Original Article
Prognosis of hypothermia treatment for coma patients after cardiopulmonary resuscitation in Wenzhou
Yuanli Lei, Yingru Lu, Shouquan Chen, Zhangping Li, Huiping Li, Huaqing Xu, Laifang Sun, Rongkai You, Xinguo Chen, Zhanwei Ruan, Xiao Liu, Xizhong Jin, Pu Chen, Liangzhi Xu, Zengfeng Huang, Xiaoming Wu
Published 2018-10-01
Cite as Chin J Crit Care Med(Electronic Edition), 2018, 11(5): 304-309. DOI: 10.3877/cma.j.issn.1674-6880.2018.05.005
Abstract
ObjectiveTo analyze the prognosis of hypothermia treatment (HT) for coma patients after cardiopulmonary resuscitation (CPR) in Wenzhou.
MethodsA implementation demonstration base and 10 implementation bases were established in Wenzhou. HT was implemented in patients with coma after CPR from January 2014 to December 2016. The data of HT were recorded. The survival rate of ICU discharge, recovery rate of neurological functions and severe disability rate in the 3-year implementation period were compared.
ResultsIn the implementation period, 133 coma patients after CPR were implemented TH. Respectively, 28, 46 and 59 cases were implemented in the first, second and third years. Time to target temperature [8.0 (3.0, 18.8), 10.0 (4.8, 20.0), 6.0 (2.0, 12.0) h], and rates of drug use [17 (60.7%), 43 (93.5%), 42 (71.2%)] and muscle relaxant use [0 (0%), 1 (2.2%), 13 (22.0%)] were significantly different in the first, second and third years (H = 10.475, P = 0.005; χ2 = 12.250, P = 0.002; χ2 = 17.647, P < 0.001). The survival rate of ICU discharge presented an upward trend, and the severe disability rate showed an downward trend year by year. However, there were no significant differences in above indicators (χ2 = 2.537, P = 0.281; χ2 = 0.308, P = 0.857) during the implementation period. The recovery rate of neurological functions during the implementation period was significantly different (χ2 = 12.232, P = 0.002); it was higher in the third year than in the first and second years [16 (27.1%), 1 (3.6%), 3 (6.5%), both P < 0.017).
ConclusionThe standardized HT can significantly improve favorable neurological recovery.
Key words:
Cardiopulmonary resuscitation; Coma; Hypothermia treatment; Targeted temperature management; Cardiac arrest
Contributor Information
Yuanli Lei
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Yingru Lu
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Shouquan Chen
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Zhangping Li
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Huiping Li
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Huaqing Xu
Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
Laifang Sun
Department of Emergency, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
Rongkai You
Department of Critical Care Medicine, Wenzhou Central Hospital, Wenzhou 325000, China
Xinguo Chen
Department of Emergency, Wenzhou People's Hospital, Wenzhou 325041, China
Zhanwei Ruan
Department of Emergency, Ruian People's Hospital, Wenzhou 325200, China
Xiao Liu
Department of Emergency, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, China
Xizhong Jin
Department of Critical Care Medicine, Wenzhou Hospital of Integrated Chinese and Western Medicine, Wenzhou 325000, China
Pu Chen
Department of Critical Care Medicine, Yueqing People's Hospital, Yueqing 325600, China
Liangzhi Xu
Department of Critical Care Medicine, People's Hospital of Pingyang, Wenzhou 325400, China
Zengfeng Huang
Department of Emergency, Cangnan Hospital of Traditional Chinese Medicine, Wenzhou325800, China
Xiaoming Wu
Department of Emergency, Wencheng People's Hospital, Wenzhou 325300, China
