A national registry would inform best practice for mild hypothermia after cardiac arrestBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6877 (Published 25 October 2011) Cite this as: BMJ 2011;343:d6877
- Raj V Nichani, consultant intensivist1
- On behalf of Brendan McGrath, Tom Owen, Rachel Markham, Dominic Sebastian, Nick Greenwood, Bernard Foex, Paul Ferris, Gareth Hardy, Alison Quinn; Association of North Western Intensive Care Units Collaborative (ANWICU kNoWLeDGe)
- 1Department of Anaesthesia and Critical Care, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool FY3 8NR, UK
With reference to the debate about whether evidence supports the use of mild hypothermia after cardiac arrest,1 we report our experience. Nine critical care units in the north west of England recently submitted data on 101 patients admitted to critical care after cardiac arrest.
We found that therapeutic hypothermia can be implemented effectively across a range of units in the UK, in routine settings, and using different methods of temperature management. Our cooling and rewarming processes are comparable to those used in randomised trials,2 3 and they meet guidelines set by the International Liaison Committee for Resuscitation.4 Our outcome data were encouraging, with 53% survival to hospital discharge after ventricular fibrillation arrest. All survivors were discharged with good neurological recovery or moderate disability but were able to function independently.
Neurological injury is responsible for much of the subsequent morbidity and mortality in initial survivors of cardiac arrest, and we must do our utmost to prevent this. Despite increasing evidence, many people remain sceptical about the benefits of therapeutic hypothermia after cardiac arrest. Even when used, it is sometimes done half heartedly and with delay.5 In our opinion, the benefits to the majority considerably outweigh the potential for harm, and this valuable treatment should continue to be used when indicated.
A UK specific national registry would help inform best practice and allow the continued development of standards for use in prehospital, emergency department, and critical care settings.
Cite this as: BMJ 2011;343:d6877
Competing interests: None declared.