Published Online
on June 21, 2007

A more recent version of this article appeared on August 1, 2007

This Article Full Text (PDF) All Versions of this Article: 38/8/2303    most recent STROKEAHA.107.483867v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tiainen, M. Articles by Roine, R. O. Search for Related Content PubMed PubMed Citation Articles by Tiainen, M. Articles by Roine, R. O. Related Collections Other Treatment Acute coronary syndromes Other Stroke Treatment - Medical

Submitted on January 28, 2007
Accepted on February 20, 2007

Cognitive and Neurophysiological Outcome of Cardiac Arrest Survivors Treated With Therapeutic Hypothermia

Marjaana Tiainen MD^*; Erja Poutiainen PhD; Tero Kovala MD, PhD; Olli Takkunen MD, PhD; Olli Häppölä MD, PhD; and Risto O. Roine MD, PhD

From the Department of Neurology (M.T., E.P., O.H., R.O.R.), Helsinki University Hospital; the Department of Psychology (E.P.), University of Helsinki; EMG Laboratories Ltd, Helsinki and the Department of Clinical Neurophysiology (T.K.), Helsinki University Hospital; the Department of Anesthesiology and Intensive Care Medicine (O.T.), Helsinki University Hospital, and the Department of Neurology (R.O.R.), Turku University Hospital, Finland.

^* To whom correspondence should be addressed. E-mail: marjaana.tiainen{at}hus.fi.

Background and Purpose--Cognitive deficits are common in survivors of cardiac arrest (CA). The aim of this study was to examine the effect of therapeutic hypothermia after CA on cognitive functioning and neurophysiological outcome.

Methods--A cohort of 70 consecutive adult patients resuscitated from out-of-hospital ventricular fibrillation CA were randomly assigned to therapeutic hypothermia of 33°C for 24 hours accomplished by external cooling or normothermia. Neuropsychological examination was performed to 45 of the 47 conscious survivors of CA (27 in hypothermia and 18 in normothermia group) 3 months after the incident. Quantitative electroencephalography (Q-EEG) and auditory P300 event-related potentials were studied on 42 patients at the same time point.

Results--There were no differences between the 2 treatment groups in demographic variables, depression, or delays related to the resuscitation. No differences were found in any of the cognitive functions between the 2 groups. 67% of patients in hypothermia and 44% patients in normothermia group were cognitively intact or had only very mild impairment. Severe cognitive deficits were found in 15% and 28% of patients, respectively. All Q-EEG parameters were better in the hypothermia-treated group, but the differences did not reach statistical significance. The amplitude of P300 potential was significantly higher in hypothermia-reated group.

Conclusions--The use of therapeutic hypothermia was not associated with cognitive decline or neurophysiological deficits after out-of-hospital CA.

Key words: cardiac arrest • cognition • hypothermia • P300 evoked response • Q-EEG

This article has been cited by other articles:

				A. O. Rossetti, M. Oddo, L. Liaudet, and P. W. Kaplan Predictors of awakening from postanoxic status epilepticus after therapeutic hypothermia Neurology, February 24, 2009; 72(8): 744 - 749. [Abstract] [Full Text] [PDF]

				G. A. Ewy and K. B. Kern Recent advances in cardiopulmonary resuscitation: cardiocerebral resuscitation. J. Am. Coll. Cardiol., January 13, 2009; 53(2): 149 - 157. [Abstract] [Full Text] [PDF]

				B. P. Meloni, F. L. Mastaglia, and N. W. Knuckey Review: Therapeutic applications of hypothermia in cerebral ischaemia Therapeutic Advances in Neurological Disorders, September 1, 2008; 1(2): 75 - 98. [Abstract] [PDF]