Abstract
Purpose
Studies suggest that the current therapeutic hypothermia (TH) protocol does not improve
outcomes in adult asphyxial arrest survivors. We sought to compare the effect of 24-hour
cooling at 33°C vs that of 72-hour cooling at 32°C on outcomes and the incidence of
adverse events in unconscious asphyxial arrest survivors.
Methods
Retrospectively collected data on 79 consecutive asphyxial arrest patients treated
with TH from January 2006 to March 2013 were analyzed. Forty-one patients who presented
between January 2006 and January 2011 formed the 33°C-24 h group, whereas 38 patients
who presented between February 2011 and March 2013 formed the 32°C-72 h group. The
primary outcome was neurologic outcome at 30 days following arrest. The secondary
outcomes were all-cause mortality at 30 days following arrest and the incidence of
adverse events.
Results
The Kaplan-Meier curve showed no significant difference in survival over time during
the 30 days after arrest between the 2 groups (P = .608). Good neurologic outcome was achieved in only 2 patients (2.5%) of the overall
cohort, despite TH. One of the 32°C-72 h group (2.6%; 95% confidence interval, 4.7%-13.5%)
had a good neurologic outcome, as did one of the 33°C-24 h group (2.4%; 95% confidence
interval, 4.3%-12.6%) (P = 1.000). There were no significant differences in the rates of adverse events between
the 2 groups.
Conclusion
The present study did not demonstrate an advantage of 72-hour cooling at 32°C in unconscious
asphyxial arrest patients compared with 24-hour cooling at 33°C.
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Article Info
Publication History
Published online: December 09, 2013
Accepted:
November 22,
2013
Received in revised form:
November 22,
2013
Received:
August 16,
2013
Footnotes
☆Funding sources/disclosures: The authors have no relevant financial information or potential conflicts of interest to disclose.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
