Therapeutic hypothermia -- cooling the body and brain down to 33°C -- is the method used worldwide to treat cardiac arrest, even though a lower body temperature may raise the risk of side-effects. However, keeping the temperature steady at 36°C is just as effective, a study led by Lund University researchers has found.
"Our results show that it is just as effective -- both for survival and recovery of neurological function -- to focus on avoiding the fever that accompanies cardiac arrest. We don't need to cool down the body and brain to 33°C. This is of course important because cooling to lower temperatures brings a higher risk of infection, bleeding and other side-effects," said Niklas Nielsen, researcher at Lund University and first author of the study.
Patients who come into hospital in cardiac arrest receive intensive care with cooling and ventilator treatment. Around half of them survive. Daily life goes quite well for those who survive, but around 30 per cent of cardiac arrest patients suffer impaired cognitive function, for example poorer memory.
"Until now, there has not been a clear place in the health service for the rehabilitation of these patients and one of our most important tasks is to identify them and tailor rehabilitation treatment to them. The median age for cardiac arrest is just over 60, and there are quite a lot of younger people who are affected. Rehabilitation can mean the difference between being able to go back to work and remaining on sick leave," said Niklas Nielsen.
The researchers are planning to analyze the patient data in more detail to see if there may be groups of patients for whom cooling could be beneficial and whether it has an impact at a more detailed cognitive level.
- Niklas Nielsen et al. Targeted Temperature Management Cardiac Arrest. New England Journal of Medicine, November 2013
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