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It is estimated that a cardiac arrest occurs approximately every minute in the United States.1 Beyond the mere return of spontaneous circulation (ROSC) and gross survival at discharge, good neurologic function with minimal disability is the goal for revived cardiac arrest patients. Partnering with the cardiology and emergency and critical care communities, neurologists helped implement therapeutic hypothermia (TH) and targeted temperature management (TTM), major breakthroughs in post–cardiac arrest care.2 Mitigating secondary brain injury after cardiac arrest (BICA) with TH is supported by 2 landmark randomized controlled trials (RCTs); supporting evidence came from nonrandomized studies, large registries, indirect evidence from pediatric trials, and animal studies.3 TH to 33°C became standard for out-of-hospital cardiac arrest with a shockable rhythm, later endorsed in the 2015 guidelines of the American Heart Association (AHA).2 Many experts were more liberal, cooling patients with all arrest rhythms and in-hospital cardiac arrests.3
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
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- © 2017 American Academy of Neurology
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