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Better understanding of neurologic defects improves post-cardiac-arrest discharge
Date:11/14/2011

Delay in initiation of therapeutic hypothermia and delay in return of spontaneous circulation (ROSC), evidenced by a palpable pulse or a measurable blood pressure, were both associated with poor neurologic outcomes in post cardiac arrest patients, according to a study being presented Nov. 14 at the at the American Heart Association (AHA) scientific sessions in Orlando, Fla. Also, caregivers who have an appropriate understanding of the patient's post cardiac arrest neurologic state could ensure better patient management at discharge.

The researchers were seeking to determine whether there were differential rates of neurologic outcomes in post cardiac patients by time to initiation, depth and duration of therapeutic hypothermia. They based the neurologic outcomes on the Cerebral Performance Category (CPC), which is ranked from 1 to 5, with 1 identified as "good," and 3 to 5 identified as poor.

"Previous studies have collapsed several CPC scores together, namely CPC 1 and 2. CPC 1 indicates the patient is conscious, alert and able to work, with only mild neurologic and psychological deficit, while with CPC 2, the patient still has sufficient cerebral function for independent activity and able to sheltered environment," explained Susan Sendelbach, RN, of the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis and researcher with Minneapolis Heart Institute Foundation.

"When you are planning discharge for patients, there is big difference between 'able to work' and 'able to work in a sheltered environment,' which really should change how we plan for discharge," she added.

Therefore, through this study, Sendelbach and her colleagues sought to further break down how the nuances of the CPC score could impact the patient and the discharge processparticularly through the separation of CPC 1 and CPC 2. Thus, they examined CPC 1, CPC 2 and CPC 3-5 independently. "We wanted to understand how the temperature manag
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Contact: Kristin Wincek
kwincek@mhif.org
612-863-0249
Minneapolis Heart Institute Foundation
Source:Eurekalert

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