Whole-body cooling (therapeutic hypothermia) involves strictly controlled lowering of a patient’s body temperature below the normal range in hopes of reducing brain injury.
Current guidelines recommend either using therapeutic hypothermia or actively maintaining body temperature within the normal range. Researchers found that both treatments helped control fever and led to similar outcomes in young patients, according to a news release from Michigan Medicine.
The international study, the first to compare outcomes between the two temperature treatments for children with in-hospital cardiac arrest, was published in the New England Journal of Medicine and presented at the annual meeting of the Society of Critical Care Medicine in Honolulu.
“Some hospitals and physicians have routinely used body cooling for all patients who experience cardiac arrest because they believed it might lead to better outcomes,” says lead author Frank Moler, MD, Pediatric Critical Care Physician at University of Michigan C.S. Mott Children’s Hospital and the study’s principal investigator.
“Our study found no evidence that there was improved survival or better functional outcome with therapeutic hypothermia compared to actively maintaining a normal temperature in infants and children experiencing cardiac arrest in a hospital,” Moler said.
Nationally, an estimated 6,000 children experience in-hospital cardiac arrest every year, according to studies evaluating the federal Kids’ Inpatient Database.
The new study, funded by the National Heart, Lung and Blood Institute, included 329 patients between 2 days and 18 years old who experienced cardiac arrest in the hospital setting. Data collection and analysis for the study was conducted at the University of Utah.
After one year, survival rates and neurobehavioral function (including measures of motor function, communication, social skills, and daily living tasks) were similar among children from both treatment groups.
Half of the patients in the body cooling treatment group received therapeutic hypothermia through special cooling blankets. Pumps circulate water through tubes in the blankets to maintain a lower-than-normal range of 89.6 to 93.2 degrees Fahrenheit. The other half of participants were already supported by a mechanical circulatory machine (ECMO or extracorporeal membrane oxygenation), and the machine itself was used to lower their temperatures.
The children in the active temperature control group also used cooling blankets or ECMO, but their body temperatures were maintained in the normal range of 96.8 to 99.5 degrees Fahrenheit.
