Dankiewicz J, et al. N Engl J Med. 2021 Jun 17;384(24):2283-2294.
Question and Methods: Open-label multicentre randomized controlled trial to determine whether targeted hypothermia reduces mortality compared to targeted normothermia in comatose patients with ROSC after OHCA.
Findings: No difference in all-cause mortality at 6 months between hypothermia vs. normothermia (465/925 (50%) vs. 446/925 (48%); 95% CI 0.94-1.14; P=0.37).
Limitations: No major methodological limitations but sets high resource-intensive standard for routine post-arrest care.
Interpretation: For every comatose patient with ROSC after OHCA, aggressively target normothermia 36-37.5°C via continuous core temperature measurement (e.g. esophageal, bladder) with readily-available external cooling methods.
Dr. Hashim Kareemi