Vol. 40 | No. 2 | July-December 2012 Back

Open Access

Cardiovascular Effects , Safety and Efficacy of Therapeutic Hypothermia in Post-Cardiac Arrest Patients

Janet W. Elcano, Raul E. Ramboyong, Marcellus Francis Ramirez, Jose Emmanuel Palo
Dec 2012 DOI 10.69944/pjc.6d4769e559

Abstract

OBJECTIVE: It is well established that therapeutic hypothemia (TH) is neuroprotective and increases survival in cardiac arrest patients with shockable rhythm. This study seeks to determine effectiveness in improving overall hospital survival among post-cardiac arrest patients, as well as its cardiovascular effects and safety. 

DESIGN: Retrospective chart review study. 

SETTING: Intensive Care Unit (ICU) in a tertiary hospital in the Philippines. 

PATIENTS: All post-CA adult patients admitted in the ICU from December 2008 to January 2012, either treated or not with TH. 

INTERVENTIONS: TH or no TH, with a goal core temperature of 32-34 °C of TH, commenced within 6 hours of return of spontaneous circulation, and maintained for 12-24 hours. 

MAIN OUTCOME MEASURE: Hospital survival and neurological outcomes assessed using the Cerebral Performance Category (CPC) scale; cardiovascular effects (mean arterial pressure and heart rate) and adverse effects. 

RESULTS: A total of 140 patients were included, 95 of whom underwent TH and 45 patients served as control. Baseline characteristics between hypothermia treated and control groups were similar. Good neurological outcomes were found in 27 (28.4%) patients in the hypothermia group vs. 3 (6.7%) in the control group, (OR 5.56; 95% CI 1.587 to 19.446; p=0.003). There was a significant hospital survival benefit in the hypothermia group (36.8%) compared to the control group (20%) (p=0.045). Occurrence of adverse events and hemodynamic parameter values did not significantly differ between groups. 

CONCLUSION: Among post-arrest patients, TH was associated with improved overall survival and good outcome on hospital discharge. It appears safe and showed no considerable systemic hemodynamic and cardiovascular effects.

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