Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest

Resuscitation. 2007 Apr;73(1):29-39. doi: 10.1016/j.resuscitation.2006.08.016. Epub 2007 Jan 25.


Background: Mortality among patients admitted to hospital after out-of-hospital cardiac arrest (OHCA) is high. Based on recent scientific evidence with a main goal of improving survival, we introduced and implemented a standardised post resuscitation protocol focusing on vital organ function including therapeutic hypothermia, percutaneous coronary intervention (PCI), control of haemodynamics, blood glucose, ventilation and seizures.

Methods: All patients with OHCA of cardiac aetiology admitted to the ICU from September 2003 to May 2005 (intervention period) were included in a prospective, observational study and compared to controls from February 1996 to February 1998.

Results: In the control period 15/58 (26%) survived to hospital discharge with a favourable neurological outcome versus 34 of 61 (56%) in the intervention period (OR 3.61, CI 1.66-7.84, p=0.001). All survivors with a favourable neurological outcome in both groups were still alive 1 year after discharge. Two patients from the control period were revascularised with thrombolytics versus 30 (49%) receiving PCI treatment in the intervention period (47 patients (77%) underwent cardiac angiography). Therapeutic hypothermia was not used in the control period, but 40 of 52 (77%) comatose patients received this treatment in the intervention period.

Conclusions: Discharge rate from hospital, neurological outcome and 1-year survival improved after standardisation of post resuscitation care. Based on a multivariate logistic analysis, hospital treatment in the intervention period was the most important independent predictor of survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Blood Glucose / analysis
  • Cardiopulmonary Resuscitation*
  • Case-Control Studies
  • Clinical Protocols*
  • Emergency Medical Services
  • Female
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Hospitalization
  • Humans
  • Hypothermia, Induced
  • Intensive Care Units
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / therapy
  • Norway / epidemiology
  • Prospective Studies
  • Respiration, Artificial
  • Seizures / prevention & control
  • Survival Analysis
  • Thrombolytic Therapy


  • Blood Glucose