Time to lower body temperature is critical in out-of-hospital cardiac arrest
Time to reach the target body temperature was a significant factor in achieving favorable neurological outcomes in patients with witnessed out-of-hospital cardiac arrest. Significantly more favorable neurological outcomes occurred if the time to target temperature management was <600 min or less. These results are reported in the peer-reviewed journal Therapeutic Hypothermia and Temperature Management.
Furthermore, the effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) compared to conventional cardiopulmonary resuscitation (CCPR) increased as the interval from witnessed out-of-hospital cardiac arrest to target temperature decreased. ECPR with extracorporeal membrane oxygenation (ECMO) is a more promising treatment for out-of-hospital cardiac arrest than CCPR.
Comparing the results of this study to previous analyses, Tadashi Kaneko, Mie University Hospital, and coauthors conclude that "target temperature management may improve the neurological outcomes of witnessed out-of-hospital cardiac arrest." They report higher favorable neurological outcomes than in previous studies of patients with either ECPR or CCPR and no body temperature lowering.
"This article is a significant contribution to the field of therapeutic hypothermia therapy in out-of-hospital cardiac arrest patients emphasizing again the importance of time to treatment and the benefits of ECPR in combination with ECMO," says W. Dalton Dietrich, III, Ph.D., Editor-in-Chief of Therapeutic Hypothermia and Temperature Management, Scientific Director of The Miami Project to Cure Paralysis, and Kinetic Concepts Distinguished Chair in Neurosurgery, University of Miami Leonard M. Miller School of Medicine.