R.E.B.E.L.EM - By Mark Ramzy - November 18, 2019
"Clinical Question:
Does moderate therapeutic hypothermia at 33oC or normothermia at 37oC improve the neurologic outcome in patients who have been successfully resuscitated out of cardiac arrest with a non-shockable rhythm?
Author’s Conclusions:
Among patients with coma who had been resuscitated from cardiac arrest with non-shockable rhythm, moderate therapeutic hypothermia at 33°C for 24 hours led to a higher percentage of patients who survived with a favorable neurologic outcome at day 90 than was observed with targeted normothermia.
Our Conclusion:
This study emphasizes the importance of using definitive temperature control using an adaptive-control device. However, it provides no information about whether 33oC vs 36oC is preferable. Lastly, additional studies are needed to investigate more of the body’s effect at a temperature of 33oC and whether this or the avoidance of fever leads to better neurologic outcomes.
Clinical Bottom Line
Therapeutic hypothermia may be neurologically beneficial for post-cardiac arrest patients with non-shockable rhythms however efforts should be directed at avoiding fevers in these patients."