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Therapeutic hypothermia after cardiac arrest.

Introduction Induction of moderate hypothermia (28°C to 32°C) before cardiac arrest has been used successfully since the 1950s to protect the brain against the global ischemia that occurs during some open-heart surgeries. Successful use of therapeutic hypothermia after cardiac arrest in humans was also described in the late 1950s1–3 but was subsequently abandoned because of uncertain benefit and difficulties with its use.4 Since then, induction of hypothermia after return of spontaneous circulation (ROSC) has been associated with improved functional recovery and reduced cerebral histological deficits in various animal models of cardiac arrest.5–8 Additional promising preliminary human studies have been completed.9–16 At the time of publication of the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the evidence was insufficient to recommend use of therapeutic hypothermia after resuscitation from cardiac arrest.17