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01.05.2013 | Original

Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study

verfasst von: Jukka Vaahersalo, Pamela Hiltunen, Marjaana Tiainen, Tuomas Oksanen, Kirsi-Maija Kaukonen, Jouni Kurola, Esko Ruokonen, Jyrki Tenhunen, Tero Ala-Kokko, Vesa Lund, Matti Reinikainen, Outi Kiviniemi, Tom Silfvast, Markku Kuisma, Tero Varpula, Ville Pettilä, the FINNRESUSCI Study Group

Erschienen in: Intensive Care Medicine | Ausgabe 5/2013

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Abstract

Purpose

We aimed to evaluate post-resuscitation care, implementation of therapeutic hypothermia (TH) and outcomes of intensive care unit (ICU)-treated out-of-hospital cardiac arrest (OHCA) patients in Finland.

Methods

We included all adult OHCA patients admitted to 21 ICUs in Finland from March 1, 2010 to February 28, 2011 in this prospective observational study. Patients were followed (mortality and neurological outcome evaluated by Cerebral Performance Categories, CPC) within 1 year after cardiac arrest.

Results

This study included 548 patients treated after OHCA. Of those, 311 patients (56.8 %) had a shockable initial rhythm (incidence of 7.4/100,000/year) and 237 patients (43.2 %) had a non-shockable rhythm (incidence of 5.6/100,000/year). At ICU admission, 504 (92 %) patients were unconscious. TH was given to 241/281 (85.8 %) unconscious patients resuscitated from shockable rhythms, with unfavourable 1-year neurological outcome (CPC 3–4–5) in 42.0 % with TH versus 77.5 % without TH (p < 0.001). TH was given to 70/223 (31.4 %) unconscious patients resuscitated from non-shockable rhythms, with 1-year CPC of 3–4–5 in 80.6 % (54/70) with TH versus 84.0 % (126/153) without TH (p = 0.56). This lack of difference remained after adjustment for propensity to receive TH in patients with non-shockable rhythms.

Conclusions

One-year unfavourable neurological outcome of patients with shockable rhythms after TH was lower than in previous randomized controlled trials. However, our results do not support use of TH in patients with non-shockable rhythms.

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Titel: Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study
verfasst von: Jukka Vaahersalo
Pamela Hiltunen
Marjaana Tiainen
Tuomas Oksanen
Kirsi-Maija Kaukonen
Jouni Kurola
Esko Ruokonen
Jyrki Tenhunen
Tero Ala-Kokko
Vesa Lund
Matti Reinikainen
Outi Kiviniemi
Tom Silfvast
Markku Kuisma
Tero Varpula
Ville Pettilä
the FINNRESUSCI Study Group
Publikationsdatum: 01.05.2013
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 5/2013
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-2868-1

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Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study