After restoration of spontaneous circulation and adequate oxygenation, 262 comatose survivors of cardiac arrest were randomly assigned to receive standard brain-oriented intensive care or the same standard therapy plus a single intravenous loading dose of thiopental (30 mg per kilogram of body weight). The study was designed to have an 80 percent probability of detecting a 20 percent reduction in the incidence of permanent postischemic cerebral dysfunction. Base-line characteristics were similar in the two treatment groups. At the end of one year of follow-up, there was no statistically significant difference between treatment groups in the proportion of patients who died (77 percent of the thiopental vs. 80 percent of the standard-therapy group), survived with "good" cerebral recovery (20 percent of the thiopental vs. 15 percent of the standard-therapy group), or survived with permanent severe neurologic damage (2 percent of the thiopental vs. 5 percent of the standard-therapy group). The results of this study do not support the use of thiopental for brain resuscitation after cardiac arrest.
This article has been cited by other articles:
Neumar, R. W., Nolan, J. P., Adrie, C., Aibiki, M., Berg, R. A., Bottiger, B. W., Callaway, C., Clark, R. S.B., Geocadin, R. G., Jauch, E. C., Kern, K. B., Laurent, I., Longstreth, W.T. Jr, Merchant, R. M., Morley, P., Morrison, L. J., Nadkarni, V., Peberdy, M. A., Rivers, E. P., Rodriguez-Nunez, A., Sellke, F. W., Spaulding, C., Sunde, K., Vanden Hoek, T.
(2008). Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council. Circulation
118: 2452-2483
[Full Text]
Gueugniaud, P.-Y., David, J.-S., Chanzy, E., Hubert, H., Dubien, P.-Y., Mauriaucourt, P., Braganca, C., Billeres, X., Clotteau-Lambert, M.-P., Fuster, P., Thiercelin, D., Debaty, G., Ricard-Hibon, A., Roux, P., Espesson, C., Querellou, E., Ducros, L., Ecollan, P., Halbout, L., Savary, D., Guillaumee, F., Maupoint, R., Capelle, P., Bracq, C., Dreyfus, P., Nouguier, P., Gache, A., Meurisse, C., Boulanger, B., Lae, C., Metzger, J., Raphael, V., Beruben, A., Wenzel, V., Guinhouya, C., Vilhelm, C., Marret, E.
(2008). Vasopressin and Epinephrine vs. Epinephrine Alone in Cardiopulmonary Resuscitation. NEJM
359: 21-30
[Abstract][Full Text]
Rincon, F.
(2008). Therapeutic Hypothermia after Cardiac Arrest. ANN INTERN MED
148: 485-486
[Full Text]
O'Donnell, C. P F, Kamlin, C O. F, Davis, P. G, Morley, C. J
(2008). Ethical and legal aspects of video recording neonatal resuscitation. Arch. Dis. Child. Fetal Neonatal Ed.
93: F82-F84
[Full Text]
Marler, J. R.
(2007). NINDS Clinical Trials in Stroke: Lessons Learned and Future Directions. Stroke
38: 3302-3307
[Abstract][Full Text]
Fukuda, S., Warner, D. S.
(2007). Cerebral protection. Br J Anaesth
99: 10-17
[Abstract][Full Text]
Geocadin, R. G., Buitrago, M. M., Torbey, M. T., Chandra-Strobos, N., Williams, M. A., Kaplan, P. W.
(2006). Neurologic prognosis and withdrawal of life support after resuscitation from cardiac arrest.. Neurology
67: 105-108
[Abstract][Full Text]
El-Menyar, A. A.
(2005). The Resuscitation Outcome: Revisit the Story of the Stony Heart. Chest
128: 2835-2846
[Abstract][Full Text]
Cao, H., Kass, I. S., Cottrell, J. E., Bergold, P. J.
(2005). Pre- or Postinsult Administration of Lidocaine or Thiopental Attenuates Cell Death in Rat Hippocampal Slice Cultures Caused by Oxygen-Glucose Deprivation. Anesth. Analg.
101: 1163-1169
[Abstract][Full Text]
Bell, D. D., Brindley, P. G., Forrest, D., Muslim, O. A., Zygun, D.
(2005). Management following resuscitation from cardiac arrest: recommendations from the 2003 Rocky Mountain Critical Care Conference: [Conduite a tenir apres la reanimation post-arret cardiaque : recommendations de la conference du Rocky Mountain Critical Care 2003]. Canadian J. Anesthesia
52: 309-322
[Abstract][Full Text]
Warner, D. S.
(2004). Perioperative Neuroprotection: Are We Asking the Right Questions?. Anesth. Analg.
98: 563-565
[Full Text]
Booth, C. M., Boone, R. H., Tomlinson, G., Detsky, A. S.
(2004). Is This Patient Dead, Vegetative, or Severely Neurologically Impaired?: Assessing Outcome for Comatose Survivors of Cardiac Arrest. JAMA
291: 870-879
[Abstract][Full Text]
Laurent, I., Monchi, M., Chiche, J.-D., Joly, L.-M., Spaulding, C., Bourgeois, B.e., Cariou, A., Rozenberg, A., Carli, P., Weber, S., Dhainaut, J.-F.
(2002). Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest. J Am Coll Cardiol
40: 2110-2116
[Abstract][Full Text]
Longstreth, W. T. Jr., Fahrenbruch, C. E., Olsufka, M., Walsh, T. R., Copass, M. K., Cobb, L. A.
(2002). Randomized clinical trial of magnesium, diazepam, or both after out-of-hospital cardiac arrest. Neurology
59: 506-514
[Abstract][Full Text]
Goh, W. C., Heath, P. D., Ellis, S. J., Oakley, P. A.
(2002). Neurological outcome prediction in a cardiorespiratory arrest survivor. Br J Anaesth
88: 719-722
[Abstract][Full Text]
Xu, Y., Liachenko, S., Tang, P.
(2002). Dependence of Early Cerebral Reperfusion and Long-Term Outcome on Resuscitation Efficiency After Cardiac Arrest in Rats. Stroke
33: 837-843
[Abstract][Full Text]
Bernard, S. A., Gray, T. W., Buist, M. D., Jones, B. M., Silvester, W., Gutteridge, G., Smith, K.
(2002). Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia. NEJM
346: 557-563
[Abstract][Full Text]
Felberg, R. A., Krieger, D. W., Chuang, R., Persse, D. E., Burgin, W. S., Hickenbottom, S. L., Morgenstern, L. B., Rosales, O., Grotta, J. C.
(2001). Hypothermia After Cardiac Arrest: Feasibility and Safety of an External Cooling Protocol. Circulation
104: 1799-1804
[Abstract][Full Text]
Bottiger, B. W., Mobes, S., Glatzer, R., Bauer, H., Gries, A., Bartsch, P., Motsch, J., Martin, E.
(2001). Astroglial Protein S-100 Is an Early and Sensitive Marker of Hypoxic Brain Damage and Outcome After Cardiac Arrest in Humans. Circulation
103: 2694-2698
[Abstract][Full Text]
Tang, W., Weil, M. H., Sun, S., Pernat, A., Mason, E.
(2000). KATP channel activation reduces the severity of postresuscitation myocardial dysfunction. Am. J. Physiol. Heart Circ. Physiol.
279: H1609-H1615
[Abstract][Full Text]
Ewy, G. A., Ornato, J. P.
(2000). Emergency cardiac care: introduction. J Am Coll Cardiol
35: 825-880
[Full Text]
Shaffner, D. H., Eleff, S. M., Koehler, R. C., Traystman, R. J., Ornato, J. P.
(1998). Effect of the No-Flow Interval and Hypothermia on Cerebral Blood Flow and Metabolism During Cardiopulmonary Resuscitation in Dogs • Editorial Comment. Stroke
29: 2607-2615
[Abstract][Full Text]
Gueugniaud, P.-Y., Mols, P., Goldstein, P., Pham, E., Dubien, P.-Y., Deweerdt, C., Vergnion, M., Petit, P., Carli, P., The European Epinephrine Study Group,
(1998). A Comparison of Repeated High Doses and Repeated Standard Doses of Epinephrine for Cardiac Arrest Outside the Hospital. NEJM
339: 1595-1601
[Abstract][Full Text]
Maiese, K., Caronna, J. J.
(1988). Coma Following Cardiac Arrest: A Review of the Clinical Features, Management, and Prognosis. J Intensive Care Med
3: 153-163
[Abstract]