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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
  • Graduation date
    2016-06
  • 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.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Master's
  • Department
    • Department of Medicine
  • Specialization
    • Experimental Medicine
  • Supervisor / co-supervisor and their department(s)
    • Chan, Michael (Medicine)
    • Tsuyuki, Ross (Medicine)
    • Al Hamarneh, Yazid (Medicine)
  • Examining committee members and their departments
    • Butcher, Ken (Medicine)
    • Tsuyuki, Ross (Medicine)
    • Al Hamarneh, Yazid (Medicine)
    • Chan, Michael (Medicine)