Patients with cardiac arrest are cooled – can reduce brain damage

10,000 people suffer cardiac arrest in Sweden every year – only one third are taken to hospital alive.
But the majority of survivors die from widespread brain damage caused by the cardiac arrest.
In an ongoing international study, early cooling of the patient is being tested – which is believed to be able to reduce the risk of brain damage.

Patients who suffer cardiac arrest often die from brain damage caused by lack of oxygen and the reoxygenation that occurs with the cardiac arrest, according to the study PRINCESS2 which is led by a senior physician at Karolinska University Hospital.

– If you survive at the site of the cardiac arrest and the heart starts, we know that less than 50 percent survive with good neurological function. It is a huge problem, says Per Nordberg, senior physician at Karolinska who leads the study Swedens radio.

However, severe cooling of the body temperature immediately after the cardiac arrest has yielded results in animal studies and has been shown to reduce the risk of subsequent brain damage.

Despite this, all cryotherapy is currently carried out in hospital, which means that treatment does not start until several hours after the cardiac arrest.

“Our research group has shown that cold treatment that is started already in the ambulance has the potential to increase the chance of survival with complete neurological recovery,” the study says.

“Knowledge gap”

Using a portable cooling method, patients in the study are to be cooled on site and in the ambulance. The cooling treatment then continues in the hospitals’ intensive care units for 24 hours.

The effect of early cooling treatment is described as “one of the most important knowledge gaps identified in the international guidelines in cardiac arrest treatment”.

The aim of the study is to conduct a randomized trial to investigate whether early cooling treatment initiated by paramedics improves 90-day survival with complete recovery of brain function.