Hypothermia Improved Neurologic Outcome for Cardiac Arrest with Nonshockable Rhythm

A French open-label, randomized, controlled trial showed that among patients with coma who had been resuscitated from cardiac arrest with nonshockable rhythm (asystole or pulseless electrical activity), the use of moderate therapeutic hypothermia at 33°C led to a higher percentage of patients who survived with a favorable neurologic outcome at day 90 than was observed with targeted normothermia. The trial included a total of 584 patients, and 581 were included in the analysis (cardiac arrest out of the hospital in 72.6%, noncardiac cause of cardiac arrest in two thirds, and  circulatory shock in 58% of the patients. 3 patients withdrew consent). On day 90, a total of 29 of 284 patients (10.2%) in the hypothermia group were alive with a Cerebral Performance Category score of 1 or 2 (defined as a favorable neurologic outcome), as compared with 17 of 297 (5.7%) in the normothermia group. Mortality at 90 days did not differ significantly between the hypothermia group and the normothermia group (81.3% and 83.2%, respectively). The incidence of prespecified adverse events did not differ significantly between groups. Moderate therapeutic hypothermia is recommended to improve neurologic outcomes for all patients with coma after successful resuscitation from cardiac arrest. Source: https://www.nejm.org/