Therapeutic hypothermia after out of hospital cardiac arrest improve 1-year survival rate for selective patients


Autoři: Ofir Koren aff001;  Ehud Rozner aff001;  Sawsan Yosefia aff003;  Yoav Turgeman aff001
Působiště autorů: Heart Institute, Emek Medical Center, Afula, Israel aff001;  Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel aff002;  Internal Medicine C, Emek Medical Center, Afula, Israel aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0226956

Souhrn

Background

Therapeutic Hypothermia (TH) is a standard of care after out-of-hospital cardiac arrest (OHCA). Previous reports failed to prove a significant benefit for survival or neurological outcomes. We examined whether the proper selection of patients would enhance treatment efficacy.

Method

We conducted a retrospective cohort study. Data was collected from January 2000 and August 2018. Patients were enrolled after OHCA and classified into two groups, patients treated with TH and patients who were not treated with TH.

Results

A total of 92 patients were included in the study. 57 (63%) patients were in the TH Group and 34 (37%) in the Non-TH group. There was no statistical difference in favorable neurological outcomes between the groups. Patients presenting with ventricular fibrillation had a higher 1-year survival rate from TH, while patients with asystole were found to benefit only if they were younger than 65 years (p < .007, p < .02, respectively).

Conclusion

Therapeutic Hypothermia patients failed to demonstrate a significant benefit in terms of improved neurological outcomes. Patients treated with TH following ventricular fibrillation experienced the most benefit in terms of 1-year survival, while patients who had suffered from asystole experienced a modest benefit only if they were younger than 65 years of age. Guidelines should address age and primary arrhythmia for proper treatment selection.

Klíčová slova:

Arrhythmia – Cardiac arrest – Cardiology – Critical care and emergency medicine – Death rates – Hypothermia – Myocardial infarction – Sepsis


Zdroje

1. Buxton A. E., Calkins H., Callans D. J., DiMarco J. P., Fisher J. D., Greene H. L., et al. ACC/AHA/HRS 2006 key data elements and definitions for electrophysiological studies and procedures: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (ACC/AHA/HRS Writing Committee to Develop Data Standards on Electrophysiology). Circulation. 2006;114(23):2534–2570. doi: 10.1161/CIRCULATIONAHA.106.180199 17130345

2. Jolly S. S., Shenkman H., Brieger D., Fox K. A., Yan A. T., Eagle K. A., et al. Quantitative troponin and death, cardiogenic shock, cardiac arrest and new heart failure in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS): insights from the Global Registry of Acute Coronary Events. Heart, 2011;97(3):197–202. doi: 10.1136/hrt.2010.195511 21076124

3. Yang H. J., Kim G. W., Kim H., Cho J. S., Rho T. H., Yoon H. D., et al. Epidemiology and Outcomes in Out-of-hospital Cardiac Arrest: A Report from the NEDIS-Based Cardiac Arrest Registry in Korea. Journal of Korean Medical Science. 2014;30(1):95–103. doi: 10.3346/jkms.2015.30.1.95 25552889

4. Walters JH, Morley PT, Nolan JP. The role of hypothermia in post-cardiac arrest patients with return of spontaneous circulation: a systematic review. Resuscitation. 2011;82(5):508–516. doi: 10.1016/j.resuscitation.2011.01.021 21367510

5. E F, B R, SN S. Beneficial effects of hypothermia after cardiac arrest. Journal of the American Medical Association. 1960;173(5):499–501. doi: 10.1001/jama.1960.03020230025006 13822025

6. BENSON DW, WILLIAMS GR, JR, SPENCER FC YATES AJ. The use of hypothermia after cardiac arrest. Anesth Analg. 1959;38:423–428. 13798997

7. Holzer M, Bernard SA, Hachimi-Idrissi S, Roine RO, Sterz F, Mullner M. Hypothermia for neuroprotection after cardiac arrest: systematic review and individual patient data meta-analysis. Crit Care Med. 2005;33(2):414–418. doi: 10.1097/01.ccm.0000153410.87750.53 15699847

