May 26, 2011

Impact of therapeutic hypothermia onset and duration on survival, neurologic function, and neurodegeneration after cardiac arrest

Critical Care Medicine
Dongfang CheRobert W Neumar

Abstract

Post-cardiac-arrest therapeutic hypothermia improves outcomes in comatose cardiac arrest survivors. This study tests the hypothesis that the efficacy of post-cardiac-arrest therapeutic hypothermia is dependent on the onset and duration of therapy. Prospective randomized laboratory investigation. University research laboratory. A total of 268 male Long Evans rats. Post-cardiac-arrest therapeutic hypothermia. Adult male Long Evans rats that achieved return of spontaneous circulation after a 10-min asphyxial cardiac arrest were block randomized to normothermia (37°C ± 1°C) or therapeutic hypothermia (33°C ± 1°C) initiated 0, 1, 4, or 8 hrs after return of spontaneous circulation and maintained for 24 or 48 hrs. Therapeutic hypothermia initiated 0, 1, 4, and 8 hrs after return of spontaneous circulation resulted in 7-day survival rates of 45%*, 36%*, 36%*, and 14%, respectively, compared to 17% for normothermic controls and survival with good neurologic function rates of 24%*, 24%*, 19%*, and 0%, respectively, compared to 2% for normothermic controls (*p < .05 vs. normothermia). These outcomes were not different when therapeutic hypothermia was maintained for 24 vs. 48 hrs. In contrast, hippocampal CA1 pyramidal neuron counts were ...Continue Reading

  • References23
  • Citations69

References

  • References23
  • Citations69

Citations

Mentioned in this Paper

CA1 Pyramidal Cell Area
Neurons
Nerve Degeneration
Neuroprotection
Neuronal
Hypothermia, Natural
Mild Hypothermia, Induced
Infantile Neuroaxonal Dystrophy
Antineoplaston A10
Nervous System Disorder

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