A large-scale study from the University of Utah School of Medicine may lead to changes in the standard of care for children who suffer from cardiac arrest. The study was recently published in the New England Journal of Medicine.
In adults, cardiac arrest is most commonly caused by heart disease, but in children it often happens after a trauma like accidental drowning or strangulation. When this occurs, the standard of care has been to cool the body from 98 to 91 degrees Fahrenheit. It’s called therapeutic hypothermia. The idea is to reduce brain and organ damage from fever. But in the first pediatric study of its kind, the University of Utah School of Medicine in partnership with 38 hospitals across North America have studied the impacts of therapeutic hypothermia versus normothermia – maintenance of a 98 degree temperature.
“I see patients after drownings and cardiac arrests on a regular basis, and this will certainly guide our care,” says Jill Sweney, Medical Director of the Pediatric Intensive Care Unit at Primary Children’s Hospital in Salt Lake City. She’s also a principal investigator for the study. The 295 patients in the study were assessed one year after treatment for mortality and neurocognitive function. Sweney says they found no difference in outcomes for those who were cooled versus those who were kept at a normal body temperature. Both methods prevent fevers.
“The main key is that avoiding fever is important, but keeping them at a normal body temperature versus cooling them would be the treatment of choice,” Sweney says. She says there are some risks associated with therapeutic hypothermia, since it involves chemically paralyzing and sedating patients while they’re cooled to reduce shivering and discomfort.
Primary Children’s Hospital was the second highest enrolling site in the study. Investigators hope the new information will lead to improved guidelines for care. More than 6,000 children suffer out-of-hospital cardiac arrest in the US each year.
