Safety, Feasibility, and Outcomes of Induced Hypothermia Therapy Following In-Hospital Cardiac Arrest—Evaluation of a Large Prospective Registry*

Dankiewicz, Josef; Nielsen, Niklas; Kern, Karl B.; Mooney, M.; Stammet, Pascal; Riker, Richard R.; Rubertsson, Sten; Seder, David B.; Šmíd, Ondřej; Sunde, Kjetil; Søreide, Eldar; Unger, Barbara; Friberg, Hans

doi:10.1097/ccm.0000000000000543

Cited by 33 publications

(14 citation statements)

References 44 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The proportions of shockable and non-shockable rhythms in IHCA patients vary substantially in other reports due to differences in patient populations and settings 8,11,15,16,19,20. Still, the proportions of VF and asystole in IHCA patients are comparable to that reported in a recent study conducted in a setting similar to the present analysis 21. Time to ROSC was short not only for IHCA patients but also for OHCA patients due to the highly effective EMS covering the Copenhagen area 22…”

Section: Discussionsupporting

confidence: 79%

Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

Engsig

Søholm

Folke

et al. 2016

CLEP

View full text Add to dashboard Cite

ObjectiveThe long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM.Design, setting, and patientsRetrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed.MeasurementsPrimary endpoints were survival to hospital discharge and long-term survival. Secondary endpoint was neurological outcome assessed using the Pittsburgh cerebral performance category (CPC).ResultsA total of 282 patients were included in this study; 233 (83%) OHCA and 49 (17%) IHCA. The IHCA group presented more often with asystole, received bystander cardiopulmonary resuscitation (CPR) in all cases, and had shorter time to return of spontaneous circulation (ROSC). Survival to hospital discharge was 54% for OHCA and 53% for IHCA (adjusted odds ratio 0.98 [95% confidence interval {CI}; 0.43–2.24]). Age ≤60 years, bystander CPR, time to ROSC ≤10 min, and shockable rhythm at presentation were associated with survival to hospital discharge. Good neurologic outcome among survivors was achieved by 86% of OHCA and 92% of IHCA (P=0.83). After a median follow-up time of >5 years, 83% of OHCA and 77% of IHCA were alive (adjusted hazard ratio [HR] 1.51 [95% CI; 0.59–3.91]). Age ≤60 years was the only factor associated with long-term survival (adjusted HR 2.73 [95% CI; 1.36–5.52]).ConclusionThere was no difference in short- and long-term survival and no difference in neurologic outcome to hospital discharge between IHCA and OHCA patients treated with TTM despite higher frequency of asystole in IHCA.

show abstract

Section: Discussionsupporting

confidence: 79%

Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

Engsig

Søholm

Folke

et al. 2016

CLEP

View full text Add to dashboard Cite

show abstract

“…Thus, Starodub et al failed to find an association between initial lactate levels and neurological prognosis but they included a significant proportion of in-hospital cardiac arrest patients (IHCA) [11]. Despite the absence of study comparing specifically IHCA to out-of-hospital counterpart, we presume these 2 populations are different as reported by recent studies [4,20]. In-hospital cardiac arrest patients presented more comorbidity, higher percentages of cardiac origin and shockable rhythm, and a shorter downtime.…”

Section: Discussionmentioning

confidence: 90%

Association of serum lactate with outcome after out-of-hospital cardiac arrest treated with therapeutic hypothermia

