Short video segment in which Dr. Peter Antevy reviews evidence and guideline recommendations on therapeutic hypothermia in pediatrics, contrasting two studies (one small positive pediatric study and the larger THAPCA out-of-hospital arrest trial) and noting that pediatric guidelines allow either targeted normothermia or a brief hypothermia protocol after out-of-hospital pediatric cardiac arrest.
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Hi, I'm Dr. Peter Henteve and here for another edition of the Entevi Minute. Therapeutic hypothermia has been a hot topic for both adult and pediatrics. But there's something about the pediatric guidelines that we should probably look deeper into the science about.
Let's take a look and so I'll show you two studies and then I'll show you the guideline recommendations. The first study was a positive study looking at 42 children. The hypothermic group had a significantly increased survival to discharge. Their neurologic outcomes were better, but not statistically better. So this was a positive study published in 2013, the Thapca trial, which was a very large out of hospital arrest trial. You can see here that although it seems that the hypothermia group did better both for survival and good function, none of these numbers were statistically significant. So that's a very interesting point there. So what do the guidelines do? They said this was a negative trial. The guidelines basically hedged and they said you can either do five days of normothermia or two days of continuous hypothermia followed by three days of continuous normothermia. This is the only place in the guidelines that you'll find the recommendation for hypothermia and it's in pediatric out of hospital cardiac arrest.
