Study Finds Cooling Patients after CPR Reduces Brain Damage

Cooling a person's body within six hours of cardiac arrest with successful CPR might improve survival and lessen brain damage, according to a new Cochrane review.

The cooling technique, known as therapeutic hypothermia, "is one of the most successful treatment options for patients after cardiac arrest," said lead author Jasmin Arrich, M.D., a researcher at the Medical University of Vienna in Austria. "Clinical studies showed that by cooling the body after cardiac arrest to 33 degrees Celsius (91 degrees Fahrenheit) for 24 hours, patients are 40 percent to 80 percent more likely to leave the hospital without a major handicap."

Arrich and her colleagues pooled data from three studies of 481 patients who had suffered cardiac arrest, undergone CPR and had their hearts restarted. Those who received hypothermia treatments were 55 percent more likely than those receiving standard care to reach a high brain function test score during their hospital stay. They were also 35 percent more likely to survive to hospital discharge. The researchers found no evidence of increased side effects in those who had the therapy.

Arrich described therapeutic hypothermia as a simple method to improve outcome after cardiac arrest by using ice packs, cooling pads or water immersion, as well as by cooling the body directly using cold IV fluids or catheters that lower the blood's temperature directly. It's like putting the brain into hibernation while the body clears toxins that built up in the body during the cardiac arrest.

"If patients suffer from sudden cardiac death, the best way to save their life and to prevent brain damage is to start with basic life support immediately and call professional help," Arrich said. "After successful resuscitation, treatment with mild hypothermia may further help to improve outcome. Of course, in this situation, patients are usually unable to decide about their treatment; therefore it is usually a physician's task."

The new review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Clifton Callaway, M.D., an associate professor of emergency medicine at the University of Pittsburgh School of Medicine, said that the review results confirm the usefulness of what many physicians already felt was best practice.

"Mild hypothermia for those successfully revived from cardiac arrest improves survival," he said. "Perhaps more important, it also decreases brain injury, so that the person can go back home fully intact mentally and physically."

Many patients and their families are concerned about treatments that might increase survival following a heart attack but that can result in severe brain injury.

"For a couple decades we have made strides in saving the heart so that most people ask doctors about things like clot dissolving medications or bypass surgery," Callaway said. "Now there is treatment for the brain as well and family members should be expecting it and demanding it be made available."

David Beiser, M.D., an assistant professor of medicine at the Emergency Resuscitation Center of the University of Chicago, said the review reinforces the standards of care the American Heart Association set out in 2005.

However not all hospitals will have the ability to cool patients rapidly who have been successfully resuscitated. He likens this to the trauma system where not every community has the resources needed to operate a Level 1 Center.

"If a loved one is not at a hospital that has a cooling protocol in place, family should ask about the feasibility of a quick transfer to a center that is familiar with therapeutic hypothermia," he said. "At this point, this is what I would recommend--and have recommended--to a friend or loved one."

The review discloses that Arrich received funds through a non-restricted grant to the University from Alsius Corporation, a company that produces hypothermia supplies. A co-author received travel grants or honoraria from Alsius, Kinetic Concepts Inc. and Medivance.

Download Center

  • Industrial Premium Library

    Empower your workforce with the manufacturing, industrial maintenance, operations, HSE, compliance, and professional development skills they need to complete their tasks efficiently and safely. Not only will you boost productivity, reliability, skills, and morale but you’ll also onboard faster, and retain your best employees while meeting regulatory standards. Vector Solutions offers over 1,800 award-winning eLearning courses designed to keep your employees safe, transfer knowledge of fundamentals, and develop industry and job-specific skills that reduce downtime, maintenance costs and more.

  • Safety Metrics & Insights Webinar

    EHS professionals have been tackling the subject of how to best measure performance for many years. Lagging indicators like the Total Recordable Incident Rate (TRIR) and Days Away Restricted Transfer Rate (DART) are a good place to start, but you shouldn’t forget about the leading indicators that your workforce does every day to prevent incidents from occurring. Learn about some of the most common KPIs of safety programs and how Vector EHS Management software can be used to track these metrics in this webinar.

  • Risk Matrix Guide

    Understanding the components of a risk matrix will allow you and your organization to manage risk effectively. Download this guide for details on risk matrix calculations including severity, probability, and risk assessment.

  • OSHA Recordkeeping Guide

    In case you missed it, OSHA recently initiated an enforcement program to identify employers who fail to electronically submit Form 300A recordkeeping data to the agency. When it comes to OSHA recordkeeping, there are always questions regarding the requirements and ins and outs. This guide is here to help! We’ll explain reporting, recording, and online reporting requirements in detail.

  • Safety Metrics Guide

    Is your company leveraging its safety data and analytics to maintain a safe workplace? With so much data available, where do you start? This downloadable guide will give you insight on helpful key performance indicators (KPIs) you should track for your safety program

  • Vector Solutions

Featured Whitepaper

OH&S Digital Edition

  • OHS Magazine Digital Edition - September 2022

    September 2022


    • ESG
      EHS Will Guide Future ESG Success for Many Organizations
      Handling Material Handlers: Training Beyond PIT Requirements
      The Missing Link with EHS Software
      Noise Surveys from the Trenches
    View This Issue