Reply to: Therapeutic hypothermia after cardiac arrest: outcome predictors - Critical Care Science (CCS)
We would like to thank the interest paid to our study and the valuable comments regarding it.() Herein, we clarify the comments and questions raised.
Despite advances in cardiopulmonary resuscitation, cardiac arrest is still associated with high morbidity and mortality.() Survival of these patients depends on the quality of care, and despite the fact that basic and advanced life support have been the subject of intensive research, the main focus is currently on care provided post-recovery of spontaneous circulation.() Therapeutic hypothermia has been shown to be effective in the prevention and reversal of neurological injury, cardiac protection, and mortality reduction.() It has been recommended since 2003 in comatose outpatients with ventricular fibrillation. Subsequent studies have shown the benefits of its immediate use after spontaneous circulation is restored and with other initial rhythms, which led to the initiation of cooling in pre-hospital settings and in patients with other rhythms.(,) This fact introduced a new variable in the so important prognosis evaluation of patients; thereby, we conducted a study to determine the validity of several markers that could be used to identify patients with poor prognosis who underwent therapeutic hypothermia after cardiac arrest. Thus, we studied the influences of the setting (in-hospital and out-of-hospital), time, rhythms, clinical evaluation, and biochemical, neurophysiological or imaging parameters on the final prognosis, using a population that was appropriate for these analyses.
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We would like to thank the interest paid to our study and the valuable comments regarding it.() Herein, we clarify the comments and questions raised.
Despite advances in cardiopulmonary resuscitation, cardiac arrest is still associated with high morbidity and mortality.() Survival of these patients depends on the quality of care, and despite the fact that basic and advanced life support have been the subject of intensive research, the main focus is currently on care provided post-recovery of spontaneous circulation.() Therapeutic hypothermia has been shown to be effective in the prevention and reversal of neurological injury, cardiac protection, and mortality reduction.() It has been recommended since 2003 in comatose outpatients with ventricular fibrillation. Subsequent studies have shown the benefits of its immediate use after spontaneous circulation is restored and with other initial rhythms, which led to the initiation of cooling in pre-hospital settings and in patients with other rhythms.(,) This fact introduced a new variable in the so important prognosis evaluation of patients; thereby, we conducted a study to determine the validity of several markers that could be used to identify patients with poor prognosis who underwent therapeutic hypothermia after cardiac arrest. Thus, we studied the influences of the setting (in-hospital and out-of-hospital), time, rhythms, clinical evaluation, and biochemical, neurophysiological or imaging parameters on the final prognosis, using a population that was appropriate for these analyses.
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