4. Diskussion 20
4.6 Slutsats
Patienter med primärt registrerad hjärtrytm VF/VT hade signifikant bättre kognitiv och fysisk funktion 6 månader efter hypotermibehandlat hjärtstopp än patienter med asystoli/PEA som primärt registrerad hjärtrytm.
Detta belyser vikten av snabb tillgång till defibrillatorer både på publiktäta ställen i samhället och på sjukhus, samt att utbildning av lekmän och sjukhusvårdpersonal är optimal.
Både kognitiv och fysisk funktion och självskattad hälsa förbättras över tid, vilket kan vara en viktig faktor att förmedla till både patienter, närstående och sjukvårdspersonal för motivering till fortsatt fysisk och kognitiv rehabilitering.
30
Referenser
1 Nolan P, Soar J, Zideman D et al. European Council Guidelines for Resusitation
2010 section 1. Resucitation 2010; 81: 1219-1276 Excecutive summary
2 American Heart Association 2005. American Heart Association guidelines for
cardiopumonary resucitation and emergency cardiovascular care. Part 7.5: Postresucitation support. Circulation 2005; 112: 84-88
3 Holzer M. Mild therapeutic hypothermia to improve neurological outcome after
cardic arrest. New England Journal of Medicine 2002; 346: 549-556
4 Bernard SA Gray TW, Buist MD et al. Treatment of comatose survivors of
out-of-hospital cardiac arrest with induced hypothermia. New England Journal of
Medicine 2002; 346: 557-563
5 Girotra S, Nallamuto BK, Spertus JA et al. Trends in in-hospital cardiac arrest. New England Journal of Medicine 2012;367: 1912-1920
6 Chan P, McNally B, Tang F. Recent trends from out-f-hospital cardiac arrest in
United States. American Heart Association. Circulation online november 2014
7 Swedish Resusitation Council, Årsredovisning 2012
8 Strömsö A, Cardiopulmonary resusitation in Sweden – Yesterday, today and
tomorrow. Institute of Medicine at Sahlgrenska Academy University of Gothenburg
2013
9 Berdowski J, Berg RA, Tijssen JG et al. Global incidence of out-of-hospital cadiac
arrest and survival rates: Systemaic review of 67 prospective studies. Resusitation
2010; 81(11): 1479-1487
10 Nolan J, Soar J and Eikeland H. The Chaine of Survival. Resusitation 2006; 71: 270-271
11 HLR-Rådet: www.hlr.nu /register/2013
12 Herlitz J, Engdahl J, Svensson L et al. Factors associated with an increased chance
of survival among patients suffering from out-of- hospital cardiac arrest in a national perspective of Sweden. American Heart Journal 2005; 149:61-66
13 Nolan JP, Neumar RW, Adrie C et al. Post-cardiac arrest syndrome: Epimediologi,
pathophysiologi, treatment and prognostisation. Resusitation 2008; 79: 350-379
14 Rubertsson S, Larsson A Hjärtlungräddning – Hjärtstopp Intensivvård Stockholm. Libers förlag 2005; 557-563
15 (Polderman KH. Mecanisms of action, phyiological effects and complications of
hypothermia. Critical Care Medicine. 2009; jul 37: 186-202
31
for therapeutic hypothermia and postresucitation care after cardiac arrest. Acta
Anesteshiol Scandinaiva 2009; 53: 280-288
17 Nielsen N, Wetterslev J, Cronberg T, et al. Target Temperature Management. N Engl J Med 2013; 369: 2197-2206
18 Nielsen N, Hovdenes J, Nilsson F et al. Outcome, timing and adverse events in
therapeutic hyperthermia after out-of-hospital cardiac arrest. Acta Anestesiologica
Scandinavia 2009. Aug; 53 (7): 926-934
19 Jennett B and Bond M. Assessment of outcome after servere brain damage. Lancet 1975; 1:480-484
20 Cronberg T, Lilja G, Rundgren M et al. Long-term neurological outcome after
cardiac arrest and therapeutic hypothermia. Resusitation 2009; oct; 80 (10):
1119-1123
