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Sudden cardiac arrest (SCA) remains one of the major leading causes of death. Cognitive deficits are common in survivors of SCA. Postresuscitative mild induced hypothermia (MIH) lowers mortality and reduces neurologic damage after cardiac arrest. The investigators evaluated the efficacy and side effects of therapeutic hypothermia in an unselected group of patients after SCA.
Consecutive patients with restoration of spontaneous circulation (ROSC) after resuscitation due to out-of-hospital SCA, admitted to our intensive care unit, underwent MIH. Hypothermia was induced by infusion of cold saline and whole-body-cooling methods (electronic randomization: invasive Coolgard or non-invasive ArcticSun). The core body temperature was operated at 32 to 34 °C over a period of 24 hours followed by active rewarming. Neurological status was evaluated at hospital discharge and 6 months after discharge using the Pittsburgh Cerebral Performance Category (CPC). Blood samples of neuron-specific enolase (NSE) were collected during 72 hours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CG | Active Comparator | Coolgard: invasive Cooling |
|
| AS | Active Comparator | ArcticSun: Surface-Cooling |
|
| UnCOOL | Sham Comparator | No Cooling-Therapy due to non-operational cooling-devices |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coolgard | Device | invasive Cooling via femoral ICY-catheter |
| |
| ArcticSun |
| Measure | Description | Time Frame |
|---|---|---|
| Time to reach the target temperature | Twenty-four hours | |
| NSE as a parameter for cerebral damage | Seventy-two hours |
| Measure | Description | Time Frame |
|---|---|---|
| Neurologic outcome | Six months | |
| Survival | Six months | |
| Periprocedural complications |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Holger Thiele, Associate Professor | Study Chair | Principal Investigator |
| Undine Pittl, MD | Study Sub-Investigator | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Leipzig, Heart Center, Cardiology | Leipzig | 04289 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10625721 | Background | Zeiner A, Holzer M, Sterz F, Behringer W, Schorkhuber W, Mullner M, Frass M, Siostrzonek P, Ratheiser K, Kaff A, Laggner AN. Mild resuscitative hypothermia to improve neurological outcome after cardiac arrest. A clinical feasibility trial. Hypothermia After Cardiac Arrest (HACA) Study Group. Stroke. 2000 Jan;31(1):86-94. doi: 10.1161/01.str.31.1.86. | |
| 11856794 |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D007035 | Hypothermia |
| D016757 | Death, Sudden, Cardiac |
| D009461 | Neurologic Manifestations |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
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| Device |
Noninvasive surface-cooling by saline-cooled thermo-vest |
|
| Conventional treatment | Other | Intensive care-treatment without cooling |
|
| Seventy-two hours |
| Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002 Feb 21;346(8):557-63. doi: 10.1056/NEJMoa003289. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D003645 | Death, Sudden |
| D003643 | Death |
| D010335 | Pathologic Processes |
| D009422 | Nervous System Diseases |