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General Critical Care

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Which target temperature do you use in patients with coma after in-hospital cardiac arrest?

  • 32-34°C

  • 36°C

  • <37.5°C

A recent study published in CIRCULATION was conducted to determine the effect of hypothermic temperature control after an in-hospital cardiac arrest on mortality and functional outcome. The study was an investigator-initiated, open-label, blinded-outcome-assessor, multicenter, randomized controlled trial that was conducted in Germany and included a total of 249 patients with coma after in-hospital cardiac arrest. The study found that the survival rate at day 180 was not significantly different in the hypothermic group (32-34°C) compared to the normothermia group (37 degrees). Additionally, the study found that there was a statistically significant difference between the two groups in functional outcomes at 180 days. However, the study was prematurely terminated because of futility and was underpowered, and may have failed to detect clinically important differences between hypothermic temperature control and normothermia.

While further studies may be warranted, this particular study does not provide enough evidence to suggest using hypothermia (32-34°C) in patients after in-hospital cardiac arrest.

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