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Korean J Crit Care Med > Volume 28(1); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(1): 25-32. doi: https://doi.org/10.4266/kjccm.2013.28.1.25
일개 응급센터에서 소아 병원 밖 심정지 환자에 대한 치료적 저체온 요법의 적용
김우진ㆍ김진주ㆍ장재호ㆍ현성열ㆍ양혁준ㆍ이 근
가천대 길병원 응급의학과
Implementation of Therapeutic Hypothermia after Pediatric Out-of Hospital Cardiac Arrest in One Tertiary Emergency Center
Woo Jin Kim, Jin Joo Kim, Jae Ho Jang, Sung Youl Hyun, Hyuk Jun Yang, Gun Lee
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea. empearl@gilhospital.com
ABSTRACT
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.
Key Words: induced hypothermia; out-of-hospital cardiac arrest; pediatrics
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