UMEM Educational Pearls

Category: Cardiology

Title: hypothermia in the cath lab?

Keywords: hypothermia, cardiac arrest, percutaneous coronary intervention, myocardial infarction (PubMed Search)

Posted: 11/1/2009 by Amal Mattu, MD (Updated: 1/21/2022)
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Increasing literature has demonstrated that patients post-cardiac arrest benefit from induced hypothermia (IH). In addition, increasing literature has demonstrated that patients with cardiac arrest associated with STEMI are best treated with rapid percutaneous intervention (PCI) after their resuscitation. But what about the combination of IH + PCI in resuscitated cardiac arrest patients with STEMI?

There's now growing support for this concept as well. Wolfrum et al. demonstrated an improved mortality at 6 mos. (35% vs. 25%) in patients that had the combination of IH + PCI vs. patients receiving PCI alone after cardiac arrest and they also had better neurological outcomes.

Next time you have a STEMI patient that has a cardiac arrest who you resuscitate, talk to your cardiologists about the literature demonstrating the improved outcomes with combination IH plus PCI.

[Wolfrum S, Pierau C, Radke PW, et al. Mild therapeutic hypothermia in patients after out-of-hospital cardiac arrest due to acute ST-segment elevation myocardial infarction undergoing immediate percutaneous coronary intervention. Crit Care Med 2008;36:1780-1786.]