Effect of lowering of body temperature for adults with cardiac arrest prior to hospital arrival

November 17, 2013, The JAMA Network Journals

Francis Kim, M.D., of Harborview Medical Center, Seattle, and colleagues evaluated whether early prehospital cooling (lowering body temperature) improved survival to hospital discharge and neurological outcome in cardiac arrest patients with or without ventricular fibrillation (VF).

Cardiac arrest can cause brain injury and many patients never awaken after resuscitation. Hypothermia is a promising treatment that can help brain recovery. "Hospital cooling improves outcome after , but prehospital cooling immediately after return of spontaneous circulation may result in better outcomes," according to background information in the article. "The optimal timing for induction of hypothermia is uncertain."

For this trial, 1,359 patients (583 with VF and 776 without VF) with prehospital cardiac arrest and resuscitated by paramedics were assigned to standard care with or without prehospital cooling, accomplished by infusing up to 2 liters of 4°C normal saline as soon as possible following return of spontaneous circulation. Nearly all of the patients resuscitated from VF and admitted to the hospital received hospital cooling regardless of their randomization.

The intervention reduced core temperature by more than 1°C and patients reached the goal temperature about 1 hour sooner than in the control group. The researchers found that survival to was similar in the intervention and control groups among patients with VF (62.7 percent vs. 64.3 percent, respectively) and among patients without VF (19.2 percent vs. 16.3 percent, respectively). The intervention was also not associated with improved neurological status of full recovery or mild impairment at discharge for patients with or without VF.

"Although hypothermia is a promising strategy to improve resuscitation and brain recovery following cardiac arrest, the results of the current study do not support routine use of cold intravenous fluid in the prehospital setting to improve clinical outcomes," the authors write.

Explore further: Common IV fluid associated with reduced likelihood of full recovery in patients with cardiac arrest

More information: JAMA doi:10.l001/jama.2013.282173

Related Stories

Common IV fluid associated with reduced likelihood of full recovery in patients with cardiac arrest

February 19, 2013
Although an intravenous fluid that paramedics in Japan often give to patients in cardiac arrest before they reach hospital may help restore circulation, it may also be linked to reduced survival with minimal neurological ...

Combination therapy may help improve rate of favorable neurological status following cardiac arrest

July 16, 2013
Among patients who experienced in-hospital cardiac arrest requiring vasopressors (drugs that increase blood pressure), use of a combination therapy during cardiopulmonary resuscitation resulted in improved survival to hospital ...

Potentially life-saving cooling treatment rarely used for in-hospital cardiac arrests

June 21, 2013
The brain-preserving cooling treatment known as therapeutic hypothermia is rarely being used in patients who suffer cardiac arrest while in the hospital, despite its proven potential to improve survival and neurological function, ...

Coronary angioplasty improves cardiac arrest survival

October 20, 2012
Coronary angioplasty improves survival in all patients with out of hospital cardiac arrest, according to research presented at the Acute Cardiac Care Congress 2012. The study was presented by Dr Annamaria Nicolino from the ...

Study finds increase in survival following bystander CPR for out-of-hospital cardiac arrest

October 1, 2013
In Denmark between 2001 and 2010 there was an increase in bystander cardiopulmonary resuscitation (CPR) that was associated with an increase in survival following out-of-hospital cardiac arrest, according to a study in the ...

CPR for 38 minutes or longer improves chance to survive cardiac arrest (w/ Video)

November 17, 2013
Performing CPR for 38 minutes or longer can improve a patient's chance of surviving cardiac arrest, according to a study presented at the American Heart Association's Scientific Sessions 2013.

Recommended for you

Biomechanical mapping method aids development of therapies for damaged heart tissue

January 23, 2018
Researchers have developed a new way to capture the detailed biomechanical properties of heart tissue. The high-resolution optical technique fills an important technology gap necessary to develop and test therapies that might ...

Researchers borrow from AIDS playbook to tackle rheumatic heart disease

January 22, 2018
Billions of US taxpayer dollars have been invested in Africa over the past 15 years to improve care for millions suffering from the HIV/AIDS epidemic; yet health systems on the continent continue to struggle. What if the ...

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.