dc.contributor.author | Nordberg, Per | |
dc.contributor.author | Taccone, F. | |
dc.contributor.author | Truhlar, A. | |
dc.contributor.author | Forsberg, S. | |
dc.contributor.author | Hollenberg, J. | |
dc.contributor.author | Jonsson, M. | |
dc.contributor.author | Cuny, J. | |
dc.contributor.author | Goldstein, P. | |
dc.contributor.author | Vermeersch, N | |
dc.contributor.author | Higuet, A | |
dc.contributor.author | Jimenes, F. | |
dc.contributor.author | Ortiz, F. | |
dc.contributor.author | Williams, Julia | |
dc.contributor.author | Desruelles, D | |
dc.contributor.author | Creteur, J | |
dc.contributor.author | Dillenback, E. | |
dc.contributor.author | Busche, C | |
dc.contributor.author | Busch, Hans-Jorg | |
dc.contributor.author | Ringh, M. | |
dc.contributor.author | Konrad, D. | |
dc.contributor.author | Peterson, J | |
dc.contributor.author | Vincent, Jean-Louis | |
dc.contributor.author | Svensson, Leif | |
dc.date.accessioned | 2019-07-31T16:21:53Z | |
dc.date.available | 2019-07-31T16:21:53Z | |
dc.date.issued | 2019-05-07 | |
dc.identifier.citation | Nordberg , P , Taccone , F , Truhlar , A , Forsberg , S , Hollenberg , J , Jonsson , M , Cuny , J , Goldstein , P , Vermeersch , N , Higuet , A , Jimenes , F , Ortiz , F , Williams , J , Desruelles , D , Creteur , J , Dillenback , E , Busche , C , Busch , H-J , Ringh , M , Konrad , D , Peterson , J , Vincent , J-L & Svensson , L 2019 , ' Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest : The PRINCESS Randomized Clinical Trial ' , Journal of the American Medical Association (JAMA) , vol. 321 , no. 17 , pp. 1677 - 1685 . https://doi.org/10.1001/jama.2019.4149 | |
dc.identifier.issn | 0098-7484 | |
dc.identifier.other | ORCID: /0000-0003-0796-5465/work/62748017 | |
dc.identifier.uri | http://hdl.handle.net/2299/21510 | |
dc.description | © 2019 American Medical Association. All rights reserved. | |
dc.description.abstract | Importance: Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups. Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. Trial Registration: ClinicalTrials.gov Identifier: NCT01400373. | en |
dc.format.extent | 9 | |
dc.format.extent | 295205 | |
dc.language.iso | eng | |
dc.relation.ispartof | Journal of the American Medical Association (JAMA) | |
dc.subject | Aged | |
dc.subject | Brain/physiopathology | |
dc.subject | Brain Injuries/etiology | |
dc.subject | Cardiopulmonary Resuscitation/methods | |
dc.subject | Emergency Medical Services | |
dc.subject | Epistaxis/etiology | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Hypothermia, Induced/adverse effects | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Out-of-Hospital Cardiac Arrest/complications | |
dc.subject | Sample Size | |
dc.subject | Single-Blind Method | |
dc.subject | Survival Rate | |
dc.subject | Time-to-Treatment | |
dc.subject | Treatment Outcome | |
dc.title | Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest : The PRINCESS Randomized Clinical Trial | en |
dc.contributor.institution | School of Health and Social Work | |
dc.contributor.institution | Allied Health Professions | |
dc.contributor.institution | Paramedic Science | |
dc.contributor.institution | Centre for Applied Clinical, Health and Care Research (CACHE) | |
dc.contributor.institution | Centre for Future Societies Research | |
dc.description.status | Peer reviewed | |
dc.date.embargoedUntil | 2019-11-07 | |
dc.identifier.url | http://www.scopus.com/inward/record.url?scp=85065779601&partnerID=8YFLogxK | |
rioxxterms.versionofrecord | 10.1001/jama.2019.4149 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |