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Terler, S.
Outcome präklinisch reanimierter Patienten durch Anwendung frühzeitiger Kühlung.
[ Diplomarbeit/Master Thesis ] Medical University of Graz; 2009. pp.82. [OPEN ACCESS]
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Authors Med Uni Graz:
Advisor:: Prause Gerhard
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Abstract:: Background On the occasion of the recommendations of the ILCOR and ERC 2005 to initiate therapeutic hypothermia as early as possible after resuscitation from cardiac arrest, the possibility to start cooling in the prehospital setting has been established in the emergency medical systems of Graz and Bruck an der Mur. The aim of this observational study is to evaluate, whether the early initiation of therapeutic hypothermia actually improves the neurologic outcome recorded one month after cardiac arrest, without interacting with the patients therapy. Methods According to the cooling method, the patients were assigned to different groups: in patients of group 1 cooling was initiated delayed, this means after admission to the intensive care unit and patients of group 2 were cooled early in the prehospital setting. Patients who were cooled in the preclinical setting, but in whom therapeutic hypothermia was not maintained in the intensive care unit, as well as patients who were not cooled although they met the indication criteria were recorded separately. Neurologic outcome was evaluated one month after cardiac arrest using the Glasgow-Pittsburgh Outcome Categories. Results 19 patients were assigned to group 1 and 11 patients to group 2. In 36,8% of the delayed cooled patients good neurological recovery was recorded in comparison to 45,5% of the early cooled patients, in whom therapeutic hypothermia had been maintained on the intensive care unit. In an analysis of correlations a statistically significant coherence between the cooling method and neurological outcome could not be shown. Conclusion Taking in consideration the small number of patients, statistically significant improvement in the neurologic outcome that could be drawn back to prehospital initiation of therapeutic hypothermia could not be observed.