The Effect of Therapeutic Hypothermia on Neurological Outcomes Following Resuscitation from Cardiac Arrest

• Author / Creator

  Dunn, Meagan E

• Therapeutic Hypothermia (TH) is a relatively new therapy used to treat those resuscitated from cardiac arrest. The purpose of the therapy is to attenuate any neurological damage resulting from the arrest, thereby increasing survival and improving subsequent quality of life. The current evidence for TH is limited in regards to neurological outcomes. The purpose of this work was to explore neurological outcomes of patients following resuscitation from cardiac arrest, specifically those who receive TH. We conducted a systematic review of the effect of TH on neurological outcomes for patients resuscitated from cardiac arrest, including all studies which compared TH to a control group. Additionally, we prospectively created a registry of patients resuscitated from cardiac arrest, and evaluated their neurological functioning over 6 months of follow-up with the use of several tools, primarily the Montreal Cognitive Assessment (MoCA) test. We also assessed survival for these patients. Our systematic review included 40 studies which reported on neurological outcomes following TH for cardiac arrest. We found that TH was associated with more favourable neurological outcomes compared to no TH: RR 1.75 (95% CI 1.54, 1.99; p<0.001). In the 37 studies that reported on survival, the benefit of TH on survival was significant: RR 1.48 (95% CI 1.33, 1.65; p<0.001). Of the 110 patients enrolled in our registry, surviving patients who received TH demonstrated continuous neurological improvement over the 6 month follow-up period. Using the MoCA test, we observed a mean improvement of 3.3 (SD 2.60) and 4.3 (SD 4.72) points at 3 months and 6 months following arrest respectively, for those who received TH. Those who received TH also had a decreased hazard of death compared to the no TH group, HR 0.39 (95% CI 0.24, 0.64; p=0.0006).

• Subjects / Keywords

  • Cardiac Arrest
  • Targeted Temperature Management
  • Therapeutic Hypothermia

• Graduation date

  Spring 2016

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R3862BP08

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.