8. Dae MW, Gao DW, Sessler DI, Chair K, Stillson CA. Effect of endovascular cooling on myocardial temperature, infarct size, and cardiac output in human-sized pigs. Am J Physiol Heart Circ Physiol. 2002;282(5):H1584–91. doi: 10.1152/ajpheart.00980.2001 11959619

9. D'Cruz BJ, Fertig KC, Filiano AJ, Hicks SD, DeFranco DB, Callaway CW. Hypothermic reperfusion after cardiac arrest augments brain-derived neurotrophic factor activation. J Cereb Blood Flow Metab. 2002;22(7):843–851. doi: 10.1097/00004647-200207000-00009 12142569

10. Hicks SD, DeFranco DB, Callaway CW. Hypothermia during reperfusion after asphyxial cardiac arrest improves functional recovery and selectively alters stress-induced protein expression. J Cereb Blood Flow Metab. 2000;20(3):520–530. doi: 10.1097/00004647-200003000-00011 10724117

11. Bhattacharjee S, Baidya DK, Maitra S. Therapeutic hypothermia after cardiac arrest is not associated with favorable neurological outcome: a meta-analysis. J Clin Anesth. 2016;33:225–232. doi: 10.1016/j.jclinane.2016.03.001 27555170

12. Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott CG, Carli P, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015;95:100–147. doi: 10.1016/j.resuscitation.2015.07.016 26477701

13. Callaway CW, Soar J, Aibiki M, Böttiger BW, Brooks SC, Deakin CD, et al. Part 4: Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2015;132(16 Suppl 1):S84–145. doi: 10.1161/CIR.0000000000000273 26472860

14. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48(5):e247–346. doi: 10.1016/j.jacc.2006.07.010 16949478

15. Bernard S. Hypothermia after cardiac arrest: expanding the therapeutic scope. Crit Care Med. 2009;37(7 Suppl):S227–33. doi: 10.1097/CCM.0b013e3181aa5d0c 19535951

16. Hovdenes J, Laake JH, Aaberge L, Haugaa H, Bugge JF. Therapeutic hypothermia after out-of-hospital cardiac arrest: experiences with patients treated with percutaneous coronary intervention and cardiogenic shock. Acta Anaesthesiol Scand. 2007;51(2):137–142. doi: 10.1111/j.1399-6576.2006.01209.x 17181536

17. Nielsen N, Hovdenes J, Nilsson F, Rubertsson S, Stammet P, Sunde K, et al. Outcome, timing and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest. Acta Anaesthesiol Scand. 2009;53(7):926–934. doi: 10.1111/j.1399-6576.2009.02021.x 19549271

18. Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WG, Billi J, et al. Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation. 2003;108(1):118–121. doi: 10.1161/01.CIR.0000079019.02601.90 12847056

19. Sanders AB. Therapeutic hypothermia after cardiac arrest. Current Opinion in Critical Care. 2006;12(3). http://journals.lww.com/co-criticalcare/Fulltext/2006/06000/Therapeutic_hypothermia_after_cardiac_arrest.7.aspx.

20. Fröhlich GM, Lyon RM, Sasson C, Crake T, Whitbread M, Indermuehle A, et al. Out-of-hospital cardiac arrest -optimal management. Curr Cardiol Rev. 2013 Nov;9(4):316–24. doi: 10.2174/1573403X10666140214121152 23228073; PMCID: PMC3941096.

