***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : Mild therapeutic hypothermia after out-of-hospital cardiac arrest is usually achieved either by surface cooling or by core cooling via the patient 's bloodstream . We compared modern core ( Coolgard ) and surface ( A rct ic Sun ) cooling devices with a zero hypothesis of equal cooling , complications , and neurologic outcomes . Design : Single-center observational study . Setting : University hospital medical and cardiac intensive care units . Patients : One hundred sixty-seven consecutive patients comatose after out-of-hospital cardiac arrest of all causes treated with mild therapeutic hypothermia in a 5-yr period . Interventions : Nonr and omized allocation to core or surface cooling depending on availability and physician preference . Measurements and Main Results : All out-of-hospital cardiac arrest patients ' records were review ed for relevant data regarding medical history , cardiac arrest event , prehospital care , in-hospital treatment , and complications . Survivor neurologic function was reassessed at follow-up after 6 to 12 months . Baseline patient and arrest episode characteristics were similar in the treatment groups . There was no significant difference in survival with good neurologic function , either to hospital discharge ( surface , 34/90 , 38 % ; core , 34/75 , 45 % ; p = .345 ) or at follow-up ( surface , 34/88 , 39 % ; core , 34/75 , 45 % ; p = .387 ) . Time from cardiac arrest to achieving mild therapeutic hypothermia was equal with both devices ( surface , 273 min , interquartile range 158–330 ; core , 270 min , interquartile range 190–360 ; p = .479 ) . There were significantly more episodes of sustained hyperglycemia among the surface-cooled patients ( surface , 64/92 , 70 % ; core , 36/75 , 48 % ; p = .005 ) and significantly more hypomagnesaemia among core-cooled patients ( surface , 16/87 , 18 % ; core , 27/74 , 37 % ; p = .01 ) . Conclusions : In this study , surface and core cooling of out-of-hospital cardiac arrest patients following the same established postresuscitation treatment protocol result ed in similar survival to hospital discharge and comparable neurologic function at follow-up Introduction Mild induced hypothermia ( MIH ) is indicated for comatose survivors of sudden cardiac arrest ( SCA ) to improve clinical outcome . In this study , we compared the efficacy of two different cooling devices for temperature management in SCA survivors . Methods Between April 2008 and August 2009 , 80 patients after survived in-hospital ( IHCA ) and out-of-hospital cardiac arrest ( OHCA ) were included in this prospect i ve , r and omized , single center study . Hypothermia was induced after r and omization by either invasive Coolgard ® cooling or non-invasive A rct icSun ® surface cooling at 33.0 ° C core body temperature for 24 h followed by active rewarming . The primary endpoint was defined as the efficacy of both cooling systems , measured by neuron-specific enolase ( NSE ) levels as a surrogate parameter for brain damage . Secondary efficacy endpoints were the clinical and neurological outcome , time to start of cooling and reaching the target temperature , target temperature-maintenance and hypothermia-associated complications . Results NSE at 72 h did not differ significantly between the 2 groups with 16.5 ng/ml , interquartile range 11.8–46.5 in surface-cooled patients versus 19.0 ng/ml , interquartile range 11.0–42.0 in invasive-cooled patients , p = 0.99 . Neurological and clinical outcome was similar in both groups . Target temperature of 33.0 ° C was maintained more stable in the invasive group ( 33.0 versus 32.7 ° C , p < 0.001 ) . Bleeding complications were more frequent with invasive cooling ( n = 17 [ 43.6 % ] versus n = 7 [ 17.9 % ] ; p = 0.03 ) . Conclusion Invasive cooling has advantages with respect to temperature management over surface cooling ; however , did not result in different outcome as measured by NSE release in SCA survivors . Bleeding complications were more frequently encountered by invasive cooling BACKGROUND Therapeutic hypothermia is currently the best-documented method of improving neurological outcomes in patients after cardiac arrest and successful resuscitation . There is a variety of methods for lowering body temperature . However , there are no data showing that