Neurological Benefit of Therapeutic Hypothermia Following Return of Spontaneous Circulation for Out-of-Hospital Non-Shockable Cardiac Arrest
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概要
- 論文の詳細を見る
Background: Although therapeutic hypothermia is an effective therapy for comatose adults experiencing out-of-hospital shockable cardiac arrest, there is insufficient evidence that is also applicable for those with out-of-hospital non-shockable cardiac arrest. Methods and Results: Of 452 comatose adults treated with therapeutic hypothermia after return of spontaneous circulation (ROSC) subsequent to an out-of-hospital cardiac arrest of cardiac etiology, 372 who had a bystander-witnessed cardiac arrest, target core temperature of 32–34°C and cooling duration of 12–72h were eligible for this study (75 cases of non-shockable cardiac arrest, 297 cases of shockable cardiac arrest). The median collapse-to-ROSC interval was significantly longer in the non-shockable group than in the shockable group (30min vs. 22min, P=0.008), resulting in a significantly lower frequency of 30-day favorable neurological outcome in the non-shockable group compared with the shockable group (32% vs. 66%, P<0.001). However, an analysis of data in quartiles assigned to varying lengths of collapse-to-ROSC interval revealed a similar frequency of 30-day favorable neurological outcome among both groups when the collapse-to-ROSC interval was ≤16min (90% non-shockable group vs. 92% shockable group; odds ratio 0.80, 95% confidence interval 0.09–7.24, P=0.84). Conclusions: Post-ROSC cooling is an effective treatment for patients with non-shockable cardiac arrest when the time interval from collapse to ROSC is short. (Circ J 2012; 76: 2579–2585)
- 2012-10-25
著者
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Yasuga Yuji
Departmane Of Cardiology Rinku General Hospital
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NONOGI Hiroshi
National Cardiovascular Center
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Yokoyama Hiroyuki
National Cerebral and Cardiovascular Center
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Sawano Hirotaka
Senri Critical Care Medical Center, Saiseikai Senri Hospital
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Sawano Hirotaka
Senri Critical Care Medical Center Saiseikai Senri Hospital
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Kasaoka Shunji
Advanced Medical Emergency And Critical Care Center Yamaguchi University Hospital
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Nagao Ken
Department Of Cardiology Cardiopulmonary Resuscitation And Emergency Cardiovascular Care Surugadai N
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Kuroda Yasuhiro
Emergency And Critical Care Center Kagawa University Hospital
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Hase Mamoru
Emergency And Critical Care Center Sapporo City University Hospital
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HAZUI Hiroshi
Emergency Medicine, Osaka Mishima Emergency and Critical Care Center
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Kashiwase Kazunori
Division Of Cardiology Osaka Police Hospital
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Tahara Yoshio
Critical Care And Emergency Medical Center Yokohama City University Medical Center
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Shirai Shinichi
Division Of Cardiology Kokura Memorial Hospital
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Hazui Hiroshi
Emergency Medicine Osaka Mishima Emergency And Critical Care Center
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Yonemoto Naohiro
Department Of Cardiovascular Medicine National Cardiovascular Center
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Soga Taketomo
Department Of Cardiology Resuscitation And Emergency Cardiovascular Care Surugadai Nihon University Hospital
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ARIMOTO Hideki
Emergency and Critical Care Medical Center, Osaka City General Hospital
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KURODA Yasuhiro
Emergency and Critical Care Center, Kagawa University Hospital
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MOTOMURA Tomokazu
Department of Emergency Medicine, Saga University Hospital
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OTANI Takayuki
Hiroshima City Hospital
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NONOGI Hiroshi
National Cerebral and Cardiovascular Center
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SOGA Taketomo
Department of Cardiology, Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
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HASE Mamoru
Emergency and Critical Care Center, Sapporo City University Hospital
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YASUGA Yuji
Department of Cardiology, Sumitomo Hospital
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SHIRAI Shinichi
Division of Cardiology, Kokura Memorial Hospital
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YONEMOTO Naohiro
Department of Epidemiology and Biostatistics, National Center of Neurology and Psychiatry
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Yonemoto Naohiro
Department of Biostatistics, Kyoto University School of Public Health
-
Kasaoka Shunji
Advanced Medical Emergency and Critical Care Center
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