21 Moulert VR, Van Heugten C, Verbunt J et al. Cognitive impairments in survivors of
out-of-hospital cardiac arrest: a systematic review. Resusitation 2009; dec 30; 80:
297-305
22 Torgesen J, Strand K, Bjelland TW et al. Cognitiv dysfunction and health-related
quality of life after a cardiac arrest and therapeutic hypothermia. Acta
Anestesiologica Scandinavia 2010 jul; 54 (6): 721-728
23 World Health Organisation 1948: http://www.who.int/about/definition/en/print.html
24 C-J Göthe. Hälsa, sjukdom, välbefinnande. Läkartidningen nr 5, 2006; 271
25 Nordenfelt, L. Livskvalitet & Hälsa. 1991; Stockholm, Almqvist & Wiksell Förlag
26 Naess S, Quality of life research. 1987; Oslo, Institute of Applied Social Research
27 Larsson I-M, Wallin E, Rubertsson S, Kristofferzon M-L. Health-related quality of
life improves during the first six months after cardiac arrest and hypothermia treatment. Resusitation 85, 2014; 215-220
28 Elliot VJ, Rodgers DL, Brett SJ. Systematic review of quality of life and other
patient-centred outcomes after cardiac arrest survival. Resusitation2011; 82:
247-256
29 Bro-Jeppesen J, Kjaergaard J, Horsted TI, et al. The impact of therapeutic
hypothermia on neurological function and quality of life after cardiac arrest.
Resusitation 2009; 80: 171-176
30 Moulert VR, Wachelder EM, Verbunt JA. Determinates of quality of life after
cardiac arrest. Journal of Rehabilitation Medicine 2010; 42: 553-558
32 32 Svenska intensivvårdsregister SIR: www.icuregswe.org
33 The World Health Organisation, Quality of Life Assessement WHOQOL, 1998; 46: 1569-1585
34 Folstein MF, Folstein SE, McHugh PR. Mini Mental State, A practical method for
grading the cognitive state of patients for the clinican. Journal of psychiatric
research, 1975; 12(3): 189-198
35 Mahoney FI, Barthel D. The Barthels Index. Maryland State Medical Journal 1965; 14: 56-61
36 www.euroqol.org
37 WMA declaration of Helsinki-Ethical Principles for medical Research Involving Human subjects. www.wma.net
38 Vetenskapsrådet CODEX – regler för riktlinjer och forskning: www.codex.vr.se
39 HLR-rådet. www.hlr.nu/faka-riktlinjer /riktlinjer 2011
40 Strömsö A, Afzelius S, Axelsson C et al Improvement in logistics could increase
survival after out-of-hospital cardiac arrest in Sweden. Journal of Internal Medicine
2013; jun 273 (6) 622-627
41 Oddo M, Ribordy V, Fiehl F et al. Early predictors of outcome in comatose
survivors of ventricular fibrillation and non-ventricular fibrillation cardiac arrest treated with hypothermia. Critical Care medicine 2008; vol 36. No 8, 2296-2301
42 Peberdy MA, Callaway CW, Neumar CW et al Post cardiac Arrest care: 2010
American Heart Association Guidelines for cardiopulmonary resusitation and emergencycardiovascular care. Circulation 2010 122; supplement 3: 768-786
43 Bro-Jeppesen J, Hassager C, Wancher M et al. Post-hypotermia fever is associated
with increased mortality after out-of-hospital cardiac arrest. Resusitation 2013;
Volume 84: Issue 12, 1734-1740
44 Testori C, Stertz F, Behringer W et al. Mild terapeutic hypothermia is associated
with favourable outcome in patients after cardiac arrest with non-shockable rytms. Resusitation 2011; 82: 1162-1167
45 Wallin E, Larsson I-M, Rubertsson S et al. Cardiac arrest and hypothermia
treatment-function and life satisfaction among survivors in the first 6 months.
Resusitation 2014; 85: 538-543
46 Larsson I-M, Wallin E, Rubertsson S et al Cold saline infusion and ice-packs alone
are effective in inducing and maintaining therapeutic hypothermia after cardiac arrest. Resusitation 2010; 81: 15-19