Human Clinical Trials With Hypothermia For Global Ischemia Cardiac Arrest

Although initial pilot studies of hypothermia following cardiac arrest showed great promise (61,74-76), two larger, randomized, controlled studies proved the effectiveness of moderate hypothermia for anoxic encephalopathy (60,62) . Both of the trials assessed the effectiveness of hypothermia following ventricular tachycardia (VT) or VF. One study randomized 77 patients (43 to hypothermia and 34 to normothermia) (60). The hypothermia group was cooled to 33°C for 12 hr, starting in the ambulance on the way to hospital. At the time of discharge from the hospital, 21 of the 43 (49%) hypothermia-treated patients had a good outcome, compared to 9 of the 34 (26%) in the control group ( p=0.46). The other study, the Hypothermia After Cardiac Arrest (HACA) study, randomized 273 patients (136 to hypothermia and 137 to normothermia) (62). The hypothermia group was cooled to 33°C for 24 hr. Outcomes were based on 6-month follow-up. Good outcomes were seen in 55% of the hypothermia-treated patients, compared to 39% of the normothermia controls. Although both of these studies limited entry to patients with VT/VF, hypothermia has also been shown to be effective in other cardiac rhythms (asystole) (77).

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