Outcome and adverse events with 72-hour cooling at 32°C as compared to 24-hour cooling at 33°C in comatose asphyxial arrest survivors

Abstract Purpose Studies suggest that the current therapeutic hypothermia (TH) protocol does not improve outcomes in adult asphyxial arrest survivors. We sought to compare the effect of 24-hour cooling at 33°C vs that of 72-hour cooling at 32°C on outcomes and the incidence of adverse events in unco...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The American journal of emergency medicine 2014-04, Vol.32 (4), p.297-301
Hauptverfasser: Lee, Byung Kook, MD, PhD, Lee, Seung Joon, MD, Jeung, Kyung Woon, MD, PhD, Lee, Hyoung Youn, MD, Heo, Tag, MD, PhD, Min, Yong Il, MD, PhD
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Abstract Purpose Studies suggest that the current therapeutic hypothermia (TH) protocol does not improve outcomes in adult asphyxial arrest survivors. We sought to compare the effect of 24-hour cooling at 33°C vs that of 72-hour cooling at 32°C on outcomes and the incidence of adverse events in unconscious asphyxial arrest survivors. Methods Retrospectively collected data on 79 consecutive asphyxial arrest patients treated with TH from January 2006 to March 2013 were analyzed. Forty-one patients who presented between January 2006 and January 2011 formed the 33°C-24 h group, whereas 38 patients who presented between February 2011 and March 2013 formed the 32°C-72 h group. The primary outcome was neurologic outcome at 30 days following arrest. The secondary outcomes were all-cause mortality at 30 days following arrest and the incidence of adverse events. Results The Kaplan-Meier curve showed no significant difference in survival over time during the 30 days after arrest between the 2 groups ( P = .608). Good neurologic outcome was achieved in only 2 patients (2.5%) of the overall cohort, despite TH. One of the 32°C-72 h group (2.6%; 95% confidence interval, 4.7%-13.5%) had a good neurologic outcome, as did one of the 33°C-24 h group (2.4%; 95% confidence interval, 4.3%-12.6%) ( P = 1.000). There were no significant differences in the rates of adverse events between the 2 groups. Conclusion The present study did not demonstrate an advantage of 72-hour cooling at 32°C in unconscious asphyxial arrest patients compared with 24-hour cooling at 33°C.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2013.11.046