Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia.

Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia. - 2016


English

1556-9039


*Cardiotoxins/to [Toxicity]
*Heart Arrest/th [Therapy]
*Hypothermia, Induced/ae [Adverse Effects]
*Poisoning/pp [Physiopathology]
Adolescent
Adult
Aged
Analgesics, Opioid/po [Poisoning]
Analgesics, Opioid/to [Toxicity]
Benzodiazepines/po [Poisoning]
Cocaine/to [Toxicity]
Combined Modality Therapy/ae [Adverse Effects]
Female
Heart Arrest/ep [Epidemiology]
Heart Arrest/et [Etiology]
Heart Arrest/pc [Prevention & Control]
Hospitals, Teaching
Humans
Incidence
Male
Middle Aged
North Carolina/ep [Epidemiology]
Poisoning/ep [Epidemiology]
Registries
Retrospective Studies
Secondary Prevention
Young Adult=520 \\
The incidence and outcome of patients who undergo therapeutic hypothermia (TH) after toxin-induced cardiac arrest (TICA) is not previously described. Our study aimed to describe the incidence, epidemiologic characteristics, and outcomes of patients who experience TICA in a dedicated clinical pathway for post-cardiac arrest care between November 2007 and February 2013. All patients were treated in an evidence-based clinical pathway that included TH. Database and medical records were independently reviewed by investigators to ascertain TICA. TICA was defined as cardiac arrest (CA) directly and immediately caused by a xenobiotic exposure. All patients were enrolled at Carolinas Medical Center, an urban 874-bed teaching hospital that serves as a regional cardiac resuscitation center. All patients were adult victims of cardiac arrest who had obtained return of spontaneous circulation and were enrolled in a clinical pathway for post-cardiac arrest care that included TH. Three hundred eighty-nine patients underwent treatment following CA during the study period and 48 (12 %) were deemed TICA. Patients who suffered TICA were slightly younger, less likely to have an initial shockable rhythm, and less likely to receive bystander CPR as compared to non-toxic cases. TICA accounted for a significant proportion of patients in this study. Additional, larger studies are needed to fully elucidate the optimal role for TH in TICA.


MedStar Washington Hospital Center


Medicine/Pulmonary-Critical Care


Journal Article

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