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Critical Care
Published in: Critical Care 4/2007

01-08-2007 | Commentary

Number needed to treat = six: therapeutic hypothermia following cardiac arrest – an effective and cheap approach to save lives

Authors: Bernd W Böttiger, Andreas Schneider, Erik Popp

Published in: Critical Care | Issue 4/2007

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Abstract

In 2005, the European Resuscitation Council (ERC) guidelines stated: Unconscious adult patients with spontaneous circulation after out-of-hospital ventricular fibrillation cardiac arrest should be cooled to 32 to 34°C for 12 to 24 hours. Patients with cardiac arrest from a non-shockable rhythm, in-hospital patients and children may also benefit from hypothermia. There is no argument to wait. We have to treat the next unconscious cardiac arrest patient with hypothermia.
Literature
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Pichon N, Amiel JB, Francois B, Dugard A, Etchecopar C, Vignon P: Efficacy of and tolerance to mild induced hypothermia after out-of-hospital cardiac arrest using an endovascular cooling system. Crit Care 2007, 11: R71. 10.1186/cc5956PubMedCentralCrossRefPubMed
2.
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, 346: 557-563. 10.1056/NEJMoa003289CrossRefPubMed
3.
Hypothermia after Cardiac Arrest Study Group: Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002, 346: 549-556. 10.1056/NEJMoa012689CrossRef
4.
Holzer M, Bernard SA, Hachimi-Idrissi S, Roine RO, Sterz F, Müllner M: Hypothermia for neuroprotection after cardiac arrest: systematic review and individual patient data meta-analysis. Crit Care Med 2005, 33: 414-418. 10.1097/01.CCM.0000153410.87750.53CrossRefPubMed
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Bernard GR: Drotrecogin alfa (activated) (recombinant human activated protein C) for the treatment of severe sepsis. Crit Care Med 2003, 31: S85-S93. 10.1097/00003246-200301001-00012CrossRefPubMed
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International Liason Committee on Resuscitation: Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life support Task Force of the International Liaison committee on Resuscitation. Resuscitation 2003, 57: 231-235. 10.1016/S0300-9572(03)00184-9CrossRef
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European Resuscitation Council: European Resuscitation Council guidelines for resuscitation 2005. Resuscitation 2005, 67: S1-S189. 10.1016/j.resuscitation.2005.10.001CrossRef
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Popp E, Böttiger BW: Cerebral resuscitation: state of the art, experimental approaches and clinical perspectives. Neurol Clin 2006, 24: 73-87. 10.1016/j.ncl.2005.10.008CrossRefPubMed
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Merchant RM, Soar J, Skrifvars MB, Silfvast T, Edelson DP, Ahmad F, Huang KN, Khan M, Vanden Hoek TL, Becker LB, Abella BS: Therapeutic hypothermia utilization among physicians after resuscitation from cardiac arrest. Crit Care Med 2006, 34: 1935-1940. 10.1097/01.CCM.0000220494.90290.92CrossRefPubMed
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Haugk M, Sterz F, Grassberger M, Uray T, Kliegel A, Janata A, Richling N, Herkner H, Laggner AN: Feasibility and efficacy of a new non-invasive surface cooling device in post-resuscitation intensive care medicine. Resuscitation 2007, in press.
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Kuboyama K, Safar P, Radovsky A, Tisherman SA, Stezoski SW, Alexander H: Delay in cooling negates the beneficial effect of mild resuscitative cerebral hypothermia after cardiac arrest in dogs: a prospective, randomized study. Crit Care Med 1993, 21: 1348-1358. 10.1097/00003246-199309000-00019CrossRefPubMed
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Bernard S, Buist M, Monteiro O, Smith K: Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 2003, 56: 9-13. 10.1016/S0300-9572(02)00276-9CrossRefPubMed
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Virkkunen I, Yli-Hankala A, Silfvast T: Induction of therapeutic hypothermia after cardiac arrest in prehospital patients using ice-cold Ringer's solution: a pilot study. Resuscitation 2004, 62: 299-302. 10.1016/j.resuscitation.2004.04.003CrossRefPubMed
Metadata
Title
Number needed to treat = six: therapeutic hypothermia following cardiac arrest – an effective and cheap approach to save lives
Authors
Bernd W Böttiger
Andreas Schneider
Erik Popp
Publication date
01-08-2007
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2007
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6100

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