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Thanks for asking. This is a very important question. There was major discussion about the topic of therapeutic hypothermia presented at the meeting. You have hit the nail on the head, when you indicate that there is NO EVIDENCE IN PEDIATRICS EXCEPT IN NEONATES, that therapeutic hypothermia is beneficial, and it might be harmful, so we were cautioned to NOT jump in and just do it in all patients who have been resucitated from a cardiac arrest. However, there is GOOD DATA to support prevention of HYPERTHERMIA (higher than normal body temperature) as outcome worsens significantly for every degree in the celcius system over 37. It is believed that fevers generate worse outcomes through a variety of mechanisms, including causing an increase in cerebral metabolism that then requires more blood flow and might cause the pressure in the brain to rise, an increase in the generation of free radicals, that can cause cellular damage, more inflammation that can also cause brain swelling, andan increase in the rate at which brain cells die. So, the bottom line is that until we have better data from the studies you mentioned that are now underway, we should do everything we can to keep the patient's temperature within the normal range for the first 48 hours after the cardiac arrest and resuscitation occured.

The lecture I attended on this topic was presented by Dr. Erica Fink, a pediatric intensivist who works at the Safar center for resuscitation research in Pittsburgh,+Ericka+L.,+MD
It is associated with Pittsburgh Children's Hospital.

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