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Implementation of Therapeutic Hypothermia after Pediatric Out-of Hospital Cardiac Arrest in One Tertiary Emergency Center
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Woo Jin Kim, Jin Joo Kim, Jae Ho Jang, Sung Youl Hyun, Hyuk Jun Yang, Gun Lee
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Korean J Crit Care Med. 2013;28(1):25-32.
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DOI: https://doi.org/10.4266/kjccm.2013.28.1.25
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 Abstract
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- BACKGROUND
Cardiac arrest in infants and children is rare than adults yet, it is critical. The efficacy and feasibility of therapeutic hypothermia after cardiac arrest in adults is proved through many studies however, there are few data on pediatric out-of hospital cardiac arrest. We analyzed several variables in pediatric therapeutic hypothermia after out-of hospital cardiac arrest.
METHODS
Infants and children (1 to 17 years old), who were admitted to our emergency intensive care units following the return of spontaneous circulation after out-of hospital cardiac arrest from Jan 2008 to Apr 2012, were included in this study. Basal patients' characteristics and variables about therapeutic hypothermia were analyzed.
RESULTS
A total of seventy-six patients visited our emergency center after a pediatric cardiac arrest during the study period. Among this, sixty-three patients received pediatric advanced life support, twenty one patients were admitted to intensive care units and nine patients received therapeutic hypothermia. Overall, the survival discharge was 7.9% (5 of 63). Among the admitted patients, 3 patients (14.3%) had a good Cerebral Performance Category (CPC). Two patients received endovascular cooling and seven patients received surface cooling. The mean time from the induction of therapeutic hypothermia to reaching the temperature with in the therapeutic range was 193.9 minutes. There were no critical adverse events during induction, maintenance and the rewarming period of therapeutic hypothermia.
CONCLUSIONS
Therapeutic hypothermia after pediatric out-of hospital cardiac arrest was performed safely and effectively in one emergency center. The standardized pediatric therapeutic hypothermia protocol should be established in order to be used widely in pediatric intensive care units.
Further, larger studies are needed on the subject of pediatric therapeutic hypothermia.
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Citations
Citations to this article as recorded by  - Epidemiological and Survival Trends of Pediatric Cardiac Arrests in Emergency Departments in Korea: A Cross-sectional, Nationwide Report
Jae Yun Ahn, Mi Jin Lee, Hyun Kim, Han Deok Yoon, Hye Young Jang
Journal of Korean Medical Science.2015; 30(9): 1354. CrossRef
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The Frequency of Defibrillation Related to the Survival Rate and Neurological Outcome in Patients Surviving from Out-of-hospital Cardiac Arrest
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Sung Yeol Hyun, Jae Ho Jang, Jin Joo Kim, Hyuk Jun Yang, Woo Jin Kim
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Korean J Crit Care Med. 2012;27(4):263-268.
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DOI: https://doi.org/10.4266/kjccm.2012.27.4.263
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3,200
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25
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Abstract
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- BACKGROUND
Early defibrillation is the treatment of choice in out-of-hospital cardiac arrests (OHCA) with initial shockable rhythms. However, the relationship between the frequency of defibrillation and neurological outcome was not clear. In this study, the frequency of defibrillation and other factors related to neurological outcome were investigated.
METHODS
Records of 255 adult patients, who were admitted to the hospital after resuscitation from OHCA between November 2008 and March 2012, were retrospectively reviewed. 6 months after the return of spontaneous circulation, patients were divided into two groups based on the cerebral performance category (CPC) score for neurologic prognosis. The frequency of defibrillation during resuscitation and other variables were analyzed between the two groups.
RESULTS
In the study group, initial rhythm was divided into two groups, non shockable rhythm (200, 78.4%) and shockable rhythm (55, 21.6%). The frequency of 1-7 defibrillations was significantly associated with good neurological outcome (OR 3.05, 95% CI 1.328-6.850). In addition, shockable initial rhythm (OR 4.520, 95% CI 1.953-10.459), arrest caused cardiac origin (OR 2.945, 95% CI 1.334-6.500), time to BLS (OR 1.139, 95% CI 1.033-1.256) and lower APACHII score (OR 1.095, 95% CI 1.026-1.169), which were associated with good neurological outcomes, independently.
CONCLUSIONS
In those patients who survived from OHCA, adequate defibrillation was important to improve the neurological outcome, whether the initial rhythm was shockable or not. Frequency of 1-7 times defibrillation was associated with good neurological outcome.
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Citations
Citations to this article as recorded by - The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology
Su-Yeon Jeong, Chul-Woung Kim, Sung-Ok Hong
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(2): 560. CrossRef
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