Acute cardiac care & resuscitationRandomised controlled trial
Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery
- Randomised controlled trial
- single-blind
- multicentre
- non-inferiority
- 4 US referral aortic centres
Authors' conclusion
This randomized multicenter study evaluating arch surgery HCA temperature strategies found low-moderate hypothermia noninferior to traditional deep hypothermia on global cognitive change 4 weeks after surgery, although in secondary analysis, structured verbal memory was better preserved in the deep group.
Study context
- Population
- Patients undergoing aortic arch surgery with hypothermic circulatory arrest plus antegrade cerebral perfusion, 2016–2021251 completed 4-week follow-up
- Participants
- 282 patients
- Comparison
- Deep vs low-moderate vs high-moderate hypothermia during hypothermic circulatory arrest (HCA)
- Primary endpoint
- Composite global cognitive change score
- Follow-up
- Baseline to 4 weeks postoperatively
Primary result
As reported in the abstract
Global cognitive change score · 4 weeks
- LM noninferior to DP
- No significant difference between DP and HM
- intention-to-treat
Secondary outcomes
Domain-specific cognitive change scores
- Structured verbal memory better preserved in DP vs HM
- P = 0.036
- LM noninferior to DP and no DP vs HM difference, except structured verbal memory
- Structured verbal memory: noninferiority of LM vs DP not established
Structural and functional MRI brain imaging · postoperatively
- No significant differences between groups
- Significant reductions in gray matter volume, cortical thickness and regional functional connectivity regardless of temperature
Quality of life
- Not different between groups
30-day in-hospital mortality and major morbidity
- Not different between groups
Original publication
Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery. Circulation. Published 12 December 2023. doi:10.1161/circulationaha.123.067022
Summarised from the published abstract; every number is checked against it