title: Therapeutic hypothermia following resuscitation.
abstract: OBJECTIVE
  The 2010 Cardiopulmonary Resuscitation (CPR) Guidelines recommended therapeutic hypothermia for postcardiac arrest syndrome as a beneficial and effective treatment. However, the optimal temperature, method, onset, duration and rewarming rate, and therapeutic window remain unknown.
  
  
  RESULTS
  Recent animal studies have shown that the sooner cooling is initiated after cardiac arrest, the better the outcome. Induction of hypothermia during cardiac arrest before return of spontaneous circulation (ROSC) (intra-arrest cooling) enhances its efficacy. In 2010, the Pre-ROSC IntraNasal Cooling Effectiveness (PRINCE) study and our clinical study of intra-arrest cooling concluded that intra-arrest cooling before ROSC was likely to have neurological benefits while protecting the myocardium for patients with out-of-hospital cardiac arrest.
  
  
  CONCLUSIONS
  One of the most significant advances in CPR treatment in the past decade is therapeutic hypothermia. Although post-ROSC cooling has been shown to improve neurological outcome for patients with out-of-hospital cardiac arrest, intra-arrest cooling during CPR is likely to protect the myocardium from reperfusion injury and enhance neurological benefits.
authors.affiliation: Department of Cardiology with Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, Nihon University School of Medicine, Tokyo, Japan. nagao.ken@nihon-c.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control; D058687:Out-of-Hospital Cardiac Arrest / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic