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Lowering body temperature increases survival, brain function in cardiac arrest patients with non-shockable heart rhythms

Date:
November 16, 2015
Source:
American Heart Association
Summary:
Lowering the body's temperature in cardiac arrest patients with 'non-shockable' heart rhythms increases survival and brain function. Patients who received the treatment were about three times more likely to survive cardiac arrest and have better neurological function compared to those who did not receive it.
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Heart illustration.
Credit: Image courtesy of American Heart Association

Lowering the body's temperature of cardiac arrest patients with "non-shockable" heart rhythms increases survival rates and brain function, according to new research in the American Heart Association's journal Circulation.

Therapeutic hypothermia is a medical treatment that intentionally lowers the body's temperature to protect the body following a period of insufficient blood flow due to such events as a cardiac arrest, blood clot or stroke.

Although previous studies have shown that therapeutic hypothermia can improve survival and neurological function, it is more commonly recommended for patients with "shockable" rhythms such as ventricular fibrillation -- a condition where the lower chambers quiver and the heart can't pump any blood, causing cardiac arrest.

Findings from a new study show that therapeutic hypothermia may also benefit comatose cardiac arrest patients with "non-shockable" heart rhythms -- those that won't respond to the defibrillation because there is no pulse or electrical activity in the heart.

Researchers examined data from 519 patients who had a cardiac arrest due to a non-shockable heart rhythm in the Penn Alliance for Therapeutic Hypothermia (PATH) registry between 2000 and 2013.

After adjusting for other factors, researchers found that those who received therapeutic hypothermia were 2.8 times more likely to survive after cardiac arrest and 3.5 times more likely to have better neurologic recovery compared to those who were not cooled.

Cardiac arrest occurs when the heart's electrical system malfunctions and the heart stops beating suddenly, causing blood to stop pumping to the body. Death can result in minutes without treatment.

"Neurologic injury after cardiac arrest is devastating," said Sarah Perman, M.D., the study's lead author and assistant professor of emergency medicine at the University of Colorado in Aurora. "We have one chance to give some form of neuroprotection, and that's immediately after the arrest.

"Our resources right now are not extensive and our outcomes are still fairly grim. Therapeutic hypothermia is one therapy we do have in our arsenal, and if a patient is comatose after arrest, it's very important to consider applying this therapy, specifically in patients who are neurologically injured," she said.

Despite established guidelines for the use of therapeutic hypothermia in patients who suffer cardiac arrest, adoption of this practice has been low, especially for in-hospital cardiac arrest patients and those who arrest with initial non-shockable rhythms.

"The perception that there is no benefit to patients who have an initial non-shockable rhythm has hindered application," Perman said.

However, the researchers encourage more research into the use of neuro-protective strategies for cardiac arrest patients with non-shockable rhythms such as the use of therapeutic hypothermia.


Story Source:

Materials provided by American Heart Association. Note: Content may be edited for style and length.


Journal Reference:

  1. Sarah M. Perman, Anne V. Grossestreuer, Douglas J. Wiebe, Brendan G. Carr, Benjamin S. Abella, and David F. Gaieski. The Utility of Therapeutic Hypothermia for Post-Cardiac Arrest Syndrome Patients With an Initial Non-Shockable Rhythm. Circulation, November 2015 DOI: 10.1161/CIRCULATIONAHA.115.016317

Cite This Page:

American Heart Association. "Lowering body temperature increases survival, brain function in cardiac arrest patients with non-shockable heart rhythms." ScienceDaily. ScienceDaily, 16 November 2015. <www.sciencedaily.com/releases/2015/11/151116181009.htm>.
American Heart Association. (2015, November 16). Lowering body temperature increases survival, brain function in cardiac arrest patients with non-shockable heart rhythms. ScienceDaily. Retrieved May 23, 2017 from www.sciencedaily.com/releases/2015/11/151116181009.htm
American Heart Association. "Lowering body temperature increases survival, brain function in cardiac arrest patients with non-shockable heart rhythms." ScienceDaily. www.sciencedaily.com/releases/2015/11/151116181009.htm (accessed May 23, 2017).

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