In Comatose Survivors of Out-of-Hospital-Cardiac Arrest, Colder Isn't Better

Current guidelines recommend targeted temperature management between 32°C and 36°C for a minimum of 24 hours in all comatose patients with return of spontaneous circulation after out-of-hospital-cardiac-arrest (OHCA), regardless of the underlying cardiac rhythm. Whether certain subgroups of patients benefit from lower temperatures is unknown.

Researchers at one hospital in Canada randomized nearly 400 comatose patients after OHCA to either “moderate hypothermia” (31°C) or “mild hypothermia” (34°C). Nearly all patents in both groups underwent immediate coronary angiography, and 86% had “shockable” rhythms. Patients were maintained at their target temperature for 24 hours and then gradually were rewarmed during the next 48 hours; this warming …