Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest

Abstract

IMPORTANCEComatose survivors of out-of-hospital cardiac arrest experience high rates of death and severe neurologic injury. Current guidelines recommend targeted temperature management at 32 °C to 36 °C for 24 hours. However, small studies suggest a potential benefit of targeting lower body temperatures.OBJECTIVE To determine whether moderate hypothermia (31 °C), compared with mild hypothermia (34 °C), improves clinical outcomes in comatose survivors of out-of-hospital cardiac arrest.DESIGN, SETTING, AND PARTICIPANTS Single-center, double-blind, randomized, clinical superiority trial carried out in a tertiary cardiac care center in eastern Ontario, Canada. A total of 389 patients with out-of-hospital cardiac arrest were enrolled between

Targeted Temperature Management in Cardiac Arrest: An Updated Narrative Review

“…Similar results were reported in the CAPITAL CHILL (Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial) trial [ 41 ], published shortly after the TTM2 trial. This was a single-center, double-blinded, randomized, clinical superiority trial carried out in a tertiary cardiac care center in eastern Ontario, Canada.…”

Temperature Control After Cardiac Arrest: A Narrative Review

“…The trial randomly assigned adult patients to a targeted temperature of 31 °C or 34 °C for 24 h, and demonstrated that a lower temperature goal of 31 °C did not improve outcomes compared to the standard of care targeted temperature of 34 °C. It is important to note that this was a single-center study and likely underpowered [ 46 ].…”

The year in cardiovascular medicine 2021: acute cardiovascular care and ischaemic heart disease

“… 30 The primary outcome of 6-month all-cause mortality was no different between the groups. In the CAPITA-CHILL study (single-centre, double-blind randomized clinical superiority trial), 389 patients with OHCA were randomly assigned to 31°C (193 patients) vs. 24°C (196 patients) for 24 h. 31 Primary outcome was 180-day all-cause mortality/poor neurological outcome with no difference between the groups. These findings support recommendations in current resuscitation guidelines.…”