The International Cardiac Arrest Registry
In 2003, two independent prospective clinical trials suggested that early treatment with induced hypothermia reduces death and disability in survivors of out-of-hospital cardiac arrest (NEJM 2002 346(8): 549-556, 557-563). Targeted temperature management after cardiac arrest is supported by an advisory statement from the International Liaison Committee on Resuscitation (ILCOR), published in 2003 (Resuscitation 57 (2003) 231-235, Circulation, 2003; 108:118-121), and emphasized in clinical guidelines from both the European Resuscitation Council and American Heart Association. Hypothermia therapy was upgraded in 2005 and 2010 AHA guidelines, and is a standard component in both European and US post-resuscitation care.
Global adoptation of temperature management as a standard of care is incomplete, and many poorly characterized research domains remain, including:The
- The role of cardiac catheterization and hemodynamic support following emergency stabilization
- The full spectrum of adverse events associated with therapy
- The importance of various elements of post-resuscitation care including oxygen and carbon dioxide tension, blood pressure, blood glucose, and other biochemical and metabolic factors
- The incidence, type, and significance of epileptiform activity
- The most effective and safest techniques for cooling, maintaining hypothermia, and rewarming
- The post-hypothermia prognostication landscape
- The utility and interpretation of neuroimaging and biomarkers to determine the severity of brain injury
- The role of neurocognitive evaluation
INTCAR hopes to be able to shed light into these areas, and to formulate and inform the design of prospective clinical trials.