HACA
Trial question
Is hypothermia superior to normothermia in patients who have been successfully resuscitated after cardiac arrest due to VF?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
24.0% female
76.0% male
N = 275
275 patients (65 female, 210 male).
Inclusion criteria: patients who have been successfully resuscitated after cardiac arrest due to VF.
Key exclusion criteria: a tympanic-membrane temperature below 30°C on admission, a comatose state before the cardiac arrest, pregnancy, a terminal illness that preceded the arrest, or a known preexisting coagulopathy.
Interventions
N=136 therapeutic hypothermia (target temperature, 32 °C to 34 °C, measured in the bladder over a period of 24 hours).
N=137 normothermia (standard treatment and maintenance of normothermia).
Primary outcome
Favorable neurologic outcome
55%
39%
55.0 %
41.3 %
27.5 %
13.8 %
0.0 %
Therapeutic
hypothermia
Normothermia
Significant
increase ▲
NNT = 6
Significant increase in favorable neurologic outcome (55% vs. 39%; RR 1.4, 95% CI 1.08 to 1.81).
Secondary outcomes
Significant decrease in death at 6 months (41% vs. 55%; RR 0.74, 95% CI 0.58 to 0.95).
Safety outcomes
No significant difference in complication rate.
Conclusion
In patients who have been successfully resuscitated after cardiac arrest due to VF, therapeutic hypothermia was superior to normothermia with respect to favorable neurologic outcome.
Reference
HACA Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002 Feb 21;346(8):549-56.
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