Cooling Cardiac-Arrest Patients: The Sooner, the Better?

Findings from two studies suggest that prehospital and intra-arrest cooling are safe and might contribute to improved outcomes.

Cooling patients resuscitated from cardiac arrest (therapeutic hypothermia) saves lives and is now routine in many hospitals. Two new studies explore the potential benefits of initiating cooling before the return of spontaneous circulation (intra-arrest) and in the field by paramedics.

In a manufacturer-sponsored feasibility trial, investigators in five European countries randomized 194 patients with witnessed cardiac arrest to systemic cooling after hospital arrival with or without intra-arrest cooling in the field via a portable transnasal cooling device. Transnasal cooling was initiated a median of 23 minutes after collapse and about 100 minutes before systemic cooling. Although the overall rate of survival to hospital discharge was highe…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI