Cooling the body may not always help people who have cardiac arrest in hospital

14th October 2016

Cooling the body can help many people recover after a cardiac arrest in the community, many studies have shown.

But the effect may not be the same for people who have a cardiac arrest in hospital, a new study suggests.

Cooling, or therapeutic hypothermia, for those patients caused poorer survival and worse neurological outcomes compared with usual care, say researchers led by Dr Paul Chan from St Luke’s Mid America Heart Institute in Kansas City, America.

So current use of therapeutic hypothermia for in-hospital cardiac arrest may warrant reconsideration, the researchers concluded in the Journal of the American Medical Association.

Therapeutic hypothermia has generally shown advantages in out-of-hospital cardiac arrest, in which the cause of cardiac arrest is more typically cardiac and response times slower than in in-hospital cases.

"It's not so surprising," commented Dr Karl Kern, co-director of the University of Arizona Sarver Heart Center in Tucson. "Maybe we should study this with a randomised trial, rather than just expect that outpatient findings will fit the inpatient setting.

The study looked at 26,183 patients who had had in-hospital cardiac arrest, 1,568 (6.0%) of whom were cooled.

It was noted, however, that the findings could reflect poor implementation of the therapy.

"These observational findings warrant a randomised clinical trial to assess efficacy of therapeutic hypothermia for in-hospital cardiac arrest," the researchers concluded.

For more details, see here