Metrics details. Nevertheless, the latest recommendations issued by the International Liaison Committee on Resuscitation and by the European Resuscitation Council recommend therapeutic hypothermia. New data are available on the adverse effects of therapeutic hypothermia, notably infectious complications. Both groups are managed with therapeutic normothermia for the next 24 hours. TTM is achieved using locally available equipment.
The primary outcome is assessed by a blinded psychologist during a semi-structured telephone interview of the patient or next of kin. Secondary outcomes are day mortality, hospital mortality, severe adverse events, infections, and neurocognitive performance. Two interim analyses will be performed, after inclusion of and patients, respectively. The HYPERION trial is a multicenter, randomized, controlled, assessor-blinded, superiority trial that may provide an answer to an issue of everyday relevance, namely, whether TTM is beneficial in comatose patients resuscitated after nonshockable cardiac arrest.
Furthermore, it will provide new data on the tolerance and adverse events especially infectious complications of TTM at Cardiac arrest remains a major cause of mortality, as well as a cause of disability in survivors [ 2 ]. In Europe, cardiac arrests occur annually, of which are fatal. After early work suggesting a neuroprotective effect of hypothermia [ 5 ], animal studies provided evidence of neurological recovery after a period of controlled hypothermia [ 6 ]. These findings were confirmed by two randomized trials performed 10 years ago and published in the same issue of the New England Journal of Medicine.
In both trials, therapeutic hypothermia significantly improved the neurological outcomes of patients with cardiac arrest in shockable rhythms ventricular fibrillation or pulseless ventricular tachycardia. The first randomized trial was a European multicenter study in patients managed with normothermia or hypothermia [ 7 ]. In addition, mortality was significantly lower in the hypothermia group OR, 0.
The second randomized trial was an Australian multicenter study in 77 patients managed with normothermia or hypothermia [ 8 ]. Again, good neurological outcomes were more common in the hypothermia group OR, 1. However, hypothermia was not associated with a significant decrease in mortality OR, 1.
