1 / 16

Intra-Arrest Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest: A Comprehensive Review

Explore the benefits of intra-arrest hypothermia on ROSC, survival, and neurological outcomes in cardiac arrest patients. Review key studies and discuss implications for clinical practice. Learn about the safety and feasibility of this intervention. Considerations for implementation. For more information, refer to the provided references.

felipelopez
Download Presentation

Intra-Arrest Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest: A Comprehensive Review

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Intra-arrest therapeutische hypothermie Fabienne Roossien, AIOS SEH Regionaal refereren 18-07-2013

  2. Inhoud • Achtergrond • Search • Studies • Conclusie • Discussie • THM

  3. Achtergrond • Dierstudies: • Intra-arrest TH 1-4: • betere kans op ROSC & survival • betere neurologische uitkomst • Veilig, uitvoerbaar 5-7 • Effect mensen?

  4. Search

  5. Search • Medline/CINAHL: • Intra-arr*/ intra arr* AND hypothermia • 27 hits => 2 relevant • Embase • Therapeutic/Induced hypothermia AND intra-arrest • 63 hits=> 6 relevant, 3 cf. pubmed, 3 abstracts (2 AHA congres 2011; 1 Critical Care congres 2011)

  6. Artikelen • Castren et al.Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC intranasal cooling effectiveness).Circulation 2010; 122: 729-736 • Garret et al.The association between intra-arrest therapeutic hypothermia and return of spontaneous circulation among individuals experiencing out of hospital cardiac arrestResuscitation 82 (2011) 21–25

  7. Abstracts • J. FreeseIntra-arrest induction of therapeutic hypothermia via large-volume ice-cold saline infusion improves immediate outcomes for out-of-hospital cardiac arrestIntra-arrest induction of therapeutic hypothermia via large-volume, ice-cold saline infusion results in improved outcomes among out-of-hospital cardiac arrests of cardiac etiologyCirculation 2011 124: A97& A2 • Castren et al.Earlier intra-arrest transnasal cooling may be beneficialCritical care 2011, 15(suppl):P303

  8. Conclusie studies • IATH middels infusie/transnasaal • Veilig en haalbaar • Trend naar meer ROSC, • Wschl. ook meer survival en betere neurologie • M.n. bij snelle start CPR en snelle start IATH

  9. Discussie • Beperkte humane studies • Abstracts veelbelovend, grote aantallen, nog niet uitgewerkt • Meer ROSC bij IATH • Relatie ROSC-survival-neurologie nog niet bewezen • Meer RCT’s nodig met primaire doel survival/ neurologie

  10. THM • O.b.v. eerder onderzoek: • geen adverse events, IATH haalbaar, neiging naar meer ROSC • Positief effect • Echter: veilig en haalbaar, dus… • Keep it cool & fast!

  11. Vragen?

  12. Referenties • Nozari et al. Critical time window for intra-arrest cooling with cold-saline flush in a dog model of CPR Circulation 2006; 113; 2690-6 • Zhao et al. Intra-arrest cooling with delayed reperfusion yields higher survival than earier normothermic resuscitatoion in a mouse-model. Resuscitation 2008; 77:242-9 • Abella et al. Intra-arrest cooling improves outcomes in a murine cardiac arrest model. Circulation 2004; 109:2786-91 • Menegazzi et al Effects of pre-arrest and intra-arrest hypothermia on ventricular defirillation and resuscitation Resuscitation 2009; 80:126-32 • Bernard et al. Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 2003, 56:9-13. • Kim F et al. Pilot randomized clinical trial of prehospital induction of mild hypothermia in out-ofhospital cardiac arrest patients with a rapid infusion of 4 degrees C normal saline. Circulation 2007, 115:3064-3070. • Virkkunen I et al. Induction of therapeutic hypothermia after cardiac arrest in prehospital patients using ice-cold Ringer's solution: a pilot study. Resuscitation 2004, 62:299-302. • Castren et al. Intra-arrest transnasalevaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC intranasal cooling effectiveness). Circulation 2010; 122: 729-736 • Garret et al. The association between intra-arrest therapeutic hypothermia and return of spontaneous circulation among individuals experiencing out of hospital cardiac arrest Resuscitation 82 (2011) 21–25 • Scolletta et al. Intra-arrest hypothermia during cardiac arrest: a systematic review. Critical Care 2012, 16:R41 • Freese Intra-arrest Induction of Therapeutic Hypothermia via Large-Volume, Ice-Cold Saline Infusion Results in Improved Outcomes Among Out-of-Hospital Cardiac Arrests of Cardiac Etiology • Freese Intra-arrest Induction of Therapeutic Hypothermia via Large-Volume Ice-Cold Saline Infusion Improves Immediate Outcomes for Out-of-Hospital Cardiac Arrest • Castren et al . Earlier intra-arrest transnasal cooling may be beneficialCritical care 2011, 15(suppl):P303

More Related