scholarly journals Improved Survival with Therapeutic Hypothermia after Cardiac Arrest with Cold Saline and Surfacing Cooling: Keep It Simple

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Cristina Granja ◽  
Pedro Ferreira ◽  
Orquídea Ribeiro ◽  
João Pina
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Hospital Mortality ◽  
General Hospital ◽  
Therapeutic Hypothermia ◽  
Mild Therapeutic Hypothermia ◽  
Saline Infusion ◽  
Surface Cooling ◽  
Cold Saline

Aim. To evaluate whether the introduction of a therapeutic hypothermia (TH) protocol consisting of cold saline infusion and surface cooling would be effective in targeting mild therapeutic hypothermia (32–34∘C). Additionally, to evaluate if TH would improve survival after cardiac arrest.Design. Before-after design.Setting. General Intensive Care Unit (ICU) at an urban general hospital with 470 beds.Patients and Methods. Patients admitted in the ICU after cardiac arrest between 2004 and 2009 were included. Effectiveness of the TH protocol to achieve the targeted temperature was evaluated. Hospital mortality was compared before (October 2004–March 2006) and after (April 2006–September 2009) the protocol implementation.Results. Hundred and thirty patients were included, 75 patients were not submitted to TH (before TH group), and 55 were submitted to TH (TH group). There were no significant differences concerning baseline, ICU, and cardiac arrest characteristics between both groups. There was a significant reduction in hospital mortality from 61% () in the before TH group to 40% () in the TH group.Conclusion. Our protocol consisting of cold saline infusion and surface cooling might be effective in inducing and maintaining mild therapeutic hypothermia. TH achieved with this protocol was associated with a significant reduction in hospital mortality.

scholarly journals Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry)

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Anjala Chelvanathan ◽  
David Allen ◽  
Hilary Bews ◽  
John Ducas ◽  
Kunal Minhas ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Renal Insufficiency ◽  
Hospital Mortality ◽  
Therapeutic Hypothermia ◽  
Cardiac Catheterization ◽  
Tertiary Care ◽  
Mild Therapeutic Hypothermia ◽  
Neurologic Outcome ◽  
Critically Ill Patient ◽  
Bystander Cpr

Objective.Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization.Design.A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined.Results.The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, andp= 0.009).Conclusion.Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA.

Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality*

2011 ◽  
Vol 39 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Greetje van der Wal ◽  
Sylvia Brinkman ◽  
Laurens L. A. Bisschops ◽  
Cornelia W. Hoedemaekers ◽  
Johannes G. van der Hoeven ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Therapeutic Hypothermia ◽  
Mild Therapeutic Hypothermia

Trends in Therapy and Outcomes Associated With Respiratory Failure in Patients Admitted to the Cardiac Intensive Care Unit

2021 ◽  
pp. 088506662110034
Author(s):  
Jacob C. Jentzer ◽  
Carlos L. Alviar ◽  
P. Elliott Miller ◽  
Thomas Metkus ◽  
Courtney E. Bennett ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Temporal Trends ◽  
Invasive Ventilation ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care ◽  
Over Time

Purpose: To describe the epidemiology, outcomes, and temporal trends of respiratory failure in the cardiac intensive care unit (CICU). Materials and Methods: Retrospective cohort analysis of 2,986 unique Mayo Clinic CICU patients from 2007 to 2018 with respiratory failure. Temporal trends were analyzed, along with hospital and 1-year mortality. Multivariable logistic regression was used to determine adjusted hospital mortality trends. Results: The prevalence of respiratory failure in the CICU increased from 15% to 38% during the study period ( P < 0.001 for trend). Among patients with respiratory failure, the utilization of invasive ventilation decreased and noninvasive ventilation modalities increased over time. Hospital mortality and 1-year mortality were 24% and 54%, respectively, with variation according to the type of respiratory support (highest among patients receiving invasive ventilation alone: 35% and 46%, respectively). Hospital mortality was highest among patients with concomitant cardiac arrest and/or shock (52% for patients with both). Hospital mortality decreased in the overall population from 35% to 25% ( P < 0.001 for trend), but was unchanged among patients receiving positive-pressure ventilation. Conclusions: The prevalence of respiratory failure in CICU more than doubled during the last decade. The use of noninvasive respiratory support increased, while overall mortality declined over time. Cardiac arrest and shock accounted for the majority of deaths. Further research is needed to optimize the outcomes of high-risk CICU patients with respiratory failure.

Sign in / Sign up

Export Citation Format

Share Document