"Our results show that it is just as effective – both for survival and recovery of neurological function – to focus on avoiding the fever that accompanies cardiac arrest. We don't need to cool down the body and brain to 33°C. This is of course important because cooling to lower temperatures brings a higher risk of infection, bleeding and other side-effects", said Niklas Nielsen, researcher at Lund University and first author of the study.
Patients who come into hospital in cardiac arrest receive intensive care with cooling and ventilator treatment. Around half of them survive. Daily life goes quite well for those who survive, but around 30 per cent of cardiac arrest patients suffer impaired cognitive function, for example poorer memory.
"Until now, there has not been a clear place in the health service for the rehabilitation of these patients and one of our most important tasks is to identify them and tailor rehabilitation treatment to them. The median age for cardiac arrest is just over 60, and there are quite a lot of younger people who are affected. Rehabilitation can mean the difference between being able to go back to work and remaining on sick leave", said Niklas Nielsen.
The researchers are planning to analyse the patient data in more detail to see if there may be groups of patients for whom cooling could be beneficial and whether it has an impact at a more detailed cognitive level.About the study:
The study was led by researchers from Lund University, Helsingborg Hospital and Skåne University Hospital – Niklas Nielsen, Hans Friberg, Tobias Cronberg and David Erlinge – together with an international steering group.
The research project has involved strong collaboration with Rigshospitalet in Copenhagen and has resulted in the establishment of a joint centre by Lund University, Skåne University Hospital, Helsingborg Hospital and Region Huvudstaden in Copenhagen.Publication:
Niklas Nielsen, Jørn Wetterslev, Tobias Cronberg, David Erlinge, Yvan Gasche, Christian Hassager, Janneke Horn, Jan Hovdenes, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Michael Wanscher, Matt P. Wise, Anders Åneman, Nawaf Al-Subaie, Søren Boesgaard, John Bro-Jeppesen, Iole Brunetti, Jan Frederik Bugge, Christopher D. Hingston, Nicole P. Juffermans, Matty Koopmans, Lars Køber, Jørund Langørgen, Gisela Lilja, Jacob Eifer Møller, Malin Rundgren, Christian Rylander, Ondrej Smid, Christophe Werer, Per Winkel, and Hans Friberg for the TTM Trial Investigators
Background:The origin of the extensive study is the criticism of the two studies that was made when they were first published in 2002. The criticism that was made, with which Niklas Nielsen and his colleagues in Lund agree, was that:
no assessment was made of whether the effect of the treatment was due to the removal of the fever or to the cooling itself
The results have been presented today in the New England Journal of Medicine, and at the American Heart Association meeting in Dallas.
Contact:Niklas Nielsen, consultant and researcher, Lund University
Niklas Nielsen | EurekAlert!
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