RICH
Rapid Infusion of Cold Hartmanns: Induction of Therapeutic Hypothermia by Paramedics
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 234 adults resuscitated from VF cardiac arrest, prehospital paramedic cooling did not improve discharge functional outcome versus in-hospital cooling.
N
234
Schéma
Prospective, multicentre randomised controlled trial: 234 adults resuscitated from out-of-hospital cardiac arrest with an initial rhythm of ventricular fibrillation were assigned to paramedic-initiated prehospital cooling with a rapid infusion of 2 L ice-cold lactated Ringer's solution (n=118) or to cooling begun after hospital admission (n=116).
Critère
Primary: functional status at hospital discharge, with a favourable outcome defined as discharge either to home or to a rehabilitation facility.
RésultatFavourable outcome in 47.5% with paramedic cooling versus 52.6% with hospital cooling (risk ratio 0.90, 95% CI 0.70-1.17; P=0.43). Patients allocated to paramedic cooling received a median of 1900 mL (Q1 1000 mL, Q3 2000 mL) of ice-cold fluid, producing a mean decrease in core temperature of 0.8 °C (P=0.01).
Bernard SA, Smith K, Cameron P, Masci K, Taylor DM, Cooper DJ, Kelly AM, Silvester W; RICH Investigators. Circulation. 2010;122(7):737-742. 10.1161/circulationaha.109.906859