Mild Therapeutic Hypothermia to Improve the Neurologic Outcome After Cardiac Arrest written by Michael Holzer, MD (2002) conducted research to determine if mild systemic hypothermia after resuscitation from cardiac arrest resulting from ventricular fibrillation improves neurologic recovery. Cardiac arrest is known to lead to brain ischemia in a short amount of time; by cooling the body the hope is to preserve the brain on a cellular level. The author cites many preliminary studies with positive results in patients treated with mild hypothermia post-arrest comparing their outcomes favorably to historical controls. His background from the Emergency Department at the Medical University of Vienna provides firsthand experience with patients presenting with cardiac arrest. The critique of this article was formatted by Vlatente (2003) and Burns (2009).
Holzer’s study included 275 patients with the majority, 77%, being male for unknown reasons; half were treated with hypothermia and half with conventional normothermia techniques. This is a reasonably large study for the subject matter and strict inclusion criteria. A total of 3,551 patients were screened to find the 275 that were eligible. The groups were assigned in a randomized controlled fashion with a blind assessment post-study. The abstract provided in the article displayed a good amount of information with a clear and concise background statement. Within the abstract, the methods discussed were exactly as conducted in the study and the means of measurement and results were reported as well. The problem and purpose for the study were established early in the introduction. Findings and conclusions were predictable from early on from the author’s strong introduction and reasoning.
After resuscitation from cardiac arrest conventional treatments are mainly supportive therapies. By initiating mild hypothermia post arrest, a potentially proactive approach is taken to protect cerebral function and decrease overall mortality as measured in those that survive to six months (Holzer, 2002).
The overall goal of this study was to prove and support prior research that cardiac arrest patients treated with mild hypothermia have improved neurologic outcomes both immediately, after surviving to hospital discharge, and beyond. As noted in the article, introduction the exact mechanism that leads to improved outcomes when treated with hypothermia is not known, but further research in this area may help us to understand it (Holzer, 2002). The study spanned nine medical centers in Europe over nearly six years. The study protocol and procedures were reviewed and approved by each center’s institutional review board. Families of the patients were informed of the study and could withdraw subjects, however all consented. The nature of the study requires specific events and conditions to allow for inclusion which allows for strict quality controls, but should...