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Neurological Outcomes in Cardiac Arrest Patients Who Underwent Therapeutic Hypothermia (Comparison With Control Group) FREE TO VIEW

Christopher Caesar Williams, MD; Sonia Carvajal, MD; Jayaprakash Manda, MD; Vanita Gupta, MD; Darryl Adler, MD; Anne Sutherland, MD
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St. Barnabas Hospital, Bronx, NY

Chest. 2013;144(4_MeetingAbstracts):428A. doi:10.1378/chest.1704349
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SESSION TITLE: Therapeutic Hypothermia

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 28, 2013 at 07:30 AM - 09:00 AM

PURPOSE: Inducing mild therapeutic hypothermia (32οC to 34οC) in patients resuscitated from out-of-hospital cardiac arrest has proven beneficial in neurological recovery. As a quality improvement initiative, our study aimed to compare the neurological outcome of patients who underwent therapeutic hypothermia in our hospital with similarly situated patients who did not receive the protocol.

METHODS: We conducted a retrospective chart review of 55 cardiac arrest patients who underwent therapeutic hypothermia, and compared them with 50 patients who would have undergone the protocol had it been in use in our hospital at the time. The protocol was initiated in patients who met certain inclusion criteria. Neurological outcome was assessed based on the Cerebral Performance Category (CPC) Scale, where 1 and 2 were considered good outcomes, and 3 through 5 were considered bad outcomes.

RESULTS: 18% (10/55) of patients had good outcomes in the study group as compared with 6% (3/50) of patients in the control group. The average age of patients in the study group with good outcomes and bad outcomes was 53.2 years and 58.1 years, respectively. In the control group, the average age of patients with good outcomes and bad outcomes was 41.6 years and 65.8 years, respectively. The average time from Emergency Medical Service arrival to return of spontaneous circulation in the study group was 8.25 minutes in patients with good outcomes compared to 18.05 minutes in patients with bad outcomes. In the control group, it was 10 minutes in patients with good outcomes and 15.29 minutes in patients with bad outcomes.

CONCLUSIONS: In our study, patients who underwent therapeutic hypothermia were three times as likely to have good neurological outcomes as compared to those patients who did not undergo the protocol. Note that compared to current literature, our study was unique because we had a control group and included patients irrespective of initial rhythm.

CLINICAL IMPLICATIONS: Therapeutic hypothermia following cardiac arrest was shown to correlate with good neurological outcomes in our study.

DISCLOSURE: The following authors have nothing to disclose: Christopher Caesar Williams, Sonia Carvajal, Jayaprakash Manda, Vanita Gupta, Darryl Adler, Anne Sutherland

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