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J Korean Soc Emerg Med > Volume 26(6); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(6): 526-533.
병원 전 심정지 후 자발순환이 회복된 환자에서 치료적 저체온 요법을 시행하는데 있어 치료온도까지 도달하는데 영향을 주는 인자 분석
유재진1, 김진주1, 황인철2, 조진성1, 임용수1, 양혁준1, 이근1
1가천대 길병원 응급의학교실
2가천대 길병원 가정의학과
The Analysis of Factors Related to Reaching to Therapeutic Range in Patients with Receiving Therapeutic Hypothermia after Return of Spontaneous Circulation after Out-of hospital Cardiac Arrest
Jae Jin Ryou1, Jin Joo Kim1, In Cheol Hwang2, Jin Seong Cho1, Yong Su Lim1, Hyuk Jun Yang1, Keun Lee1
1Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea
2Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
Correspondence  Jin Joo Kim ,Tel: 032) 460-3015, Fax: 032) 460-3019, Email: empearl@gilhospital.com,
Received: June 24, 2015; Revised: June 25, 2015   Accepted: October 1, 2015.  Published online: December 30, 2015.
ABSTRACT
Purpose:
The relationship between prognostic factors and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia was analyzed.
Method:
We conducted a tertiary center retrospective study of post-cardiac arrest patients treated with therapeutic hypothermia between January 2008 and December 2012. We investigated the association of the following factors with outcomes: BMI, time to ROSC, number of vasoactive drugs, smoking, alcohol, and short time to therapeutic range in hypothermia.
Results:
A total of 251 patients were enrolled in this study. Large number of vasoactive drugs was a prognostic factor of 3-month mortality (adjusted OR 1.96, 95% CI:1.41-2.71, p<0.001). Obesity (BMI≥25 kg/m2) was not associated with delayed time to therapeutic range in hypothermia. Both univariate and multivariate analysis showed that high initial BT (β(SE)=63.64 (11.53), p<0.001) and a small number of vasoactive drugs (β(SE)=18.66(8.74), p=0.034) were independent predictors of delayed time to therapeutic range in hypothermia.
Conclusion:
In this study, a small number of vasoactive drugs showed a significant influence on delayed time to therapeutic range in patients receiving therapeutic hypothermia after return of spontaneous circulation after out-of-hospital cardiac arrest.
Key words: Induced hypothermia, Heart arrest, Vasoactive drug, Outcome
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