any specific method of cooling improves the results or increases survival . A simple method involving surface cooling and ice-cold intravenous fluids , as well as more technologically advanced methods , are used in clinical practice . One of the more advanced methods is intravascular hypothermia , during which cooling is carried out with the use of a special catheter located in the central vein . AIM To compare cooling with the use of intravascular hypothermia and cooling using the traditional method . METHODS A prospect i ve study was performed in 41 patients with acute coronary syndromes who did not regain consciousness after out-of-hospital or in-hospital cardiac arrest and restoration of spontaneous circulation .  Therapeutic hypothermia ( 32 - 34 ° C ) was obtained with the use of an intravascular method ( group A , n = 20 ) or a traditional method ( group B , n = 21 ) for a period of 24 hours . Intravascular cooling involved the use of a catheter inserted in the femoral vein connected to a heat exchanger ( Alsius Coolgard , Zoll , Chelmsford , MA , USA ) . Traditional cooling was carried out using uncontrolled surface cooling , ice-cold intravenous fluids and ice-cold gastric lavage .  Nasopharyngeal and urinary bladder temperatures were recorded hourly . The main analysed temperature was the urinary bladder temperature , as the heat exchanger in the intravascular hypothermia group was controlled by the readings taken from this site . Temperature profiles were compared . RESULTS Temperature < 34 ° C was reached in 19 ( 95.0 % ) patients in group A and in 11 ( 52.4 % ) patients in group B ( p = 0.004 ) . Stable temperature profile ( temperature in the range 32 - 34 ° C during the final 12 h of cooling ) was reached in 16 ( 80 % ) patients in group A and in three ( 14.3 % ) patients in group B ( p < 0.001 ) . Periods of inadequate cooling ( temperature > 34 ° C ) and temperature overshoots ( temperature < 32 ° C ) were significantly more frequent in group B. Temperature profiles were significantly different in both groups in the readings taken from both sites . CONCLUSIONS The presented technique of intravascular hypothermia provides more precise temperature control in comparison with the traditional method BACKGROUND Mild therapeutic hypothermia ( 32 - 36 ° C ) is associated with improved outcomes in patients with brain injury after cardiac arrest ( CA ) . Various devices are available to induce and maintain hypothermia , but few studies have compared the performance of these devices . We performed a prospect i ve study to compare four frequently used cooling systems in inducing and maintaining hypothermia followed by controlled rewarming . METHODS We performed a prospect i ve multi-centered study in ten ICU 's in three hospitals within the UPMC health system . Four different cooling technologies ( seven cooling methods in total ) were studied : two external water-circulating cooling blankets ( Meditherm ® and Blanketrol ® ) , gel-coated adhesive cooling pads ( A rct ic Sun ® ) , and endovascular cooling catheters with balloons circulating ice-cold saline ( Thermogard ® ) . For the latter system we studied three different types of catheter with two , three or four water-circulating balloons , respectively . In contrast to previous studies , we not only studied the cooling rate ( i.e. , time to target temperature ) in the induction phase , but also the percentage of the time during the maintenance phase that temperature was on target ±0.5 ° C , and the efficacy of devices to control rewarming . We believe that these are more important indicators of device performance than induction speed alone . RESULTS 129 consecutive patients admitted after CA and treated with hypothermia were screened , and 120 were enrolled in the study . Two research ers dedicated fulltime to this study monitored TH treatment in all patients , including antishivering measures , additional cooling measures used ( e.g. icepacks and cold fluid infusion ) , and all other issues related to temperature management . Baseline characteristics were similar for all groups . Cooling rates were 2.06 ± 1.12 ° C/h for endovascular cooling , 1.49 ± 0.82 for A rct ic sun , 0.61 ± 0.36 for Meditherm and 1.22 ± 1.12 for Blanketrol . Time within target range ±0.5 ° C was 97.3 ± 6.0 % for Thermogard , 81.8 ± 25.2 % for A rct ic Sun , 