UMEM Educational Pearls

Therapeutic hypothermia (TH) following out-of-hospital cardiac arrest (OHCA) has increasingly been utilized since it was first described. TH following in-hospital cardiac arrest (IHCA), on the other hand, is not as commonplace or consistent despite a recommendation by the American Heart Association (AHA).

A recent prospective multi-center cohort-study demonstrated that of 67,498 patients with return of spontaneous circulation (ROSC) following IHCA only 2.0% of patients had TH initiated; of those 44.3% did not even achieve the target temperature (32-34 Celsius). 

The factors found to be most associated with instituting TH were:

  • Younger patients
  • Admission to non-ICU units
  • Arrests occurring Monday through Friday (as compared to weekends)
  • Arrests within teaching hospitals (as compared to non-teaching institutions)

Bottom-line: Hospitals should consider instituting and adhering to local TH protocols for in-house cardiac arrests.