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For Some, Care May Be Withdrawn Too Soon After Cardiac Arrest
Date:11/13/2010

By Steven Reinberg
HealthDay Reporter

SATURDAY, Nov. 13 (HealthDay News) -- For people stricken with sudden cardiac arrest, doctors often resort to a brain-protecting "cooling" of the body, a procedure called therapeutic hypothermia.

But new research suggests that physicians are often too quick to terminate potentially lifesaving supportive care when these patients' brains fail to "re-awaken" after a standard waiting period of three days. The research suggests that these patients may need care for up to a week before they regain neurological alertness.

"Most patients receiving standard care -- without hypothermia -- will be [neurologically] awake by day 3 if they are waking up," explained the lead author of one study, Dr. Shaker M. Eid, an assistant professor of medicine at Johns Hopkins University School of Medicine.

However, in his team's study, "patients treated with hypothermia took five to seven days to wake up," he said.

The results of Eid's study and two others on therapeutic hypothermia were scheduled to be presented Saturday during the meeting of the American Heart Association in Chicago.

For over 25 years, the prognosis for recovery from cardiac arrest and the decision to withdraw care has been based on a neurological exam conducted 72 hours after initial treatment with hypothermia, Eid pointed out. The new findings may cast doubt on the wisdom of that approach, he said.

For the Johns Hopkins report, Eid and colleagues studied 47 patients who survived cardiac arrest -- a sudden loss of heart function, often tied to underlying heart disease. Fifteen patients were treated with hypothermia and seven of those patients survived to hospital discharge. Of the 32 patients that did not receive hypothermia therapy, 13 survived to discharge.

Within three days, 38.5 percent of patients receiving conventional care were alert again, with only mild mental deficits. However, at three d
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