Out-of-hospital cardiac arrest (OHCA): "targeted hypothermia does not reduce deaths in coma patients"
Targeted hypothermia does not reduce the incidence of death at six months among comatose patients after out-of-hospital cardiac arrest (OHCA), according to a study published in the 17 June issue of the New England Journal of Medicine
Patients undergoing targeted hypothermia after out-of-hospital cardiac arrest (OHCA): Swedish study
Dr. Josef Dankiewicz, Ph.D., of Skåne University Hospital Lund in Sweden, and colleagues conducted an open-label, blinded outcome assessment trial involving comatose adults who had experienced an out-of-hospital cardiac arrest and were randomly assigned to receive targeted hypothermia at 33 degrees Celsius followed by controlled rewarming or targeted normothermia with early treatment of fever.
A total of 1,850 patients were evaluated for the primary outcome of death from any cause at six months.
The researchers found that 50% and 48% of patients in the hypothermia and normothermia groups, respectively, had died at six months (relative risk with hypothermia: 1.04; 95% confidence interval: 0.94 to 1.14; P = 0.37).
Of the 1,747 patients in whom functional outcome was assessed, 55% and 55% of patients in the hypothermia and normothermia groups, respectively, had modified severe or worse disability (modified Rankin scale score ≥4) (relative risk with hypothermia: 1.00; 95% confidence interval: 0.92-1.09).
In the prespecified subgroups, outcomes were consistent.
“Comatose patients after out-of-hospital cardiac arrest treated with targeted hypothermia did not have a lower incidence of death at six months than those treated with normothermia,” the authors write
Several authors disclosed financial ties to the biopharmaceutical and medical device industries; one author reported holding patents.