Temperature control to improve neurological outcomes after cardiac arrest

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 8 systematic reviews and meta-analyses and 1 randomised controlled trial (RCT). It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be:

• survival

• reduction in long-term neurological disability

• independent living

• quality of life

• reduction in length of critical care and hospital stay.

The professional experts and the committee considered the key safety outcomes to be:

• arrhythmias

• shivering

• pneumonia

• sepsis

• skin damage.

Patient commentary was sought but none was received.

There are several available technologies for controlling temperature after cardiac arrest.

Using large volumes of intravenous saline to induce therapeutic hypothermia before admission to hospital can cause side effects such as pulmonary oedema.

The committee was informed that additional RCTs comparing temperature control for fever prevention with no intervention are unlikely to be done.