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Study suggests physicians wait longer for brain recovery after hypothermia Rx in cardiac arrest
Date:11/13/2010

eatment is also more effective, he says, in such people if their initial collapse was brought on by an electrical disturbance in the heart, what is known as a ventricular fibrillation rhythm. More than 300,000 cardiac arrests occur outside of hospitals each year in the United States, with less than 8 percent of victims surviving their medical crisis with brain function intact, a statistic Chandra-Strobos calls "pitiful."

In the new study, the Johns Hopkins researchers monitored the 47 men and women treated with and without therapeutic hypothermia. More than half died in the hospital. However, survival rates were higher for those whose bodies were chilled than for those who were not. In seven survivors treated with hypothermia, more than half remained comatose three days after sedation was withdrawn, with only a third showing signs of renewed brain activity. By the fifth day, the numbers were reversed, with more than half showing signs of waking up and only a third remaining comatose. And after a week, one-third were fully alert and awake, while half showed signs of brain function returning.

This contrasts, the researchers say, with the 13 other survivors who were not candidates for therapeutic hypothermia. Almost half were immediately alert upon resuscitation, while the majority, 80 percent showed signs of brain awakening by day three, as commonly expected.

Experts say current neurologic evaluation guidelines, in place since 1985, state that by day three, decisions can be made about whether or not to withdraw care in the absence of renewed brain activity.


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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
Source:Eurekalert

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