Therapeutic Hypothermia for Cardiac Arrest in the Prehospital Setting

In a prospective study of 163 patients (age, >14 years) with out-of-hospital cardiac arrest and initial rhythms of asystole or pulseless electrical activity, researchers in Melbourne, Australia, compared outcomes between patients randomized to therapeutic hypothermia initiated in the prehospital setting versus the hospital setting. Paramedics initiated standard postresuscitation measures during transport.

Time to reach the target temperature (<34°C) was significantly faster in the prehospital-cooled group (3.2 vs. 4.8 hours). In prehospital-cooled patients (who had received a median of 1500 mL of rapidly infused, ice-cold Hartmann's solution), mean core temperature had decreased by 1.4°C on hospital arrival, versus only 0.2°C in patients who…