Therapeutic hypothermia after cardiac arrest in clinical practice: Review and compilation of recent experiences

Objectives: We sought to review findings from recent literature on the postresuscitation care of cardiac arrest patients using therapeutic hypothermia as part of nontrial treatment. Design: Literature review. Setting: Hospital-based environment. Subjects: Patients initially resuscitated from cardiac arrest who underwent hypothermia induction as a treatment regimen or historical control patients who did not receive hypothermia therapy. Measurements: We compiled protocol methodology from the various studies, as well as survival-to-hospital discharge and neurological outcomes. Main Results: Although varied in their protocols and outcome reporting, results from published investigations confirmed the findings from landmark randomized controlled trials, in that the use of therapeutic hypothermia increased survival with an odds ratio of 2.5 (95% confidence interval, 1.8-3.3) and favorable outcome with an odds ratio of 2.5 (95% confidence interval, 1.9-3.4). Conclusions: The survival and neurological outcomes benefit from therapeutic hypothermia are robust when compared over a wide range of studies of actual implementation. (Crit Care Med 2009; 37[Suppl.]:S223-S226)