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Guidelines recommend targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA) but data are inconsistent as to both the target temperature and the timing of initiation of cooling. Prior studies of prehospital TTM used cold intravenous fluids, which may worsen hemodynamic instability, and these studies did not demonstrate significant benefit. A novel technique that delivers oxygen or air and a liquid coolant through nasal catheters has been explored as a noninvasive method for intra-arrest cooling.
In a multicenter European trial, researchers randomized 677 adults with bystander-witnessed cardiac arrest to the nasal cooling method initiated in the prehospital setting or standard TTM initiated after hospital arrival. Bo…