Early Induction of Hypothermia During Cardiac Arrest Improves Neurological Outcomes in Patients With Out-of-Hospital Cardiac Arrest Who Undergo Emergency Cardiopulmonary Bypass and Percutaneous Coronary Intervention

• DOI: 10.1253/circj.cj-09-0502
• Publication Date: 2009-12-25T06:01:47Z
• Authors: Ken Nagao; Kimio Kikushima; Kazuhiro Watanabe; Eizo Tachibana; Yoshiteru Tominaga; Katsushige Tada; Mitsuru Ishii; Nobutaka Chiba; Asuka Kasai; Taketomo Soga; Masakazu Matsuzaki; Kei Nishikawa; Yutaka Tateda; Harumi Ikeda; Tsukasa Yagi
• Keywords: Targeted temperature management

Therapeutic hypothermia for comatose survivors of out-of-hospital cardiac arrest has demonstrated neurological benefits. Although early cooling during enhances efficacy in animal studies, few clinical studies are available.The 171 patients who failed to respond conventional cardiopulmonary resuscitation were studied prospectively. Patients underwent emergency bypass (CPB) plus intra-aortic balloon pumping, with subsequent percutaneous coronary intervention (PCI) if needed. Mild (34 degrees C 3 days) was induced or after return spontaneous circulation. Of the patients, 21 (12.3%) had a favorable outcome at hospital discharge. An unadjusted rate decreased stepwise fashion increasing quartiles collapse-to-34 interval (P=0.016). adjusted odds ratio collapse-to-CPB 0.89 (95% confidence (CI) 0.82-0.97) and CPB-to-34 interval, 0.99 (95%CI 0.98-0.99) when divided into 2 components. Favorable accuracy cutoff 55.5 min 21.5 85.4% 89.5%, respectively.Early attainment core temperature benefits CPB PCI. (Circ J 2010; 74: 77 - 85).