Therapeutic Hypothermia after Cardiac Arrest

TO THE EDITOR:

In their article, Ali and Zafari (1) review recent advances in cardiopulmonary resuscitation and emergency cardiovascular care. Although their review is an excellent summary of the most recent updates in resuscitation medicine, the authors ignored the latest therapeutic tool for the amelioration of neurologic damage after cardiac arrest: therapeutic hypothermia. On the basis of overwhelming evidence from clinical trials, the American Heart Association incorporated therapeutic hypothermia into its advanced cardiac life support guidelines (2) as the last link of the chain of survival.

Recently, 3 trials demonstrated the neuroprotective effects of hypothermia after cardiac arrest. In the largest, the HACA (Hypothermia After Cardiac Arrest) trial (3), 275 comatose survivors of ventricular fibrillation arrest were randomly assigned to mild hypothermia to a target bladder temperature of 32 °C to 34 °C for …