PAS: Hypothermia Offers No Benefit in Comatose Children
No survival benefit for survivors of out-of-hospital cardiac arrest
TUESDAY, April 28, 2015 (HealthDay News) -- For comatose children who survive out-of-hospital cardiac arrest, therapeutic hypothermia does not confer survival benefit compared with normothermia, according to a study published online April 25 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Pediatric Academic Societies, held from April 25 to 28 in San Diego.
Frank W. Moler, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a trial of two targeted temperature interventions at 38 children's hospitals involving 260 children who remained unconscious after out-of-hospital cardiac arrest. Patients were randomized to therapeutic hypothermia (target temperature, 33 degrees Celsius) or therapeutic normothermia (target temperature, 36.8 degrees Celsius).
The researchers observed no significant difference in the primary outcome (survival at 12 months) between the hypothermia and normothermia groups (20 versus 12 percent; relative likelihood, 1.54; 95 percent confidence interval, 0.86 to 2.76; P = 0.14). No significant between-group difference was seen in the change in the Vineland Adaptive Behavior Scales, second edition, score from baseline to 12 months (P = 0.13); one-year survival was also similar between the groups (relative likelihood, 1.29; 95 percent confidence interval, 0.93 to 1.79; P = 0.13).
"In comatose children who survived out-of-hospital cardiac arrest, therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a good functional outcome at one year," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.