Endovascular Versus External Targeted Temperature Management for Patients With Out-of-Hospital Cardiac Arrest

• DOI: 10.1161/circulationaha.114.012805
• Publication Date: 2015-06-20T02:57:02Z
• Authors: Nicolas Deye; Alain Cariou; Patrick Girardie; Nicolas Pichon; Bruno Megarbane; Philippe Midez; Jean-Marie Tonnelier; Thierry Boulain; Hervé Outin; Arnaud Delahaye; Aurélie Cravoisy; Alain Mercat; Pascal Blanc; Charles Santré; Hervé Quintard; François Brivet; Julien Charpentier; Delphine Garrigue; Bruno Francois; Jean-Pierre Quenot; François Vincent; Pierre-Yves Gueug...; Jean-Paul Mira; Pierre Carli; Eric Vicaut; Frédéric J. Baud
• Keywords: Targeted temperature management; Clinical endpoint

Targeted temperature management is recommended after out-of-hospital cardiac arrest. Whether advanced internal cooling superior to basic external remains unknown. The aim of this multicenter, controlled trial was evaluate the benefit endovascular versus surface cooling.Inclusion criteria were following: age 18 79 years, arrest related a presumed cause, time return spontaneous circulation <60 minutes, delay between and inclusion <240 unconscious patient before start cooling. Exclusion terminal disease, pregnancy, known coagulopathy, uncontrolled bleeding, on admission <30°C, in-hospital arrest, immediate need for extracorporeal life support or hemodialysis. Patients randomized 2 strategies: femoral devices (Icy catheter, Coolgard, Zoll, formerly Alsius; n=203) using fans, homemade tent, ice packs (n=197). primary end point, that is, favorable outcome evaluated by survival without major neurological damage (Cerebral Performance Categories 1-2) at day 28, not significantly different groups (odds ratio, 1.41; 95% confidence interval, 0.93-2.16; P=0.107). Improvement in 90 favor group did reach significance 1.51; 0.96-2.35; P=0.07). Time target (33°C) shorter hypothermia more strictly maintained than (P<0.001). Minor side effects directly method observed frequently (P=0.009).Despite better induction maintenance, terms outcome.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00392639.