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Outcomes of therapeutic hypothermia in unconscious patients after near-hanging

Abstract

Background Hanging has been increasingly used to commit suicide. There is no specific treatment besides general intensive care after near-hanging. Therapeutic hypothermia (TH) has been used in unconscious patients after near-hanging.

Objective To describe the outcomes in unconscious patients after near-hanging in order to determine whether TH improves the outcome of near-hanging injury.

Methods Medical charts were reviewed of unconscious patients after near-hanging who presented to Chonnam National University Hospital between January 2006 and December 2010 and who were considered to be eligible for TH. According to local policy, unconscious survivors after near-hanging, whether or not they experienced cardiac arrest at the scene, were treated with TH if this was agreed by next-of-kin.

Results There were 16 survivors of asphyxial cardiac arrest after near-hanging, of whom 13 received TH. Among them, only one (7.7%, 95% CI 1.4% to 33.3%) attained Cerebral Performance Category (CPC) 1; the other 15 patients had poor neurological outcomes (CPC 5 in seven patients and CPC 4 in eight patients). Nine of the patients did not experience cardiac arrest at the scene and of these, four received TH and five received normothermic treatment. All patients who did not have cardiac arrest recovered and were discharged with CPC 1.

Conclusion In this study, outcomes in unconscious near-hanging patients with cardiac arrest were poor despite treatment with TH. Before recommending TH in near-hanging patients, a prospective, randomised controlled study is required.

  • Asphyxia
  • hypothermia
  • heart arrest
  • resuscitation
  • research
  • emergency department management
  • education
  • assessment
  • clinical care
  • effectiveness
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