Neurological Benefit of Therapeutic Hypothermia Following Return of Spontaneous Circulation for Out-of-Hospital Non-Shockable Cardiac Arrest
Neurological Benefit of Therapeutic Hypothermia Following Return of Spontaneous Circulation for Out-of-Hospital Non-Shockable Cardiac Arrest
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DOI：
10.1253/circj.cj-12-0448
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发表时间：
2012-11-01
影响因子：
3.3
通讯作者：
Nonogi, Hiroshi
中科院分区：
文献类型：
--
作者：
Soga, Taketomo;Nagao, Ken;Nonogi, Hiroshi
背景：尽管治疗性低温是治疗昏迷成人院外心脏骤停的有效方法，但对于院外非休克心脏骤停的患者，尚无足够的证据也适用于院外非休克心脏骤停患者。方法和结果：在452例因心脏原因导致的心脏骤停后恢复自主循环后接受治疗性低温治疗的昏迷成年人中，有372人旁观者见证了心脏骤停，目标核心温度为32-34℃，冷却时间为12-72小时，符合本研究的条件(75例为非休克心脏骤停，297例为可休克心脏骤停)。非电击组的中位崩溃至ROSC间期显著长于电击组(30分钟对22分钟，P=0.008)，导致非电击组30天神经预后良好的机率明显低于电击组(32%对66%，P
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 degrees C and cooling duration of 12-72 h 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 (30 min vs. 22 min, 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