Induction of prehospital therapeutic hypothermia after resuscitation from nonventricular fibrillation cardiac arrest

Journal Club Summary hypothermia

Methodology: 2/5    
Usefulness: 2/5
Bernard SA, Smith K, Cameron P, Masci K, Taylor DM, Cooper DJ, Kelly AM, Silvester W; Rapid Infusion of Cold Hartmanns Investigators.
Crit Care Med. 2012 Mar;40(3):747-53.
Pubmed Link

This study looked at the use of ice-cold Hartmann’s solution for induction of therapeutic hypothermia for non-VT/VF arrests in the pre-hospital setting compared to in-hospital cooling. They found a found a decrease in mean-time to therapeutic hypothermia (3.2 hrs versus 4.8 hrs, p=0.03), but no statistical difference in “favourable outcome” (12% pre-hospital versus 7% hospital cool, p=0.15). The study protocol was well designed, but unfortunately there were significant flaws in the enrollment and compliance to protocol that led to questions on the accuracy and validity of the results.  
 
By Dr. Andy Pan
EMottawa

EMottawa

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