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PRINCE: Cooling therapy initiated during cardiac arrest linked with improved neurological function in survivors
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The rapid cooling of a patient in cardiac arrest could potentially improve chances for survival without brain damage, results from the Pre-Resuscitation Intra-Nasal Cooling Effectiveness trial suggested.
Researchers for PRINCE randomly assigned 182 adults who underwent witnessed cardiac arrest to receive either standard resuscitation (n=99) or resuscitation with coolant introduced through nasal prongs during the cardiac arrest (n=83). The median time between arrest and initiation of cooling was 23 minutes.
The researchers reported that patients receiving cooling therapy arrived at the hospital with lower body temperatures vs. those who received standard therapy (P=.0001). At hospital discharge, 46.7% of patients who received cooling therapy survived vs. 31% of patients receiving standard therapy, with 36.7% of the cooled patients maintaining good neurological condition vs. 21.4% in the standard care group. In the group of 137 patients in whom resuscitation was performed within 10 minutes of cardiac arrest, 59.1% of the cooling group survived at hospital discharge vs. 29.4% in the standard care group, and 45.5% of those in the cooling group had intact neurological function vs. 17.6% receiving standard care (P=.03). Patients with ventricular fibrillation (n=56) were most likely to survive at hospital discharge.
“We now have a method that is safe and can be started within minutes of cardiac arrest to minimize the damage during this very critical period,” Maaret Castren, MD, a professor of emergency medicine at the Karolinska Institutet in Stockholm, said in a press release.
Castren M. Abstract 13.
