Therapeutic cooling in cardiac arrest of noncardiac origin
© BioMed Central Ltd 2006
Published: 21 March 2006
On the basis of previous published data, the Interliaison Committee on Resuscitation has advised that unconscious adults with spontaneous circulation after out-of-hospital cardiac arrest should be cooled to 33°C during 24 hours when the initial rhythm was ventricular fibrillation (VF) and the cause of the cardiac arrest is of cardiac origin. We postulate that other rhythms might beneficiate from cooling as well as cardiac arrest of noncardiac origin. We therefore started a prospective study, and we compare the effect of cooling on long-term outcome in patients resuscitated after cardiac arrest of noncardiac origin or having rhythms other than VF.
Twenty-eight patients were included, 14 of them were subjected to hypothermia after achieving return of spontaneous circulation (ROSC) (hypothermia group), the remaining other 14 patients were subjected to normothermia (normothermia group). The cause of cardiac arrest was near asphyxia after strangulation or secondary to choking. Other patients had asystole or pulseless electrical activity (PEA) at the first rhythm assessment.
Number of patients
Median age (years [range])
Type of cardiac arrest
Bystander – CPR
Median interval collapse to ROSC (min [range])
Median tympanic temperature at admission (°C)
Death of other origin than cerebral
In conclusion, cooling seems to improve the neurological outcome after cardiac arrest even in rhythms other than VF and cardiac arrest of noncardiac origin. Surprisingly cooling also mitigates the brain damage associated with asphyxial cardiac arrest in humans.