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To the Editor We read with great interest the Viewpoint by Little and Feldman titled “Therapeutic Hypothermia After Cardiac Arrest Without Return of Consciousness: Skating on Thin Ice.”1 The authors argued that literature has shed doubt on hypothermia for comatose cardiac arrest survivors, namely, research by Nielsen et al and the Targeted Temperature Management Trial investigators.2 The authors commented at the end of their article: “How can we ensure in the future that we commit resources to rigorous establishment of the value of a novel therapy before committing resources to its premature adoption with such a thin evidence base?”1 We find this last comment interesting given 2 randomized clinical trials in 2002 by Bernard et al3 and the Hypothermia after Cardiac Arrest Study Group,4 as well as the International Liaison Committee on Resuscitation/American Heart Association guidelines,5 which recommend the use of hypothermia.
Freeman WD, Karnatovskaia LV, Vadeboncoeur TF. Therapeutic Hypothermia and Targeted Temperature Management After Cardiac Arrest. JAMA Neurol. 2014;71(12):1577-1578. doi:10.1001/jamaneurol.2014.3125