A randomized controlled trial comparing the Arctic Sun to standard cooling for induction of hypothermia after cardiac arrest

Context: Hypothermia improves neurological outcome for comatose survivors of out-of-hospital cardiac arrest. Use of computer controlled high surface area devices for cooling may lead to faster cooling rates and potentially improve patient outcome. Objective: To compare the effectiveness of surface cooling with the standard blankets and ice packs to the Arctic Sun, a mechanical device used for temperature management. Design, setting, and patients: Multi-center randomized trial of hemodynamically stable comatose survivors Of out-of-hospital cardiac arrest. Intervention: Standard post-resuscitative care inducing hypothermia using cooling blankets and ice (n = 30) or the Arctic Sun (n = 34). Main outcome measures: The primary end point was the proportion of subjects who reached a target temperature within 4 h of beginning cooling. The secondary end points were time interval to achieve target temperature (34 degrees C) and survival to 3 months. Results: The proportion of subjects cooled below the 34 degrees C target at 4 h was 71% for the Arctic Sun group and 50% for the standard cooling group (p = 0.12). The median time to target was 54 min faster for cooled patients in the Arctic Sun group than the standard cooling group (p < 0.01). Survival rates with good neurological outcome were similar; 46% of Arctic Sun patients and 38% of standard patients had a cerebral performance category of 1 or 2 at 30 days (p = 0.6). Conclusions: While the proportion of subjects reaching target temperature within 4 h was not significantly different, the Arctic Sun cooled patients to a temperature of 34 degrees C more rapidly than standard cooling blankets. Trial registration: ClinicalTrials.gov NCT00282373, registered January 24, 2006. (C) 2009 Elsevier Ireland Ltd. All rights reserved.