57.4 ± 29.3 % for Meditherm , and 64.5 ± 20.1 % for Blanketrol . The following differences were significant : Thermogard vs. Meditherm ( p < 0.01 ) , Thermogard vs. Blanketrol ( p < 0.01 ) , and A rct ic Sun vs. Meditherm ( p < 0.02 ) . No major complications occurred with any device . CONCLUSIONS Endovascular cooling and gel-adhesive pads provide more rapid hypothermia induction and more effective temperature maintenance compared to water-circulating cooling blankets . This applied to induction speed , but ( more importantly ) also to time within target range during maintenance Background and Purpose — Recently 2 r and omized trials in comatose survivors of cardiac arrest documented that therapeutic hypothermia improved neurological recovery . The narrow inclusion criteria result ed in an international recommendation to cool only a restricted group of primary cardiac arrest survivors . In this retrospective cohort study we investigated the efficacy and safety of endovascular cooling in unselected survivors of cardiac arrest . Methods — Consecutive comatose survivors of cardiac arrest , who were either cooled for 24 hours to 33 ° C with endovascular cooling or treated with st and ard postresuscitation therapy  , were analyzed . Complication data were obtained by retrospective chart review . Results — Patients in the endovascular cooling group had 2-fold increased odds of survival ( 67/97 patients versus 466/941 patients ; odds ratio 2.28 , 95 % CI , 1.45 to 3.57 ; P<0.001 ) . After adjustment for baseline imbalances the odds ratio was 1.96 ( 95 % CI , 1.19 to 3.23 ; P=0.008 ) . When discounting the observational data in a Bayesian analysis by using a sceptical prior the posterior odds ratio was 1.61 ( 95 % credible interval , 1.06 to 2.44 ) . In the endovascular cooling group , 51/97 patients ( 53 % ) survived with favorable neurology as compared with 320/941 ( 34 % ) in the control group ( odds ratio 2.15 , 95 % CI , 1.38 to 3.35 ; P=0.0003 ; adjusted odds ratio 2.56 , 1.57 to 4.17 ) . There was no difference in the rate of complications except for bradycardia . Conclusion — Endovascular cooling improved survival and short-term neurological recovery compared with st and ard treatment in comatose adult survivors of cardiac arrest .  Temperature control was effective and safe with this device BACKGROUND Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment . We studied whether mild systemic hypothermia increases the rate of neurologic recovery after resuscitation from cardiac arrest due to ventricular fibrillation . METHODS In this multicenter trial with blinded assessment of the outcome , patients who had been resuscitated after cardiac arrest due to ventricular fibrillation were r and omly assigned to undergo  therapeutic hypothermia ( target temperature , 32 degrees C to 34 degrees C , measured in the bladder ) over a period of 24 hours or to receive st and ard treatment with normothermia . The primary end point was a favorable neurologic outcome within six months after cardiac arrest ; secondary end points were mortality within six months and the rate of complications within seven days . RESULTS Seventy-five of the 136 patients in the hypothermia group for whom data were available ( 55 percent ) had a favorable neurologic outcome ( cerebral-performance category , 1 [ good recovery ] or 2 [ moderate disability ] ) , as compared with 54 of 137 ( 39 percent ) in the normothermia group ( risk ratio , 1.40 ; 95 percent confidence interval , 1.08 to 1.81 ) . Mortality at six months was 41 percent in the hypothermia group ( 56 of 137 patients died ) , as compared with 55 percent in the normothermia group ( 76 of 138 patients ; risk ratio , 0.74 ; 95 percent confidence interval , 0.58 to 0.95 ) . The comp 
    Output:
    
Among adult patients receiving cardiopulmonary resuscitation , although there is no significant difference between the two cooling methods in the time from the start of cardiac arrest to achieve the target temperature , the faster cooling rate and more stable cooling process in EC shorten patients ’ ICU hospitalization time and help more patients obtain good neurological prognosis compared with patients receiving SC .
Meanwhile , although EC has no significant difference in patient outcomes compared with A rct icSun , EC has improved rates of neurologically intact survival