Does induction of hypothermia improve outcomes after in-hospital cardiac arrest?
Does induction of hypothermia improve outcomes after in-hospital cardiac arrest?
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DOI：
10.1016/j.resuscitation.2012.12.009
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发表时间：
2013-05-01
期刊：
影响因子：
6.5
通讯作者：
Callaway, Clifton W.
中科院分区：
文献类型：
--
作者：
Nichol, Graham;Huszti, Ella;Callaway, Clifton W.
简介：与常温相比，低温可改善院外室颤复苏后的神经功能恢复，但对院内心脏骤停复苏的患者可能有益，也可能无益。因此，我们评估了诱导低温在一个大的队列的患者在医院心脏骤停。方法：回顾性分析多中心前瞻性队列的患者在医院心脏骤停参加了一个正在进行的质量改进项目。纳入了在2000年至2009年期间在参与机构的住院病房中发生无脉事件并恢复自主循环的成人。感兴趣的暴露是诱导的低温。主要结局是存活至出院。次要结局是出院时的神经系统状态。分析评估了所有符合条件的患者;具有可电击心律的患者;或复苏后插入气管内导管的患者;以及无低温与低温（最低温度>32摄氏度，
Introduction: Hypothermia improves neurologic recovery compared to normothermia after resuscitation from out-of-hospital ventricular fibrillation, but may or may not be beneficial for patients resuscitated from in-hospital cardiac arrest. Therefore, we evaluated the effect of induced hypothermia in a large cohort of patients with in-hospital cardiac arrest.Methods: Retrospective analysis of multi-center prospective cohort of patients with in-hospital cardiac arrest enrolled in an ongoing quality improvement project. Included were adults with a pulseless event in an in-patient hospital ward of a participating institution who achieved restoration of spontaneous circulation between 2000 and 2009. The exposure of interest was induced hypothermia. The primary outcome was survival to discharge. The secondary outcome was neurological status at discharge. Analyses evaluated all eligible patients; those with a shockable rhythm; or those with endotracheal tube inserted after resuscitation; and the effect of no hypothermia versus hypothermia (lowest temperature >32 degrees C but