Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study
Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study
复制标题
芬兰重症监护室院外心脏骤停后的低温治疗：FINNRESUSCI 研究
作者：
J. Vaahersalo;Pamela Hiltunen;M. Tiainen;T. Oksanen;K. Kaukonen;J. Kurola;E. Ruokonen;J. Tenhunen;T. Ala;V. Lund;M. Reinikainen;Outi Kiviniemi;T. Silfvast;M. Kuisma;T. Varpula;V. Pettilä;T. F. Group
PurposeWe旨在评估复苏后护理，实施治疗性低温（TH）和重症监护室（ICU）治疗院外心脏骤停（OHCA）患者在Finland.MethodsWe包括所有成年OHCA患者入院21 ICUs在芬兰从2010年3月1日至2011年2月28日在这项前瞻性观察性研究的结果。患者进行了随访（死亡率和神经功能的脑功能分类，CPC）1年内心脏骤停后进行评估。ResultsThis研究包括548例OHCA后治疗。其中，311例患者（56.8%）具有可电击初始心律（发生率为7.4/100，000/年），237例患者（43.2%）具有不可电击心律（发生率为5.6/100，000/年）。在ICU入院时，504例（92%）患者无意识。241/281例（85.8%）从可电击节律中复苏的无意识患者接受TH治疗，42.0%接受TH治疗的患者1年神经学结局（CPC 3-4-5）不利，而77.5%未接受TH治疗的患者1年神经学结局不利（p < 0.001）。对70/223例（31.4%）从不可电击心律复苏的无意识患者给予TH，80.6%（54/70）的TH患者1年CPC为3-4-5，而84.0%（126/153）的TH患者1年CPC为3-4-5（p = 0.56）。这种缺乏差异仍然调整后的倾向，接受TH患者non-shockable rhythms. ConclusionsOne年不利的神经系统结果TH后的可电击节律的患者低于以前的随机对照试验。然而，我们的研究结果不支持在非电击节律患者中使用TH。
PurposeWe 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.MethodsWe 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.ResultsThis 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.ConclusionsOne-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.
影响因子：
6.5
作者：
Kim, Young-Min;Yim, Hyeon-Woo;Callaway, Clifton W.
通讯作者：
Callaway, Clifton W.