Abstract | BACKGROUND: METHODS: In this multicenter, randomized, controlled trial we assigned adults with out-of-hospital cardiac arrest undergoing CPR to either a rapid intravenous infusion of up to 2 L of cold saline or standard care. The primary outcome measure was survival at hospital discharge; secondary end points included return of a spontaneous circulation. The trial was closed early (at 48% recruitment target) due to changes in temperature management at major receiving hospitals. RESULTS: A total of 1198 patients were assigned to either therapeutic hypothermia during CPR (618 patients) or standard prehospital care (580 patients). Patients allocated to therapeutic hypothermia received a mean (SD) of 1193 (647) mL cold saline. For patients with an initial shockable cardiac rhythm, there was a decrease in the rate of return of a spontaneous circulation in patients who received cold saline compared with standard care (41.2% compared with 50.6%, P=0.03). Overall 10.2% of patients allocated to therapeutic hypothermia during CPR were alive at hospital discharge compared with 11.4% who received standard care (P=0.71). CONCLUSIONS: In adults with out-of-hospital cardiac arrest, induction of mild therapeutic hypothermia using a rapid infusion of large-volume, intravenous cold saline during CPR may decrease the rate of return of a spontaneous circulation in patients with an initial shockable rhythm and produced no trend toward improved outcomes at hospital discharge. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01173393.
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Authors | Stephen A Bernard, Karen Smith, Judith Finn, Cindy Hein, Hugh Grantham, Janet E Bray, Conor Deasy, Michael Stephenson, Teresa A Williams, Lahn D Straney, Deon Brink, Richard Larsen, Chris Cotton, Peter Cameron |
Journal | Circulation
(Circulation)
Vol. 134
Issue 11
Pg. 797-805
(Sep 13 2016)
ISSN: 1524-4539 [Electronic] United States |
PMID | 27562972
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2016 American Heart Association, Inc. |
Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Cardiopulmonary Resuscitation
- Humans
- Hypothermia, Induced
(methods)
- Isotonic Solutions
- Middle Aged
- Out-of-Hospital Cardiac Arrest
(mortality, therapy)
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