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Copyright © 2008 Published by Elsevier Ireland Ltd.
AS-098
Prediction of outcome after resuscitation from out-of-hospital ventricular fibrillation treated with therapeutic hypothermia
Survival was significantly higher in the hypothermia group (56%versus 36%), whereas no significant difference was observed in severity between the two periods. Only age, time from return to spontaneous circulation <20 min, and therapeutic hypothermia were independently associated with survival. Therapeutic hypothermia was well tolerated and was associated with a significant improvement in neurological outcome. Whereas only 23%of patients actually reached the target temperature in 2003, 100%did in 2005.
Therapeutic hypothermia is efficient in significantly improving survival and neurological outcome of out-of-hospital cardiac arrest with ventricular fibrillation. By using a simple method, it can be implemented easily and quickly, without side effects.
![]() | Comparison of 30 and the 100%inspired oxygen concentra... Resuscitation |
![]() Resuscitation, Volume 69, Issue 2, May 2006, Pages 199-206 M. Kuisma, J. Boyd, V. Voipio, A. Alaspää, R.O. Roine, P. Rosenberg Abstract SummaryObjectivesHigh oxygen concentration in blood may be harmful in the reperfusion phase after cardiopulmonary resuscitation. We compared the effect of 30 and 100%inspired oxygen concentrations on blood oxygenation and the level of serum markers (NSE, S-100) of neuronal injury during the early post-resuscitation period in humans. |
![]() | Outcome after cardiac arrest: predictive values and lim... Resuscitation |
![]() Resuscitation, Volume 65, Issue 1, April 2005, Pages 49-55 Rüdiger Pfeifer, Angelika Börner, Andreas Krack, Holger H. Sigusch, Ralf Surber, Hans R. Figulla Abstract Background and purpose:Patients resuscitated from cardiac arrest are at risk of subsequent death or poor neurological outcome up to a persistent vegetative state. We investigated the prognostic value of several epidemiological and clinical markers and two neuroproteins, neuron-specific enolase (NSE) and S-100 protein (S-100), in 97 patients undergoing cardiopulmonary resuscitation (CPR) after non-traumatic cardiac arrest between 1998 and 2002.Results:52.6%of the patients died, 28.8%survived with severe, moderate or without neurological disorders, and 18.6%remained in a persistent vegetative state. Unconsciousness >48 h after CPR predicted a 60.6-fold (95%CI 14.3287–257.205, p = 0.001) and a Glasgow Coma Scale (GCS) <6 points after 72 h a 11.2-fold (CI 95%, 3.55–36.44, p < 0.001) risk of poor neurological outcome. Serum levels ≥ 65 ng/ml for NSE and ≥ 1.5 μg/l for S-100 increased the risk of death and persistent vegetative state 16.8 (95%CI 2.146–131.520)- and 12.6 (95%CI 1.1093–99.210)-fold, respectively. By combination of the GCS with elevated serum concentrations of both neuroproteins above the cut off levels on third day after CPR a poor neurological outcome was predicted with a specificity of 100%. Conclusion:The combination of GCS with the serum levels of both neuroproteins at 72 h after CPR permit a more reliable prediction of outcome in post arrest coma than the single markers alone, independent of the application of anaesthetic agents. ![]() |
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Prediction of outcome after resuscitation from out-of-hospital ventricular fibrillation treated with therapeutic hypothermia