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Study of resuscitated in- and out-hospital cardiorespiratory arrest patients undergoing therapeutic hypothermia.

OBJECTIVE
To determine the characteristics of patients undergoing standard institutional protocol for management of resuscitated patients after a cardiac arrest episode, including therapeutic hypothermia.


METHODS
This was a retrospective analysis of 26 consecutive patients admitted following cardiac arrest, between January 2007 and November 2008.


RESULTS
All cases underwent therapeutic hypothermia. Average age was 63 years, and the patients were predominantly male. Cardiac arrest event was out-of-hospital in 8 cases, in the emergency room in 3 cases, in the wards in 13 cases and in the operation room in 2 cases. The cardiac arrest rhythm was ventricular fibrillation in seven patients, asystolia in 11, pulseless electrical activity in 5 cases, and was undetermined in 3 patients. The interval between the cardiac arrest and return of spontaneous circulation was 12 minutes (SD ± 5 min). The time to reach the target temperature was 5 ± 4 hours, the hypothermia time was 22 ± 6 hours and time to rewarming 9 ± 5.9 hours. Fourteen patients died in the intensive care unit, a 54% mortality, and three patients died during the in-hospital stay, a 66% in-hospital mortality. There was statistically significant reduction in hemoglobin (p<0.001), leukocytes (p=0.001), platelets (p<0.001), lactate (p<0.001) and potassium (p=0.009), values and increased C reactive protein (p=0.001) and INR (p=0.004) after hypothermia.


CONCLUSIONS
The creation of a standard operative protocol for therapeutic hypothermia in post cardiac arrest patients management resulted in a high use of therapeutic hypothermia. The clinical results of this protocol adapted from randomized studies are similar to the literature.