Therapeutic hypothermia after cardiac arrest and myocardial infarction.
About 17 million people worldwide die from cardiovascular diseases each year. Impaired neurologic function after sudden cardiac arrest is a major cause of death in these patients. Up to now, no specific post-arrest therapy was available to improve outcome. Recently, two randomized clinical trials of mild therapeutic hypothermia after successful resuscitation from cardiac arrest showed improvement of neurological outcome and reduced mortality. A broad implementation of this new therapy could save thousands of lives worldwide, as only 6 patients have to be treated to get one additional patient with favourable neurological recovery. At present, myocardial reperfusion by thrombolytic therapy or primary PCI as early as possible is the most effective therapy in patients with acute myocardial infarction. Mild therapeutic hypothermia might be a promising new therapy to prevent reperfusion injury after myocardial infarction, but its use in daily clinical routine cannot be recommended with the available evidence.
Holzer
Michael
M
Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20/6D, 1090 Wien, Austria. michael.holzer@meduniwien.ac.at
Behringer
Wilhelm
W
D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D009203:Myocardial Infarction / Q000150:complications*; D009422:Nervous System Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome