Mild hypothermia is standard of care for comatose survivors after cardiac arrest. Now there is new evidence that survivors of PEA arrest do better neurologically compared with survivors of VF/VT arrests. A retrospective, single-center study shows comatose survivors with shockable rhythms have better outcomes after mild hypothermia treatment than those with nonshockable rhythms.
Mild therapeutic hypothermia is a recommended option for comatose survivors of cardiac arrest, regardless of presenting rhythm. University of Michigan researchers reviewed charts from 123 consecutive adults with out-of-hospital cardiac arrest treated with therapeutic hypothermia over a 6-year period to compare neurologic outcomes between those with shockable and nonshockable initial rhythms.
More patients with shockable than nonshockable rhythms had favorable neurological outcomes (Cerebral Performance Category 1 or 2) at hospital discharge (42% vs. 5%) and at follow-up (range, 6 to 12 months; 48% vs. 7%).
Terman SW et al. Impact of presenting rhythm on short- and long-term neurologic outcome in comatose survivors of cardiac arrest treated with therapeutic hypothermia. Crit Care Med 2014 Jul 10; [e-pub ahead of print]. Link.