우리나라에서 병원전 심정지 후 저체온치료의 결과와 현황-한국저체온치료연구회 환자등록체계를 이용하여-

Abstract

Purpose: Therapeutic hypothermia (TH) has become astandard strategy for reducing brain damage in the postresuscitationperiod. The aim of this study is to investigatethe outcomes and current performance of TH with out-ofhospitalcardiac arrest (OHCA) survivors through theKorean hypothermia network (KORHN) registry. Methods: We used the KORHN registry, a web-based, multicenterregistry that includes 24 participating hospitalsthroughout the Republic of Korea. Adult comatose OHCAsurvivors treated with TH from 2007 to 2012 were included. The primary outcomes were neurologic outcome at hospitaldischarge and in-hospital mortality. The secondary outcomeswere 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%) weredischarged with good neurologic outcomes. The median timefrom return of spontaneous circulation (ROSC) to the start of THwas 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 ROSCto 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 performancewas managed appropriately in terms of the factorsrelated to the timing of TH, which were the start time forcooling and the rewarming duration.