Pyrexia and neurologic outcomes after therapeutic hypothermia for cardiac arrest

Resuscitation ◽  
2013 ◽  
Vol 84 (8) ◽  
pp. 1056-1061 ◽  
Author(s):  
Marion Leary ◽  
Anne V. Grossestreuer ◽  
Stephen Iannacone ◽  
Mariana Gonzalez ◽  
Frances S. Shofer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Neurologic Outcomes

Continuous electroencephalogram patterns are suggestive of eventual neurologic outcomes in post–cardiac arrest patients treated with therapeutic hypothermia

2015 ◽  
Vol 30 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Dermot Maher ◽  
Huy Tran ◽  
Miriam Nuno ◽  
Dawn Eliashiv ◽  
Taizoon Yusufali ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Neurologic Outcomes

Abstract 211: Enteral Feeding Shortly After Cardiac Arrest Treated With Veno-Arterial Extra Corporeal Membrane Oxygenation and Therapeutic Hypothermia is Safe and Feasible

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Alejandra Gutierrez ◽  
Claire Carlson ◽  
Demetris Yannopoulos ◽  
Jason A Bartos
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Enteral Feeding ◽  
Adverse Outcomes ◽  
University Of Minnesota ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Early Enteral Feeding ◽  
Neurologic Outcomes ◽  
Va Ecmo

Introduction: Literature regarding the timing and safety of enteral feeding after cardiac arrest treated with therapeutic hypothermia and veno-arterial extra corporeal membrane oxygenation (VA-ECMO) is lacking. Aim: To describe the safety and feasibility of early enteral feeding in adult patients presenting with refractory out-of-hospital cardiac arrest treated with VA ECMO and therapeutic hypothermia. Methods: We performed a retrospective analysis of the enteral feeding patterns for patients admitted through the University of Minnesota ECPR program for refractory ventricular tachycardia or fibrillation (VT/VF). Outcomes were compared in patients with early enteral feeding initiation (within 2 days of admission) versus those with delayed enteral feeding (>2 days after admission). Results: The study included 108 consecutive patients (age 56.3+/-12.2 years, 78% male) admitted to the CICU between December 2015 and February 2019. Average CPR duration was 62.8+/-15.3min. Enteral feeding was initiated in 68(62.9%) of the sample. Enteral feeding was not started in patients expected to die within 48 hours of ICU admission. All patients underwent therapeutic hypothermia and 97.2% received neuromuscular blockade. Time to enteral feeding initiation ranged from 1 to 11 days post admission. Patients who had enteral feeding started within the first two days (43%) had similar rates of feeding interruption, (with 40% of cases in the setting of a surgical procedure or family request), gut ischemia, ileus and ventilator associated pneumonia (Table 1). Mortality and neurologic outcomes were not affected by timing of enteral feeding initiation. Conclusion: Initiation of enteral feeding within the first two days of presentation was not associated with adverse outcomes in patients with refractory cardiac arrest treated with prolonged CPR, VA ECMO, and therapeutic hypothermia.

Magnesium Levels and Neurologic Outcomes in Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest

2018 ◽  
Vol 8 (1) ◽  
pp. 14-17 ◽  
Author(s):  
William H. Perucki ◽  
Brett Hiendlmayr ◽  
David M. O'Sullivan ◽  
Angeline C. Gunaseelan ◽  
Farruk Fayas ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Neurologic Outcomes

Mild Therapeutic Hypothermia to Improve the Neurologic Outcome after Cardiac Arrest

2018 ◽  
pp. 3-8
Author(s):  
Ala Nozari
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Standard Care ◽  
Important Variable ◽  
Mild Therapeutic Hypothermia ◽  
Target Temperature ◽  
Neurologic Recovery ◽  
Neurologic Outcomes ◽  
Study Intervention

This chapter provides a summary of the landmark study known as the HACA Trial. Does mild therapeutic hypothermia improve neurologic outcomes compared with standard care normothermia in patients surviving ventricular fibrillation or pulseless ventricular tachycardic arrest? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. Among the results, the preponderance of data suggests that temperature is an important variable for neurologic recovery after cardiac arrest. Guidelines suggest maintaining a target temperature between 32ºC and 36ºC for at least 24 hours after achieving target temperature. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

scholarly journals The impact of therapeutic hypothermia in elderly out-of-hospital cardiac arrest: A multicenter retrospective observational propensity-matched study

2019 ◽  
pp. 102490791989049
Author(s):  
Jeong Ho Park ◽  
Seung Pill Choi ◽  
Kyu Nam Park ◽  
Yoo Dong Son ◽  
Hoon Lim ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Propensity Score ◽  
Adverse Events ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Therapeutic Hypothermia ◽  
Neurologic Outcomes ◽  
Significant Difference ◽  
The Impact ◽  
Hospital Cardiac Arrest

Background: The therapeutic hypothermia protocol for out of hospital cardiac arrest is not standardized and the decision to apply therapeutic hypothermia relies on a physician’s judgment. Elderly patients who rely on this judgment are less likely to receive therapeutic hypothermia. Objectives: This study aimed to provide an analysis of the impact and utility of therapeutic hypothermia on elderly out of hospital cardiac arrest. Methods: This was a multicenter, retrospective, observational, registry-based study from 2007 to 2012. Adults who suffered out-of-hospital cardiac arrest and were treated with therapeutic hypothermia were included. We divided the patients into a group of elderly patients 65 years or older and a group of young adults under 65 years old and compared the neurologic outcomes and adverse events after one-to-one matching by propensity score. Results: In total, 930 patients were enrolled in the study. Among these patients, 343 were ⩾65 years, while 587 were <65 years. Of the adverse events in therapeutic hypothermia, hyperglycemia (51.31%), hypotension (41.98%) during cooling was more frequent in aged ⩾65 years and rebound hyperthermia (7.14%) and hypotension (29.93%) during rewarming. After propensity score matching was applied to all subjects of the study, 247 matched pairs of patients were available. The two groups showed no statistically significant difference in the adverse events during therapeutic hypothermia. Conclusion: Elderly patients exhibited a decreased survival to hospital discharge and good neurologic outcomes. The two groups showed no differences in the frequency of adverse events during therapeutic hypothermia, when comparing in a propensity score matching cohort analysis.

scholarly journals Therapeutic Hypothermia and Out-of-Hospital Cardiac Arrest in a Child with Hypertrophic Obstructive Cardiomyopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Nancy Spurkeland ◽  
Gregory Bennett ◽  
Chandran Alexander ◽  
Dennis Chang ◽  
Gary Ceneviva
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Therapeutic Hypothermia ◽  
Positive Outcome ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Early Initiation ◽  
National Guidelines ◽  
Positive Effects ◽  
Neurologic Outcomes ◽  
Hospital Cardiac Arrest

Neurologic outcomes following pediatric cardiac arrest are consistently poor. Early initiation of cardiopulmonary resuscitation has been shown to have positive effects on both survival to hospital discharge, and improved neurological outcomes after cardiac arrest. Additionally, the use of therapeutic hypothermia may improve survival in pediatric cardiac arrest patients admitted to the intensive care unit. We report a child with congenital hypertrophic obstructive cardiomyopathy and an out-of-hospital cardiac arrest, in whom the early initiation of effective prolonged cardiopulmonary resuscitation and subsequent administration of therapeutic hypothermia contributed to a positive outcome with no gross neurologic sequelae. Continuing efforts should be made to promote and employ high-quality cardiopulmonary resuscitation, which likely contributed to the positive outcome of this case. Further research will be necessary to develop and solidify national guidelines for the implementation of therapeutic hypothermia in selected subpopulations of children with OHCA.

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