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Therapeutic Hypothermia Care Improves STEMI Outcomes

Therapeutic hypothermia improves neurological outcomes after out-of-hospital cardiac arrest

TUESDAY, July 12 (HealthDay News) -- A comprehensive therapeutic hypothermia (TH) protocol integrated into regional ST-segment elevation myocardial infarction (STEMI) treatment improves survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA), according to a study published in the July 12 issue of Circulation.

Michael R. Mooney, M.D., from the Abbott Northwestern Hospital in Minneapolis, and colleagues investigated the use of the Cool It protocol for establishing TH as the standard of care for OHCA across a regional network of hospitals which transfer patients to a central TH-capable hospital. Of 140 patients who suffered an OHCA between 2006 and 2009 and remained unresponsive after return of spontaneous circulation, 107 were transferred to a TH-capable hospital. Of the participants, 68 with concurrent STEMI received TH and cardiac intervention simultaneously. Patients with non-ventricular fibrillation arrest or cardiogenic shock were also included in the analysis. Cerebral Performance Category 1 or 2 at discharge was considered a positive neurological outcome.

The investigators found that out of the 56 percent of patients who survived to hospital discharge, 92 percent were discharged with a positive neurological outcome. Similar survival rate was found between patients who were transferred and those who were not. Non-ventricular fibrillation arrest and cardiogenic shock correlated strongly with mortality, but the rate of positive neurological recovery in survivors was high at 100 percent and 89 percent, respectively. Each hour of delay to initiation of TH increased the risk of death by 20 percent.

"A comprehensive TH protocol can be integrated into a regional STEMI network and achieves broad dispersion of this essential therapy for OHCA," the authors write.

Data collection for the study was funded by Medivance Inc.

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