open access

Vol 9, No 4 (2014)
Original Papers
Published online: 2014-12-22
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Mild therapeutic hypothermia after cardiac arrest due to acute coronary syndrome — experience from the implementation of the method

Katarzyna Ciuraszkiewicz, Agnieszka Janion-Sadowska, Janusz Sielski
Folia Cardiologica 2014;9(4):327-336.

open access

Vol 9, No 4 (2014)
Original Papers
Published online: 2014-12-22

Abstract

Introduction. A mild therapeutic hypothermia (MTH) is a promising adjunct treatment in patients suffering from cardiac arrest.

Material and methods. In 2012–2013 a 13 out of 216 consecutive patients admitted due to cardiac arrest were qualified to MTH. Cooling was started at the admission with the intravenous infusion of saline at a degree of 4°C, then continued with intravascular automated cooling system.

Results. The study group consisted of five women and eight men (mean age 59 years). The most common mechanism of cardiac arrest was ventricular fibrillation or ventricular tachycardia due to acute myocardial infarction (92.3%). The mean time of return of spontaneous circulation (ROSC) was 15 min 54 s. The mean time from cardiac arrest to the start of the cooling was 1h 10 min. During MTH an increase in white blood cell count and serum level of amylase and CRP was observed. The in-hospital mortality was 7/13 patients (53.8%). Patients who survived were younger (53.8 vs. 63.6 years), had lower incidence of coronary artery disease and ventricular fibrillation was the mechanism of cardiac arrest. In addition, patients who survived had prolonged time to ROSC (median time 19 min vs. 13 min) and reduced time: to the start of cold saline infusion (median time 58 min vs. 85 min), from cardiac arrest to the beginning of the intravascular cooling (median time 3 h 20 min vs. 3 h 50 min) and hospital stay (median time 471 h vs. 1232 h) in comparison with patients with fatal outcome. Five patients were discharged from the hospital in a good neurological condition (4 patients — 0 points and 1 patient — 1 point in Rankin scale).

Conclusions. All the patients who survived and were treated with MTH, were discharged in a good neurological condition. The implementation of endovascular cooling device greatly improves precise temperature control in patients undergoing MTH.Mild therapeutic hypothermia after cardiac arrest due to ACS.

Abstract

Introduction. A mild therapeutic hypothermia (MTH) is a promising adjunct treatment in patients suffering from cardiac arrest.

Material and methods. In 2012–2013 a 13 out of 216 consecutive patients admitted due to cardiac arrest were qualified to MTH. Cooling was started at the admission with the intravenous infusion of saline at a degree of 4°C, then continued with intravascular automated cooling system.

Results. The study group consisted of five women and eight men (mean age 59 years). The most common mechanism of cardiac arrest was ventricular fibrillation or ventricular tachycardia due to acute myocardial infarction (92.3%). The mean time of return of spontaneous circulation (ROSC) was 15 min 54 s. The mean time from cardiac arrest to the start of the cooling was 1h 10 min. During MTH an increase in white blood cell count and serum level of amylase and CRP was observed. The in-hospital mortality was 7/13 patients (53.8%). Patients who survived were younger (53.8 vs. 63.6 years), had lower incidence of coronary artery disease and ventricular fibrillation was the mechanism of cardiac arrest. In addition, patients who survived had prolonged time to ROSC (median time 19 min vs. 13 min) and reduced time: to the start of cold saline infusion (median time 58 min vs. 85 min), from cardiac arrest to the beginning of the intravascular cooling (median time 3 h 20 min vs. 3 h 50 min) and hospital stay (median time 471 h vs. 1232 h) in comparison with patients with fatal outcome. Five patients were discharged from the hospital in a good neurological condition (4 patients — 0 points and 1 patient — 1 point in Rankin scale).

Conclusions. All the patients who survived and were treated with MTH, were discharged in a good neurological condition. The implementation of endovascular cooling device greatly improves precise temperature control in patients undergoing MTH.Mild therapeutic hypothermia after cardiac arrest due to ACS.

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Keywords

mild therapeutic hypothermia, cardiac arrest, acute coronary syndrome

About this article
Title

Mild therapeutic hypothermia after cardiac arrest due to acute coronary syndrome — experience from the implementation of the method

Journal

Folia Cardiologica

Issue

Vol 9, No 4 (2014)

Pages

327-336

Published online

2014-12-22

Bibliographic record

Folia Cardiologica 2014;9(4):327-336.

Keywords

mild therapeutic hypothermia
cardiac arrest
acute coronary syndrome

Authors

Katarzyna Ciuraszkiewicz
Agnieszka Janion-Sadowska
Janusz Sielski

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