (2009). https://doi.org/10.1186/cc7236

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Keywords

  • Public Health
  • Clinical Trial
  • Emergency Medicine
  • Cardiac Arrest
  • Potential Benefit