Abstract
Out-of-hospital cardiac arrest is a leading cause of death in developed countries and early resuscitation attempts are crucial to improve survival rates and neurological outcome. Gräsner and colleagues performed an intriguing analysis on the combined approach of mild therapeutic hypothermia (MTH) and immediate percutaneous coronary intervention (PCI) for post-resuscitation care of 584 patients with out-of-hospital cardiac arrest from the German Resuscitation Registry. PCI was independently associated with good neurological outcome at hospital discharge after successful resuscitation, and MTH was associated as an independent factor with increased chance of 24-hour survival. Moreover, a binary logistic regression analysis did not show statistical significance for MTH, in addition to PCI, as an independent predictor for good neurological outcome. The present study supports the evidence that post-resuscitation care based on standardized protocols is beneficial after successful resuscitation. Further prospective and randomized studies are warranted to elucidate criteria for a better selection of candidates for those strategies and to evaluate the potential, in terms of neurological outcome at hospital discharge, of a prehospital cooling strategy in patients who cannot be referred to immediate PCI.