CARDIOPULMONARY RESUSCITATION: Edited by Gordon A. EwyTherapeutic hypothermia following resuscitationNagao, KenAuthor Information Department of Cardiology with Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, Nihon University School of Medicine, Tokyo, Japan Correspondence to Ken Nagao, MD, Professor and Chief-Director, Department of Cardiology with Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, 1-8-13, Kanda Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan. Tel: +81 3 3293 1711; fax: +81 3 3233 2659; e-mail: [email protected]@med.nihon-u.ac.jp Current Opinion in Critical Care: June 2012 - Volume 18 - Issue 3 - p 239-245 doi: 10.1097/MCC.0b013e3283523f4a Buy Metrics Abstract Purpose of review 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. Recent findings 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. Summary 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. © 2012 Lippincott Williams & Wilkins, Inc.