Therapeutic Hypothermia Essay

Therapeutic hypothermia in cardiac arrest has shown improved neurological outcome rate in multiple trials. Current AHA guidelines report Class 1, Level B recommendation of therapeutic hypothermia for cardiac arrest with out-of-hospital shockable rhythm while it is a Class 2b, level B recommendation for in-hospital cardiac arrest with any rhythm or out of hospital arrest with a non- shockable rhythm. In North Shore Medical Center, therapeutic hypothermia is offered to all cardiac arrest patients who do not demonstrate meaningful neurologic status post-arrest.
Methods: Observational retrospective analysis was done for all 168 patients who have undergone therapeutic hypothermia after a cardiac arrest at North Shore Medical Center since 2011. Glasgow- Pittsburgh cerebral performance category (CPC) scale was used to assess the change in the neurological outcome and functional status before and after cardiac arrest with a score of 1 …show more content…
Mean CPC score of all patients with shockable rhythm increased from 1.16 pre-arrest to 3.3 post-arrest (p<0.00001), while in the non-shockable group it increased from 1.22 pre- arrest to 4.55 post-arrest (p<0.00001). For patients who survived, CPC </=2 was seen in 70% of patients with shockable rhythm as compared to 50% of patients with non-shockable rhythm. For non-shockable cardiac arrest average time between arrest and ROSC was 10.6 minutes for patients who survived as compared to 18.8 minutes for people who didn’t survive (p<0.00001). For patients with shockable rhythms, average time between arrest and ROSC in the surviving group was 6.4 minutes as compared to 21.6 minutes in the patients who died (P<0.00001). 3.3% of patients who survived cardiac arrest due to shockable rhythm required long term ventilation support and hemodialysis versus 11.1% of patients who survived cardiac arrest with non-shockable