Introduction

Improved neurological outcomes have been reported after therapeutic hypothermia for comatose survivors of cardiac arrest. Therefore therapeutic hypothermia is indicated as soon as possible after resuscitation of cardiac arrest patients who are comatose or in deep sedation. The majority of these patients have significant coronary atherosclerosis and immediate angiography and primary coronary intervention is indicated. The optimal sequence of cooling and primary coronary intervention in these patients is unclear.

This report was aimed to share our experience on therapeutic hypothermia in cardiac arrest patients undergoing primary coronary intervention.

Materials and Methods

Eight consecutive comatose patients undergoing therapeutic hypotermia and primary coronary intervention were enrolled to the study. Baseline clinical characteristics and outcomes of the study population are demonstrated in Table 1. The patients were underwent primary coronary intervention and cooled to 32⁰C-34⁰C for 24 hours using infusion of cold fluids and ice packs. Rewarming was slow at a rate of 0.3-0.5°C every hour and took approximately 8 hours. Repeat measurements of glucose, K⁺ and arterial blood gas were obtained every 6 hours. Coronary angiographic results and clinical outcomes were reported.

Results

Clinical outcomes of the study population are demonstrated in Table 1. Mean duration of hospital stay was 12 days. In hospital mortality was 56, 45%. There was no arrhythmia, bleeding, metabolic disturbances nor infection complication. Shivering was observed in 4 patients and well responded to IV diazepam. Hypokalemia was reported in 2 patients and treated with IV potassium administration.