Prehospital induction of mild hypothermia with cold normal saline for cardiac arrest: more harm than good?

Methods Objective: To determine whether prehospital cooling improves outcomes after resuscitation from cardiac arrest in patients with ventricular fibrillation (VF) and without VF. Design: A randomized clinical trial that assigned adults with prehospital cardiac arrest to standard care with or without prehospital cooling. Patient follow-up was completed by May 1, 2013. Nearly all of the patients resuscitated from VF and admitted to the hospital received hospital cooling regardless of their randomization. Setting: King County, Washington. Subjects: Adults with prehospital cardiac arrest and resuscitated by paramedics were eligible and 1359 patients (583 with VF and 776 without VF) were randomized between December 15, 2007, and December 7, 2012. Intervention: Infusing up to 2 L of 4°C normal saline to patients with prehospital cardiac arrest as soon as possible following return of spontaneous circulation.