et al. 2017

View full text Add to dashboard Cite

AimsLactate reflects hypoxic insult in many conditions and is considered as a prognosis factor. But, after cardiac arrest, its interest is still debated. Our study aimed to assess the prognosis value of lactate in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia.MethodsThis retrospective observational study included out-of-hospital cardiac arrest patients treated with therapeutic hypothermia in four ICUs. Lactate levels were compared at different times during the first 24 hours according to outcome at ICU discharge and to the type of death (multiorgan or neurologic failure).ResultsTwo hundred and seventy-two patients were included, 89 good outcome and 183 poor outcome. In the latter group, 171 patients died, from multiorgan failure in 30% and neurologic failure in 70%. Lactate levels were higher in the poor compared to the good outcome patients at admission (5.4 (3.3–9.4) vs. 2.2 (1.5–3.6) mmol/L; p<0.01), 12 hours (2.5 (1.6–4.7) vs. 1.4 (1.0–2.2) mmol/L; p<0.01) and 24 hours (1.8 (1.1–2.8) vs. 1.3 (0.9–2.1) mmol/L; p<0.01). Patients succumbing from multiorgan failure exhibited higher lactate levels compared to those dying from neurologic failure at admission (7.9 (3.9–12.0) vs. 5.2 (3.3–8.8) mmol/L; p<0.01), H12 (4.9 (2.1–8.9) vs. 2.2 (1.4–3.4) mmol/L; p<0.01) and H24 (3.3 (1.8–5.5) vs. 1.4 (1.1–2.5) mmol/L; p<0.01). Initial lactate levels showed an increasing proportion of poor outcome from the first to fourth quartile.ConclusionsAfter out-of-hospital cardiac arrest treated with therapeutic hypothermia, lactate levels during the first 24 hours seem linked with ICU outcome. Patients dying from multiorgan failure exhibit higher initial lactate concentrations than patients succumbing from neurological failure.

show abstract

“…Zaobserwowana zależność między wiekiem pacjenta a rokowaniem po NZK jest podobna do występującej w innych badaniach [11,18]. Warto jednak zwrócić uwagę, że autorzy analizujący okoliczności wpływające na rokowanie po NZK, zwracają uwagę na znaczniejszą rolę innych czynników niż wiek chorego.…”

Section: Dyskusjaunclassified

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Adamski¹,

Nowakowski²,

Goryński³

et al. 2016

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Background: In-hospital cardiac arrest with its poor prognosis is a challenging problem in hospitals. The aim of this study was to evaluate in Polish hospitals the frequency of in-hospital cardiac arrests with the subsequent mortality, with special emphasis on the type of unit at which the event occurred, and the patient's demographic data, such as age and sex. Methods: The study was a retrospective analysis of data for 2012 registered in the Polish General Hospital Morbidity Study. This research covered all Polish hospitals, excluding only government and psychiatric hospitals. The study inclusion criterion was the incidence of cardiac arrest in any hospital ward, recorded by the respective ICD-10 diagnosis code. Results: Of the 7,775,553 patients hospitalized, the diagnosis of cardiac arrest was reported in a total of 22,602 patients, which included 22,317 adults (98.7% of all patients) and 285 children (1.3%). Overall mortality after cardiac arrest among adults was 74.2%, and in children 46.7%. In both absolute numbers and as percentages of all documented cases, cardiac arrests occurred most often at the departments of intensive care, internal medicine, cardiology and emergency medicine. The accompanying mortal ity was lower than average at the departments of intensive care, cardiology, cardiology high dependency unit and emergency medicine. The median age of patients with cardiac arrest who died in the hospital was higher than the median age of those who survived (72 vs. 64; P < 0.05). Although cardiac arrests were reported more often among men than women (58.2% vs. 41.8%; P < 0.001), the hospital mortality was higher among women (79.2% vs. 71.6%; P < 0.001). Conclusion:The frequency of in-hospital cardiac arrests in Polish hospitals and the subsequent mortality is not substantially different from that observed in other countries. However, our study, based on ICD-10 diagnosis codes, gives only limited information about the patients and circumstances of this event. An in-depth analysis of the causes, prognoses, and outcome of in-hospital cardiac arrests could be facilitated by the creation of a national registry.

show abstract

Safety, Feasibility, and Outcomes of Induced Hypothermia Therapy Following In-Hospital Cardiac Arrest—Evaluation of a Large Prospective Registry*

Cited by 33 publications

References 44 publications

Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

Association of serum lactate with outcome after out-of-hospital cardiac arrest treated with therapeutic hypothermia

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Contact Info

Product

Resources

About