Mild hypothermia therapy for brain recovery after cardiopulmonary resuscitation and analysis of prognostic factors

Objective To explore the prognostic factors of mild hypothermia therapy in patients after cardiopulmonary resuscitation (CPR) and the prognostic value of the active electroencephalogram (AEEG).Methods Mild hypothermia therapy was applied in 42 patients after CRP whose circulation was stable on the basis of systemic treatment. Body temperature (jugular bulb temperature) was controlled at 31 - 34 ℃ for 3 - 6 days before rewarming. During treatment, routine examinations were made, and electroencephalogram was monitored and Hockday grade was estimated. Glasgow outcome scale (GOS) was use to evaluate the nervous system function of patients who survived for 3 months. Results There were varying degrees of difference between the good prognosis group (good recovery, moderate disability, n= 19) and the poor outcome group (severe disability, vegetative state, death, n=23) in the time of CPR after cardiac arrest (minutes: 4. 11±1.80 vs. 13.08±11.37), Glasgow coma scale (GCS) after the recovery (5.48±1.32 vs.4.13 ± 1.61), blood base excess (mmol/L: -10. 27±6.23 vs. -13. 18±7. 29) and lactate concentration (mmol/L: 6. 82±3. 12 vs. 8.47±4. 14, P＜0. 05 or P＜0. 01). There were significant differences between Hockday stage Ⅱ and Ⅲ in the rates of good prognosis in 37 patients who underwent the AEEG monitoring [85.7% (12/14) vs. 37.5% (3/8), P＜0.05]. Conclusion The duration between CPR and cardiac arrest,GCS after resuscitation, blood base excess and lactate concentration can help determine the prognosis of patients after mild hypothermia therapy; electroencephalogram monitor is a helpful measure to determine the neurological outcome of patients after mild hypothermia therapy. Key words: Mild hypothermia; Cerebral resuscitation; Prognosis; Electroencephalogram