Cooling cardiac arrest patients improves survival

Research presented at the American Heart Association’s Scientific Sessions 2012 demonstrates that cooling patients resuscitated after sudden cardiac arrest in order to achieve a lower body temperature increases survival.
Research presented at the American Heart Association’s Scientific Sessions 2012 demonstrates that cooling patients resuscitated after sudden cardiac arrest in order to achieve a lower body temperature increases survival.

In a single-centre study involving 36 patients conducted in Madrid, Spain, from March 2008-August 2011, researchers randomly assigned patients to receive therapeutic cooling to either 32°C or 34°C for 24 hours, followed by gradual rewarming for 12 to 24 hours. Patients were cooled internally with intravenous cold saline followed by use of an internal catheter and temperature management system inserted directly into a vein. The aim of the study was to provide initial data for future research on whether controlling hypothermia levels can improve outcome.

The researchers found that 44% of patients who underwent therapeutic cooling to 32°C after cardiac arrest survived without severe brain dysfunction 6 months after treatment. Survival was much lower (11%) in patients cooled to 34°C. The lead researcher emphasizes that although the results suggest a better outcome with lower target temperature levels, they should be interpreted with caution, given that they may be due to multiple factors other than the effect of lower target temperature.

Each year in the USA, roughly 382 800 people suffer cardiac arrest outside a hospital, according to the American Heart Association. This life-threatening condition occurs when the heart suddenly stops functioning. Immediate cardiopulmonary resuscitation (CPR) and emergency medical care must be provided within minutes to restore a regular rhythm - or the person will not survive.

Once a normal heartbeat is restored, treatment for comatose patients includes therapeutic cooling to decrease the body's oxygen requirements, which can help prevent brain damage associated with the cardiac arrest. American Heart Association and International Liaison Committee on Resuscitation (ILCOR) recommendations are to cool body temperature to 32 to 34°C.