Acute cardiac care & resuscitation
Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial
Authors' conclusion
In comatose survivors of out-of-hospital cardiac arrest, a target temperature of 31 °C did not significantly reduce the rate of death or poor neurologic outcome at 180 days compared with a target temperature of 34 °C. However, the study may have been underpowered to detect a clinically important difference.
Study context
- Population
- Comatose survivors of OHCA, tertiary cardiac care centre in eastern Ontario, Canada367 in primary analysis
- Participants
- 389 survivors
- Comparison
- Moderate hypothermia vs mild hypothermia for 24 hours
- 31 °Cn = 193
- 34 °Cn = 196reference
- Primary endpoint
- All-cause mortality or poor neurologic outcome (Disability Rating Scale score >5)
- Follow-up
- 180 days
Methodological detailssingle-centre, double-blind, superiority
- Single-centre
- Double-blind
- Superiority
Primary result
As reported in the abstract
Each group vs 34 °CRelative risk (95% CI)P value
31 °C
1.07(0.86–1.33)
P = 0.56- 31 °C
- risk difference 3.0% (95% CI 7.2%–13.2%)
Secondary outcomes
Mortality · 180 days
P = 0.63
ICU length of stay
P = 0.004
19 secondary outcomes
- 18 of 19 secondary outcomes not statistically significant
Safety
DVT
Thrombus in inferior vena cava
Original publication
Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial. JAMA. Published 19 October 2021. doi:10.
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