***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: Therapeutic hypothermia ( TH ) improves the outcomes of cardiac arrest ( CA ) survivors . The aim of this study was to evaluate retrospectively the efficacy and safety of an immediate prehospital cooling procedure implemented just after the return of spontaneous circulation with a prehospital setting . During 30 months , the case records of comatose survivors of out-of-hospital CA presumably due to a cardiac disease were studied . A routine protocol of immediate postresuscitation cooling had been tested by an emergency team , which consisted of an infusion of large-volume , ice-cold intravenous saline . We decided to assess the efficacy and tolerance of this procedure . A total of 99 patients were studied ; 22 were treated with prehospital TH , and 77 consecutive patients treated with prehospital st and ard resuscitation served as controls .  For all patients , TH was maintained for 12 to 24 hours . The demographic , clinical , and biological characteristics of the patients were similar in the 2 groups . The rate of patients with a body temperature of less than 35 degrees C upon admission was 41 % in the cooling group and 18 % in the control group . Rapid infusion of fluid was not associated with pulmonary edema . After 1 year of follow-up , 6 ( 27 % ) of 22 patients in the cooling group and 30 ( 39 % ) of 77 patients in the control group had a good outcome . Our preliminary observation suggests that in comatose survivors of CA , prehospital TH with infusion of large-volume , ice-cold intravenous saline is feasible and can be used safely by mobile emergency and intensive care units AIM The aim of this study is to evaluate the extent of myocardial injury by cardiac biomarkers during prolonged targeted temperature management of 24 hours vs 48 hours after out-of-hospital cardiac arrest . METHODS This r and omized Sc and inavian multicenter study compares the extent of myocardial injury quantified by area under the curve ( AUC ) of cardiac biomarkers during prolonged targeted temperature management at 33 ° C ± 1 ° C of 24 hours and 48 hours , respectively . Through a period of 2.5 years , 161 comatose out-of-hospital cardiac arrest patients were r and omized to targeted temperature management for 24 hours ( n = 77 ) or 48 hours ( n = 84 ) . The AUC was calculated using both high-sensitivity cardiac troponin T ( hs-cTnTAUC ) and creatine kinase-myocardial b and ( CK-MBAUC ) that were based upon measurements of these biomarkers every 6 hours upon admission until 96 hours after reaching target temperature . RESULTS The median hs-cTnTAUC of 33,827 ng/L/h ( interquartile range [ IQR ] 11,366 - 117,690 ) of targeted temperature management at 24 hours did not differ significantly from that of 28,973 ng/L/h ( IQR 10,656 - 163,655 ) at 48 hours . In contrast , the median CK-MBAUC of 1829 μg/L/h ( IQR 800 - 6799 ) during targeted temperature management at 24 hours was significantly lower than that of 2428 μg/L/h ( IQR 1163 - 10,906 ) within targeted temperature management at 48 hours , P < .05 . CONCLUSION This study of comatose out-of-hospital cardiac arrest survivors showed no difference between the extents of myocardial injury estimated by hs-cTnTAUC of prolonged targeted temperature management of 48 hours vs 24 hours , although the CK-MBAUC was significantly higher during 48 hours vs 24 hours . Hence , it seems unlikely that the duration of targeted temperature management has a beneficial effect on the extent of myocardial injury after out-of-hospital cardiac arrest , and may even have a worsening effect Objectives : Atrial fibrillation has been associated with increased mortality in the general population and mixed population s of critical ill . Atrial fibrillation can also affect patients during post – cardiac arrest care . We sought to assess the prognostic implication s of atrial fibrillation following out-of-hospital cardiac arrest , including relation to the level of targeted temperature management . Design : A post hoc analysis of a prospect i ve r and omized trial . Setting : Thirty-six ICUs . Patients : We included 897 ( 96 % ) of the 939 comatose out-of-hospital cardiac arrest survivors from the targeted temperature management trial ( year , 2010–2013 ) with data on heart rhythm on day 2 . Interventions : Targeted temperature management at 33 ° C or 36 ° C . Measurements and Main Results : Endpoints included cumulative proportion of atrial fibrillation following out-of-hospital cardiac arrest and 