The therapeutic hypothermia after resuscitated cardiac arrest caused by ventricular fibrillation: a retrospective study in Saint Pierre University Hospital

Background : Therapeutic hypothermia is recommended as soon as possible for the neurological protection of comatose patients after cardiorespiratory arrest ( CA ) caused by pulseless ventricular fibrillation (VF) or tachychardia (VT). This retrospective study evaluates the adherence to the hypothermia protocol in Emergency Department and Intensive Care Units of Saint Pierre University Hospital (SPUH). Methods : Retrospective analyses of the database records from the 1st January 2005 to the 31st December 2010 concerning all the out-of-hospital arrests due to ventricular fibrillation admitted alive in the hospital. Transferred or NTBR patients were excluded. Results : Of the 72 patients studied, 68% were discharged alive from the hospital, of which 84% were free of neurological sequelae. Hypothermia was used in 44 patients, unjustified in 5 cases. There were also 5 cases for which it was needed, but not applied. Hypothermia (32°C – 34°C) was achieved in a median time of 9.5 hours (range: 1.5 hours – 39 hours) and lasted a median 21 hours (range: 7 hours – 31 hours). Hypothermic patient survival was 72.7%, with 81% good neurological outcome. Conclusion : The protocol application in our small study gives as good figures as previous studies. Few errors of inclusion and exclusion are still present. Implementation of a common protocol for Emergency Medical Service (EMS), Emergency Department (ED) and Intensive Care Unit (ICU) would shorten the time to obtain the target temperature. The creation and implementation of a specific register with CA patients who received hypothermia would lead to a better medical follow-up for the patient and improve the current knowledge related to this technique.