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Is Hypothermia After Cardiac Arrest Effective in Both Shockable and Nonshockable Patients?: Insights From a Large Registry

Open access
Dumas, Florence, Grimaldi, David, Zuber, Benjamin, Fichet, Jérôme, Charpentier, Julien, Pène, Frédéric, Vivien, Benoît, Varenne, Olivier, Carli, Pierre, Jouven, Xavier, Empana, Jean-Philippe, Cariou, Alain·2011·Circulation

Abstract

Background—: Although the level of evidence of improvement is significant in cardiac arrest patients resuscitated from a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia [VF/V t ]), the use of therapeutic mild hypothermia (TMH) is more controversial in nonshockable patients (pulseless electric activity or asystole [PEA/asystole]). We therefore assessed the prognostic value of hypothermia for neurological outcome at hospital discharge according to first-recorded cardiac rhythm in a large cohort. Methods and Results—: Between January 2000 and December 2009, data from 1145 consecutive out-of-hospital cardiac arrest patients in whom a successful resuscitation had been achieved were prospectively collected. The association of TMH with a good neurological outcome at hospital discharge (cerebral performance categories level 1 or 2) was quantified by logistic regression analysis. TMH was induced in 457/708 patients (65%) in VF/V t and in 261/437 patients (60%) in PEA/asystole. Overall, 342/1145 patients (30%) reached a favorable outcome (cerebral performance categories level 1 or 2) at hospital discharge, respectively 274/708 (39%) in VF/V t and 68/437 (16%) in PEA/asystole ( P <0.001). After adjustment, in VF/V t patients, TMH was associated with increased odds of good neurological outcome (adjusted odds ratio, 1.90; 95% confidence interval, 1.18 to 3.06) whereas in PEA/asystole patients, TMH was not significantly associated with good neurological outcome (adjusted odds ratio, 0.71; 95% confidence interval, 0.37 to 1.36). Conclusions—: In this large cohort of cardiac arrest patients, hypothermia was independently associated with an improved outcome at hospital discharge in patients presenting with VF/V t . By contrast, TMH was not associated with good outcome in nonshockable patients. Further investigations are needed to clarify this lack of efficiency in PEA/asystole.

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Metadata

Authors
Dumas, F., Grimaldi, D., Zuber, B., Fichet, J., Charpentier, J., Pène, F., Vivien, B., Varenne, O., Carli, P., Jouven, X., Empana, J.-P., & Cariou, A.
Venue
Circulation
Published
2011-03
Volume
123
Issue
8
Pages
877-886
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2023125079
Cited by
296
References
24
FWCI
45.76
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Is Hypothermia After Cardiac Arrest Effective in Both Shockable and Nonshockable Patients?: Insights From a Large Registry. https://app.cochat.ai/papers/10.1161/circulationaha.110.987347
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Dumas, F., Grimaldi, D., Zuber, B., Fichet, J., Charpentier, J., Pène, F., Vivien, B., Varenne, O., Carli, P., Jouven, X., Empana, J.-P., & Cariou, A. (2011). Is Hypothermia After Cardiac Arrest Effective in Both Shockable and Nonshockable Patients?: Insights From a Large Registry. Circulation. https://doi.org/10.1161/circulationaha.110.987347

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