Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Therapeutic hypothermia for cardiac arrest of asphyxial origin.

A short-cut review was carried out to establish whether therapeutic hypothermia leads to improved neurological outcomes in adult patients who have sustained a cardiac arrest of asphyxial origin. Four studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 2. The clinical bottom line is that evidence for the use of therapeutic hypothermia in patients who are comatose following asphyxia is very limited, which precludes an evidence-based recommendation. A large, multicentre randomised controlled trial is necessary to answer this question. Our review has therefore highlighted an important area for further research.