Earlier intra-arrest transnasal cooling may be beneficial

Castrèn, Maaret; Nordberg, Per; Taccone, FS; Vincent, Jean‐Louis; Svensson, Leif; Barbut, Denise

doi:10.1186/cc9723

Cited by 1 publication

(1 citation statement)

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“…However, in the short no-flow time (CPR initiated within 10 min) subgroup, randomization to transnasal cooling was associated with improved survival (56.5% vs 29.4%, P = .04). 41 The PRINCESS trial was a randomized, international multicenter study that randomized 677 OHCA patients to either transnasal evaporative intra-arrest cooling or standard of care. Similar to the PRINCE trial, transnasal cooling was effective at lowering body temperature on hospital admission but did not translate into favorable clinical outcomes.…”

Section: Components Of High-quality Temperature Control Time To Initi...mentioning

confidence: 99%

Temperature Control in the Era of Personalized Medicine: Knowledge Gaps, Research Priorities, and Future Directions

Beekman,

Khosla,

Buckley

et al. 2023

J Intensive Care Med

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Hypoxic–ischemic brain injury (HIBI) is the leading cause of death and disability after cardiac arrest. To date, temperature control is the only intervention shown to improve neurologic outcomes in patients with HIBI. Despite robust preclinical evidence supporting hypothermia as neuroprotective therapy after cardiac arrest, there remains clinical equipoise regarding optimal core temperature, therapeutic window, and duration of therapy. Current guidelines recommend continuous temperature monitoring and active fever prevention for at least 72 h and additionally note insufficient evidence regarding temperature control targeting 32 °C-36 °C. However, population-based thresholds may be inadequate to support the metabolic demands of ischemic, reperfused, and dysregulated tissue. Promoting a more personalized approach with individualized targets has the potential to further improve outcomes. This review will analyze current knowledge and evidence, address research priorities, explore the components of high-quality temperature control, and define critical future steps that are needed to advance patient-centered care for cardiac arrest survivors.

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Section: Components Of High-quality Temperature Control Time To Initi...mentioning

confidence: 99%