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Pro/Con debate on mild hypothermia after out-of-hospital cardiac arrest
Here's a free "head-to-head" discussion with arguments for and against implementation of routine mild hypothermia for all patients with out-of-hospital cardiac arrest.
The benefits of hypothermia after out-of-hospital ventricular fibrillation cardiac arrests are reasonably well-established, and multiple society guidelines (SCCM's, AHA's) advocate the practice. The question is whether to induce mild hypothermia / targeted temperature management in all out-of-hospital cardiac arrest patients, most of whom have PEA or asystolic arrests, with much poorer prognoses and no definite accepted benefit of hypothermia.
The question is unsettled, the data is flawed, the stakes are high, and the night is young. Talk amongst yourselves.
Nolan JP, Soar J. Does the evidence support the use of mild hypothermia after cardiac arrest? Yes. BMJ 2011;343:d5830. FREE FULL TEXT
Walden AP et al. Does the evidence support the use of mild hypothermia after cardiac arrest? No. BMJ 2011;343:doi:10.1136. FREE FULL TEXT