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.

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“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.

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Source:

Nejm

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