Effect of hydrocortisone on outcome of patients with cardiac arrest and cardiopulmonary resuscitation / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the effects of hydrocortisone on the rate of return of spontaneous circulation(ROSC)and the outcome of patients with cardiac arrest(CA)and cardiopulmonary resuscitation(CPR). Methods A cohort study was conducted,78 non-traumatic patients with CA were divided into hydrocortisone group (31 cases)and control group(47 cases). Conventional treatments were given in the two groups after admission,and additionally intravenous 100 mg hydrocortisone was given to the hydrocortisone group during resuscitation. The ROSC rate and prognosis were compared between the two groups. Multivariate logistic regression analysis was used to predict the impact factor of ROSC. Results The ROSC rate and 24-hour survival rate in the hydrocortisone group were significantly higher than those of the control group(ROSC rate58.1% vs. 40.4%,24-hour survival rate48.4%vs. 36.2%,both P<0.05). There were no significant differences between the hydrocortisone and the control groups in duration of CPR〔minute17.1(6-45)vs. 15.8(7-48)〕,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in survivors(37.2±8.2 vs. 36.1±8.2),the survival rate(12.9% vs. 12.8%)and hospital discharge rate(6.4%vs. 6.4%)in 7 days. Hydrocortisone〔odds ratio(OR)=3.12,95%confidence interval(95%CI)-1.18-8.29, P=0.017〕and witness(OR=4.24, 95%CI -1.87-12.43,P=0.008) were independent predictors for an increased ROSC rate after multiple logistic regression analysis. Conclusion Giving hydrocortisone during resuscitation may increase ROSC rate in CA patients.