Abstract
Introduction. Post-resuscitation care is regulated by international guidelines. A milestone of these is the application of therapeutic hypothermia (TH). The aims of our study were: to determine the 30-day-mortality for our patients, to monitor the efficacy and effects of TH, and to investigate serum protein S100B – as an early prognostic marker.Materials and Methods. In our study, 57 patients, treated after cardiopulmonary resuscitation (CPR) on a multidisciplinary intensive care unit, were included. Patients were divided into groups who received and who didn’t receive TH. 30-day-mortality was determined as an end-point. Effects of TH were monitored using statistical analysis according to clinical parameters and laboratory tests. Serum protein S100B levels were measured with ELISA technique on 20 randomised patients atadmission and the 1st, 3rd and 5th day after CPR. Results. Total 30-day-mortality was 74%. TH did not reduced the 30-day-mortality (73% vs. 74%, p>0.05). We found a significant correlation between TH and serum lactate concentration after admission (0h,p=0.006) and at 12 (p=0.045) and 36 (p=0.049) hours after CPR. On the3rd (p=0.005) and 4th (p=0.043) day after CPR, as a result of TH, platelet count was significantly higher compared to normothermic samples. There was no significant difference in protein S100B levels between the normothermic and TH group and protein S100B levels did not correlate with 30-day-mortality.Conclusion. Despite recommendations of international guidelines, we cannot prove the beneficial effect of TH, or a correlation of protein S100B levels with a positive outcome.
Highlights
Post-resuscitation care is regulated by international guidelines
We found a significant correlation between therapeutic hypothermia (TH) and serum lactate concentration after admission (0h, p=0.006) and at 12 (p=0.045) and 36 (p=0.049) hours after cardiopulmonary resuscitation (CPR)
After cardiopulmonary resuscitation (CPR) the rate of the return of spontaneous circulation (ROSC) is 25-50%, but the chance that patients survive without neurological deficit is less than 10%. [1] CPR is regulated by international guidelines
Summary
Post-resuscitation care is regulated by international guidelines. In developed countries the major cause of out-of-hospital sudden death is cardiac arrest with a survival rate of 5-35%. After cardiopulmonary resuscitation (CPR) the rate of the return of spontaneous circulation (ROSC) is 25-50%, but the chance that patients survive without neurological deficit is less than 10%. [5] Since the 1950s, moderate hypothermia has been used in cardiac surgery to prevent cerebral ischaemia. It was applied after cardiac arrest (CA), but has been stopped due to unclear benefits. [6] Therapeutic hypothermia (TH) after ROSC has been recommended by the International Liaison Committee on Resuscitation (ILCOR) since 2003 and by the European Resuscitation It was applied after cardiac arrest (CA), but has been stopped due to unclear benefits. [6] Therapeutic hypothermia (TH) after ROSC has been recommended by the International Liaison Committee on Resuscitation (ILCOR) since 2003 and by the European Resuscitation
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