Wednesday March 4, 2009
Hypothermia after cardiac arrest: Have we gone overboard

Frieberg and Neilsen looked at the two published trial for this purpose.

Objective: The aim of the study was to evaluate the actual use of hypothermia in clinical practice, safety aspects, resource utilization, and outcome in large cohorts of patients.

Method: They looked at the two published studies from two separate registries, including 2205 cardiac arrest patients in 39 different sites, of whom 869 (39%) were treated with induced hypothermia. Another registry, The Hypothermia Registry, includes 1108 patients from 37 sites in six European countries and one center in the United States; a large majority, or 952 patients (86%), were treated with hypothermia.

Conclusions: Hypothermia is feasible to implement, that it seems reasonably safe, and that the outcome compares well with previous reports. They also conclude that the treatment with hypothermia after cardiac arrest is more widely applied than what is strictly evidence based.


Editors' comment: Institutions need to develop, implement and follow guidelines for post-cardiac arrest therapeutic hypothermia to avoid indiscriminate use and save costs.


Reference:

Frieberg H, Nielsen N. Hypothermia after Cardiac Arrest: Lessons Learned from National Registries. Journal of Neurotrauma. ahead of print. doi:10.1089/neu.2008.0637.