21. Williams GR, Spencer FC. The Clinical Use of Hypothermia Following Cardiac Arrest. Annals of Surgery. 1958;148(3):462–466. doi: 10.1097/00000658-195809000-00014 13571922

22. Merchant RM, Becker LB, Abella BS, Asch DA, Groeneveld PW. Cost-effectiveness of therapeutic hypothermia after cardiac arrest. Circ Cardiovasc Qual Outcomes. 2009;2(5):421–428. doi: 10.1161/CIRCOUTCOMES.108.839605 20031872

23. Shiozaki T, Nakajima Y, Taneda M, Tasaki O, Inoue Y, Ikegawa H, et al. Efficacy of moderate hypothermia in patients with severe head injury and intracranial hypertension refractory to mild hypothermia. J Neurosurg. 2003;99(1):47–51. doi: 10.3171/jns.2003.99.1.0047 12854743

24. Ajam K, Gold LS, Beck SS, Damon S, Phelps R, Rea TD. Reliability of the Cerebral Performance Category to classify neurological status among survivors of ventricular fibrillation arrest: a cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2011;19:38. doi: 10.1186/1757-7241-19-38 21672267

25. Steen PA, Milde JH, Michenfelder JD. The detrimental effects of prolonged hypothermia and rewarming in the dog. Anesthesiology. 1980;52(3):224–230. 7369510

26. Sterz F, Safar P, Tisherman S, Radovsky A, Kuboyama K, Oku K. Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med. 1991;19(3):379–389. doi: 10.1097/00003246-199103000-00017 1999100

27. Clifton GL, Allen S, Barrodale P, Plenger P, Berry J, Koch S, et al. A phase II study of moderate hypothermia in severe brain injury. J Neurotrauma. 1993;10(3):263–71; discussion 273. doi: 10.1089/neu.1993.10.263 8258839

28. Clifton GL, Allen S, Berry J, Koch SM. Systemic hypothermia in treatment of brain injury. J Neurotrauma. 1992;9 Suppl 2:S487–95.

29. Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med. 2001;344(8):556–563. doi: 10.1056/NEJM200102223440803 11207351

30. Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S, et al. A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. J Neurosurg. 2001;94(1):50–54. doi: 10.3171/jns.2001.94.1.0050 11147897

31. Lee JH, Wei L, Gu X, Won S, Wei ZZ, Dix TA, et al. Improved Therapeutic Benefits by Combining Physical Cooling With Pharmacological Hypothermia After Severe Stroke in Rats. Stroke. 2016;47(7):1907–1913. doi: 10.1161/STROKEAHA.116.013061 27301934

32. Dunkley S, McLeod A. Therapeutic hypothermia in patients following traumatic brain injury: a systematic review. Nurs Crit Care. 2017;22(3):150–160. doi: 10.1111/nicc.12242 27150123

33. Weinrauch V, Safar P, Tisherman S, Kuboyama K, Radovsky A. Beneficial effect of mild hypothermia and detrimental effect of deep hypothermia after cardiac arrest in dogs. Stroke. 1992 Oct;23(10):1454–62. doi: 10.1161/01.str.23.10.1454 1412583

34. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–556. doi: 10.1056/NEJMoa012689 11856793

35. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002;346(8):557–563. doi: 10.1056/NEJMoa003289 11856794


Článok vyšiel v časopise

PLOS One


2020 Číslo 1

Najčítanejšie v tomto čísle

Tejto téme sa ďalej venujú…


Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

nový kurz
Autori: MUDr. Petr Výborný, CSc., FEBO

Autori: MUDr. Jiří Horažďovský, Ph.D

Zánětlivá bolest zad a axiální spondylartritida – Diagnostika a referenční strategie
Autori: MUDr. Monika Gregová, Ph.D., MUDr. Kristýna Bubová

Krvácení v důsledku portální hypertenze při jaterní cirhóze – od pohledu záchranné služby až po závěrečný hepato-gastroenterologický pohled
Autori: PhDr. Petr Jaššo, MBA, MUDr. Hynek Fiala, Ph.D., prof. MUDr. Radan Brůha, CSc., MUDr. Tomáš Fejfar, Ph.D., MUDr. David Astapenko, Ph.D., prof. MUDr. Vladimír Černý, Ph.D.

Rozšíření možností lokální terapie atopické dermatitidy v ordinaci praktického lékaře či alergologa
Autori: MUDr. Nina Benáková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Nemáte účet?  Registrujte sa

Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa