Clinical experience of therapeutic hypothermia in cases of near-hanging and recovered from cardiac arrest due to hanging

Objective: There is no specific treatment for comatose patients after near-hanging or in those who recover from cardiac arrest (CA) caused by hanging. Since 2009, we have used therapeutic hypothermia (TH) to treat all comatose survivors of near-hanging and in patients who recovered from CA caused by hanging. The purpose of this study was to describe the outcomes in comatose patients after near-hanging. Design: Case series. Setting: Emergency departments of two regional hospitals. Methods: We collected patient data from the Samsung Medical Center hypothermia database between November 2009 and November 2011. We included all patients presented with near-hanging or CA caused by hanging; who remained comatose and received TH after resuscitation for analysis. Clinical characteristics and outcome of patients were presented. Results: During the study period, 26 patients were admitted to the emergency department after near-hanging or CA caused by hanging; 21 patients were enrolled in this study. Twelve patients with CA and 9 comatose patients without CA were treated with TH. Only 1 patient with CA had a good neurological outcome. By contrast, all near-hanging patients without CA had a good neurological outcome. Conclusions: TH can be an effective therapeutic modality in cases of near-hanging without CA. However, the effectiveness of TH is questionable in patients who survive from CA caused by hanging.