Therapeutic hypothermia in adult patients receiving extracorporeal life support: early results of a randomized controlled study

Abstract

Cardiac arrest with cerebral ischaemia frequently leads to severe neurological impairment. Extracorporeal life support (ECLS) has emerged as a valuable adjunct in resuscitation of cardiac arrest. Despite ECLS, the incidence of permanent neurological injury remains high. We hypothesize that patients receiving ECLS for cardiac arrest treated with therapeutic hypothermia at 34 °C have lower neurological complication rates compared to standard ECLS therapy at normothermia. Early results of this randomized study suggest that therapeutic hypothermia is safe in adult patients receiving ECLS, with similar complication rates as ECLS without hypothermia. Further studies are warranted to measure the efficacy of this therapy.

Associations of therapeutic hypothermia with clinical outcomes in patients receiving ECPR after cardiac arrest: systematic review with meta-analysis

“…After excluding the duplicated papers, review or meeting abstracts, and irrelevant articles, 60 articles were left for further screening by checking the full texts. 47 articles were excluded, of which, seven were overlapped studies [42][43][44][45][46][47][48], seven were performed in pediatric patients [49][50][51][52][53][54][55], two study contained patients with other disease besides CA and the data related to CA could not be obtained separately [16,56], three studies contained CA patients treated with other methods besides ECPR and the data related to ECPR could not be obtained separately [17,57,58], fifteen studies had no sufficient data [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73], and eleven studies only had therapeutic hypothermia arms (without controls) [37,[74][75][76][77][78][79][80][81][82][83]. Two...…”

Uso da hipotermia induzida após parada cardiorrespiratória

“…Estudo controlado randomizado evidenciou que a realização da RCP assistida pelo Suporte de Vida Extracorpóreo (SVEc) trouxe melhoras à sobrevivência e aos desfechos neurológicos em comparação com o RCP convencional. A hipotermia terapêutica a 33°C mantida durante 24 horas em conjunto com o SVEc foi utilizada para 24 pacientes, dos quais 13 (54%) foram desmamados com sucesso e 12 (50%) receberam alta hospitalar com recuperação neurológica total [27].…”

“…Após leitura do resumo de cada artigo, selecionaram-se apenas os que mais traziam contribuições sobre o uso da hipotermia induzida, sendo escolhidos 16 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] artigos.…”

Extracorporeal Cardiopulmonary Resuscitation: One-Year Survival and Neurobehavioral Outcome Among Infants and Children With In-Hospital Cardiac Arrest*

“…However, unintentional sustained hypothermia may be due to dysfunction of central nervous system thermoregulation as a result of severe brain injury from cardiac arrest. An early report from an ongoing trial of therapeutic hypothermia versus normothermia for adults resuscitated with ECPR suggests that therapeutic hypothermia can be administered safely in this situation although findings about the effects on neurologic outcome from the trial have not yet been reported (42).…”