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J Korean Soc Emerg Med > Volume 25(6); 2014 > Article
Journal of The Korean Society of Emergency Medicine 2014;25(6): 747-755.
Outcome and Current Status of Therapeutic Hypothermia Following Out-of-hospital Cardiac Arrest in Korea from the Korea Hypothermia Network Registry
Byung Kook Lee, Kyu Nam Park, Gu Hyun Kang, Kyung Hwan Kim, Giwoon Kim, Won Young Kim, Jin Hong Min, Yooseok Park, Jung Bae Park, Gil Joon Suh, Yoo Dong Son, Jonghwan Shin, Joo Suk Oh, Yeon Ho You, Dong Hoon Lee, Jong Seok Lee, Hoon Lim, Tae Chang Jang, Gyu Chong Cho, In Soo Cho, Kyoung Chul Cha, Seung Pill Choi, Wook Jin Choi, Chul Han
1Department of Emergency Medicine, School of Medicine, Chonnam National University, Gwangju, Korea.
2Department of Emergency Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea. emsky@catholic.ac.kr
3Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
4Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
5Department of Emergency Medicine, Ajou University Hospital, Suwon, Korea.
6Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
7Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
8Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul, Korea.
9Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
10Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Korea.
11Department of Emergency Medicine, College of Medicine, Hallym University, Anyang, Korea.
12Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
13Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
14Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
15Department of Emergency Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
16Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Gyeonggi-do, Korea.
17Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
18Department of Emergency Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University Medical Center, Seoul, Korea.
19Department of Emergency Medicine, Hanil General Hospital, Korea Electric Power Medical Corporation, Seoul, Korea.
20Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
21Department of Emergency Medicine, College of Medicine, Ulsan University, Ulsan, Korea.
22Department of Emergency Medicine, Ewha Womans University, Shool of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
Therapeutic hypothermia (TH) has become a standard strategy for reducing brain damage in the postresuscitation period. The aim of this study is to investigate the outcomes and current performance of TH with out-of-hospital cardiac arrest (OHCA) survivors through the Korean hypothermia network (KORHN) registry.
METHODS:
We used the KORHN registry, a web-based, multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH from 2007 to 2012 were included. The primary outcomes were neurologic outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH.
RESULTS:
A total of 930 patients were included; of these, 556 (59.8%) patients survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 (interquartile range (IQR): 46-200) minutes. The induction, maintenance, and rewarming durations were 150 (IQR: 80-267) minutes, 1440 (IQR: 1290-1440) minutes, and 708 (IQR: 420-900) minutes, respectively. The time from the ROSC to coronary angiography was 1,045 (IQR: 121-12,051) hours. Hyperglycemia (46.3%) was the most frequent adverse event.
CONCLUSION:
Over one quarter of OHCA survivors (26.8%) were discharged with good neurologic outcome. TH performance was managed appropriately in terms of the factors related to the timing of TH, which were the start time for cooling and the rewarming duration.
Key words: Out-of-hospital cardiac arrest, Induced hypothermia, Registries
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