Therapeutic hypothermia has been proposed to be the standard of care after cardiac arrest. However, the data has been inconclusive. This is the study in the October 4, 2016 issue of JAMA looked at whether this controversial treatment improves survival and/or neurological improvement after cardiac arrest. This study interestingly looked at in-hospital cardiac arrests and found outcomes were actually worse. So maybe we really need to think about what we are doing and whether it is making a difference.
Key Points Question Is therapeutic hypothermia associated with better survival outcomes for patients with in-hospital cardiac arrest? Findings In this cohort study using a US national registry, survival outcomes were compared for 26 183 patients who were treated vs not treated with therapeutic hypothermia after surviving an in-hospital cardiac arrest. Compared with untreated patients, those treated with therapeutic hypothermia had significantly lower rates of in-hospital survival (29.2% vs 27.4%, respectively), as well as lower rates of survival to discharge with favorable neurological status. Meaning Therapeutic hypothermia was not associated with improved survival or better neurological outcomes and was potentially harmful. Current use of therapeutic hypothermia for in-hospital cardiac arrest may warrant reconsideration.