Characteristics and prognosis of patients treated by hypothermia for an out-of-hospital cardiac arrest related to a ventricular arrhythmia in a cardiac intensive care unit of a French University Hospital




Background


Recent improvements in the management of out-of-hospital cardiac arrest (OHCA), mainly early resuscitation and therapeutic hypothermia, should allow a better prognosis. This study aims at determining the characteristics and prognosis of patients treated by hypothermia for an OHCA.




Methods


We analyzed data of patients admitted to our Cardiac Intensive Care Unit during the last 3 years (2008–2010) for management of an OHCA, related to a ventricular arrhythmia, by therapeutic hypothermia. Main characteristics were compared according to the intra hospital outcome.




Methods


We analyzed data of patients admitted to our Cardiac Intensive Care Unit during the last 3 years (2008–2010) for management of an OHCA, related to a ventricular arrhythmia, by therapeutic hypothermia. Main characteristics were compared according to the intra hospital outcome.




Results


During the inclusion time, 53 patients (mean age: 58 ± 15; male: 48 (90%)) were enrolled, including 18 with STEMI (34%). Mean resuscitation delays were: “no flow” 4.4 ± 6, “low flow” 23.2 ± 16 min. Comparison of main data according to the intra hospital outcome (patients in the “good outcome” are those discharged with good cerebral performance or moderate cerebral disability, patients in the “poor outcome” group are others) is presented in Table 1 .



Table 1

Comparison of main data according to the intra-hospital outcome.
























































































Good outcome group n = 22 Poor outcome group n = 31 P
Clinical Male 22 (100) 26 (83) .04
Age 55 ± 13 60 ± 16 .27
Diabetes mellitus 3 (13) 4 (13) .93
Current smoker 6 (27) 9 (29) .88
Known cardiopathy 9 (41) 21 (67) .052
Anamnesis of the cardiac arrest and management Time of occurring(6 am–6 pm) 16 (72) 22 (71) .28
“No flow” delay (min) 2 ± 3 5 ± 6 .039
“Low flow” delay (min) 15 ± 14 29 ± 16 .003
STEMI 10 (45) 9 (29) .21
Coronary artery disease on the admission angiography 18 (81) 16 (51) .02
Angioplasty 13 (59) 4 (13) < .001
Delay between OHCA and beginning of hypothermia (min) 181 ± 78 233 ± 113 .08
Biomarkers at the admission Troponin (ng/ml) 12.7 ± 30 3.1 ± 4 .09
Lactate blood (mmol/l) 2.4 ± 1 4.0 ± 2 .009
pH 7.33 ± 0.1 7.29 ± 0.1 .18

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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on Characteristics and prognosis of patients treated by hypothermia for an out-of-hospital cardiac arrest related to a ventricular arrhythmia in a cardiac intensive care unit of a French University Hospital

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