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Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest
- Source :
-
Resuscitation . Apr2007, Vol. 73 Issue 1, p29-39. 11p. - Publication Year :
- 2007
-
Abstract
- Summary: Background: Mortality among patients admitted to hospital after out-of-hospital cardiac arrest (OHCA) is high. Based on recent scientific evidence with a main goal of improving survival, we introduced and implemented a standardised post resuscitation protocol focusing on vital organ function including therapeutic hypothermia, percutaneous coronary intervention (PCI), control of haemodynamics, blood glucose, ventilation and seizures. Methods: All patients with OHCA of cardiac aetiology admitted to the ICU from September 2003 to May 2005 (intervention period) were included in a prospective, observational study and compared to controls from February 1996 to February 1998. Results: In the control period 15/58 (26%) survived to hospital discharge with a favourable neurological outcome versus 34 of 61 (56%) in the intervention period (OR 3.61, CI 1.66–7.84, p =0.001). All survivors with a favourable neurological outcome in both groups were still alive 1 year after discharge. Two patients from the control period were revascularised with thrombolytics versus 30 (49%) receiving PCI treatment in the intervention period (47 patients (77%) underwent cardiac angiography). Therapeutic hypothermia was not used in the control period, but 40 of 52 (77%) comatose patients received this treatment in the intervention period. Conclusions: Discharge rate from hospital, neurological outcome and 1-year survival improved after standardisation of post resuscitation care. Based on a multivariate logistic analysis, hospital treatment in the intervention period was the most important independent predictor of survival. [Copyright &y& Elsevier]
- Subjects :
- *CRITICAL care medicine
*HYPOTHERMIA
*BODY temperature
*HEART diseases
Subjects
Details
- Language :
- English
- ISSN :
- 03009572
- Volume :
- 73
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 24302845
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2006.08.016