72-h therapeutic hypothermia improves neurological outcomes in paediatric asphyxial out-of-hospital cardiac arrest-An exploratory investigation

被引:16
|
作者
Lin, Jainn-Jim [1 ,2 ,3 ,4 ,5 ]
Lin, Chia-Ying [1 ,2 ,3 ]
Hsia, Shao-Hsuan [1 ,2 ,3 ]
Wang, Huei-Shyong [3 ,5 ]
Chiang, Ming-Chou [3 ,4 ,6 ,7 ]
Lin, Kuang-Lin [3 ,5 ]
机构
[1] Chang Gung Childrens Hosp, Div Pediat Crit Care, Taoyuan, Taiwan
[2] Chang Gung Childrens Hosp, Pediat Neurocrit Care Ctr, Taoyuan, Taiwan
[3] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Taoyuan, Taiwan
[4] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan, Taiwan
[5] Chang Gung Childrens Hosp, Div Pediat Neurol, 5 Fu Shin St, Taoyuan 333, Taiwan
[6] Chang Gung Childrens Hosp, Div Neonatol, Taoyuan, Taiwan
[7] Chang Gung Childrens Hosp, Study Grp Intens & Integrated Care Pediat Cent Ne, Taoyuan, Taiwan
关键词
72-h; Therapeutic hypothermia; Asphyxial; Paediatric; Out-of-hospital cardiac arrest; HEART-ASSOCIATION GUIDELINES; CARDIOPULMONARY-RESUSCITATION; TEMPERATURE MANAGEMENT; CHILDREN; CARE; ENCEPHALOPATHY; EPIDEMIOLOGY; 33-DEGREES-C; SURVIVAL;
D O I
10.1016/j.resuscitation.2018.08.019
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Recent studies suggest that a 48-h therapeutic hypothermia protocol does not improve outcomes in paediatric out-of-hospital cardiac arrest survivors. The aim of this study was to evaluate the effect of 72-h therapeutic hypothermia at 33 degrees C compared to normothermia at 35.5 degrees C-37.5 degrees C on outcomes and the incidence of adverse events in paediatric asphyxial out-of-hospital cardiac arrest survivors. Methods: We conducted this retrospective cohort study at a tertiary paediatric intensive care unit between January 2010 and June 2017. All children from 1 month to 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions who survived for 12 h or more after the return of circulation were eligible. Results: Sixty-four patients met the eligibility criteria for the study. Forty-nine (76.6%) of the 64 children were male, and the mean age was 4.86+/-5.26 years. Twenty-four (37.5%) of the children had underlying disorders. The overall 1-month survival rate was 43.2%. Twenty-five (39.1%) of the children received therapeutic hypothermia at 33 degrees C for 72 h. The 1-month survival rate was significantly higher (p = 0.037) in the therapeutic hypothermia group (15/25, 60%) than in the normothermia group (12/39, 30.8%). The therapeutic hypothermia group had significantly better neurological outcomes (7/15, 46.7%) than the normothermia group (1/12, 8.3%) (p = 0.043). Conclusion: Paediatric asphyxial out-of-hospital cardiac arrest was associated with high mortality and morbidity. Seventy-two-hour therapeutic hypothermia was associated with a better 1-month survival rate and 6-month neurological outcomes than normothermia in our paediatric patients with asphyxial out-of-hospital cardiac arrest.
引用
收藏
页码:180 / 186
页数:7
相关论文
共 50 条
  • [21] Effect of therapeutic hypothermia on the outcomes after out-of-hospital cardiac arrest according to initial ECG rhythm and witnessed status: A nationwide observational interaction analysis
    Choi, Sae Won
    Shin, Sang Do
    Ro, Young Sun
    Song, Kyoung Jun
    Lee, Eui Jung
    Ahn, Ki Ok
    RESUSCITATION, 2016, 100 : 51 - 59
  • [22] Factors predicting the use of therapeutic hypothermia and survival in unconscious out-of-hospital cardiac arrest patients admitted to the ICU
    Lindner, T. W.
    Langorgen, J.
    Sunde, K.
    Larsen, A. I.
    Kvaloy, J. T.
    Heltne, J. K.
    Draegni, T.
    Soreide, E.
    CRITICAL CARE, 2013, 17 (04):
  • [23] The impact of sex and age on neurological outcomes in out-of-hospital cardiac arrest patients with targeted temperature management
    Oh, Sang Hoon
    Park, Kyu Nam
    Lim, Jeeyong
    Choi, Seung Pill
    Oh, Joo Suk
    Cho, In Soo
    Lee, Byung Kook
    Kim, Yong Hwan
    Kim, Young-Min
    Kim, Han Joon
    Youn, Chun Song
    Kim, Soo Hyun
    CRITICAL CARE, 2017, 21
  • [24] Temporal Trends in the Use of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest
    Bradley, Steven M.
    Liu, Wenhui
    McNally, Bryan
    Vellano, Kimberly
    Henry, Timothy D.
    Mooney, Michael R.
    Burke, M. Nicholas
    Brilakis, Emrnanouil S.
    Grunwald, Gary K.
    Adhaduk, Mehul
    Donnino, Michael
    Girotra, Saket
    JAMA NETWORK OPEN, 2018, 1 (07)
  • [25] Therapeutic hypothermia in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest
    Lee, Oh-Hyun
    Heo, Seok-Jae
    Kim, Moon-Hyun
    Park, Je-Wook
    Bae, Sunga
    Kim, Minkwan
    Roh, Ji Woong
    Kim, Yongcheol
    Im, Eui
    Jung, In Hyun
    Cho, Deok-Kyu
    BMC MEDICINE, 2025, 23 (01):
  • [26] Extracorporeal CPR and therapeutic hypothermia for out-of-hospital cardiac arrest in a patient with congenital long QT syndrome
    Lee, Jun Wan
    Yoo, Seung Woo
    Jeong, Won Joon
    Ryu, Seung
    Yoo, Youn Ho
    Yoo, In Sool
    Park, Sang Il
    Kim, Joon Hyung
    AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2016, 34 (07) : 1321.e1 - 1321.e3
  • [27] Optimal cardiopulmonary resuscitation duration for favorable neurological outcomes after out-of-hospital cardiac arrest
    Park, SungJoon
    Lee, Sung Woo
    Han, Kap Su
    Lee, Eui Jung
    Jang, Dong-Hyun
    Lee, Si Jin
    Lee, Ji Sung
    Kim, Su Jin
    SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, 2022, 30 (01)
  • [28] Duration of prehospital and in-hospital cardiopulmonary resuscitation and neurological outcome in paediatric out-of-hospital cardiac arrest
    Yasuda, Masato
    Amagasa, Shunsuke
    Kashiura, Masahiro
    Yasuda, Hideto
    Uematsu, Satoko
    EMERGENCY MEDICINE JOURNAL, 2024, 41 (12) : 742 - 748
  • [29] Neurologic outcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia
    Kim, Won Young
    Giberson, Tyler A.
    Uber, Amy
    Berg, Katherine
    Cocchi, Michael N.
    Donnino, Michael W.
    RESUSCITATION, 2014, 85 (08) : 1042 - 1046
  • [30] Better management of out-of-hospital cardiac arrest increases survival rate and improves neurological outcome in the Swiss Canton Ticino
    Mauri, Romano
    Burkart, Roman
    Benvenuti, Claudio
    Caputo, Maria Luce
    Moccetti, Tiziano
    Del Bufalo, Alessandro
    Gallino, Augusto
    Casso, Carlo
    Anselmi, Luciano
    Cassina, Tiziano
    Klersy, Catherine
    Auricchio, Angelo
    EUROPACE, 2016, 18 (03): : 398 - 404