180-day all-cause mortality and specific death causes stratified by atrial fibrillation . Atrial fibrillation on day 2 was used as primary endpoint analyses to exclude effects of short-term atrial fibrillation related to resuscitation and initial management . The cumulative proportions of atrial fibrillation were 15 % and 11 % on days 1 and 2 , respectively . Forty-three percent of patients with initial atrial fibrillation the first day were reported with sinus rhythm on day 2 . No difference was found between the groups treated with targeted temperature management at 33 ° C and 36 ° C . Patients affected by atrial fibrillation had significantly higher 180-day mortality ( atrial fibrillation : 66 % vs no-atrial fibrillation : 43 % ; plogrank < 0.0001 and unadjusted hazard ratio , 1.75 [ 1.35–2.30 ] ; p < 0.0001 ) . The association between atrial fibrillation and higher mortality remained significant ( adjusted hazard ratio , 1.34 [ 1.01–1.79 ] ; p < 0.05 ) adjusted for potential confounders . Atrial fibrillation was independently associated with increased risk of cardiovascular death and multiple-organ failure ( adjusted hazard ratio , 2.07 [ 1.39–3.09 ] ; p < 0.001 ) , whereas no association with higher risk of death from cerebral causes was found . Conclusions : Atrial fibrillation was independently associated with higher mortality , primarily driven by cardiovascular causes and multiple-organ failure , and may thus identify a vulnerable sub population . Whether treatment to prevent atrial fibrillation is associated with an improved prognosis remains to be established 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 complication rate did not differ significantly between the two groups . CONCLUSIONS In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation , therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality PURPOSE Life threatening arrhythmias are increasingly frequent with lower body temperature . While targeted temperature management ( TTM ) with mild hypothermia following out-of-hospital cardiac arrest ( OHCA ) is generally considered safe and has been suggested as a potential antiarrhythmic add-on therapy , it is unknown whether the level of TTM affects the burden of ventricular ectopic activity . We sought to assess the ventricular ectopic burden between patients treated with TTM at 33 ° C or 36 ° C for 24h . METHODS Continuous 12-lead digital Holter electrocardiograms performed during the intervention were analyzed blinded to treatment allocation in 115 comatose OHCA-survivors from a single center of the TTM-trial . The main study showed no difference with regards to mortality . RESULTS Fifty-eight patients were r and omized to 33 ° C and 57 to 36 ° C . Cardiac arrest characteristics were similar between the groups . The number of isolated ventricular ectopic beats ( VEB ) per hour was similar at the beginning of the maintenance phase of TTM and decreased over time in both groups ( both ptime<0.001 ) . The reduction in VEB per hour was significantly affected by target temperature ( pinteraction<0.0001 ) , with fewer VEB in the 36 ° C-group . The total number of isolated , couplets and number of runs of VEB per hour showed similar results , with less ventricular ectopic activity in the 36 ° C-group ( pinteraction<0.0001 ) . Increasing numbers of pre-hospital defibrillations ( log2 ) were associated with a 46 % increase in ventricular ectopic activity ( p<0.01 ) , adjusted for potential confounders . CONCLUSIONS Ventricular ectopic activity was reduced in comatose OHCA-survivors treated with TTM at 36 ° C compared to 33 ° C . Higher numbers of pre-hospital defibrillations were associated with higher incidence of ventricular ectopic activity Background and Purpose — Cognitive deficits are common in survivors of cardiac arrest ( CA ) . The aim of this study was to examine the effect of therapeutic hypothermia after CA on cognitive functioning and neurophysiological outcome . Methods — A cohort of 70 consecutive adult patients resuscitated from out-of-hospital ventricular fibrillation CA were r and omly assigned to therapeutic hypothermia of 33 ° C for 24 hours accomplished by external cooling or normothermia .  Neuropsychological examination was performed to 45 of the 47 conscious survivors of CA ( 27 in hypothermia and 18 in normothermia group ) 3 months after the incident . Quantitative electroencephalography ( Q-EEG ) and auditory P300 event-related potentials were studied on 42 patients at the same time point . Results — There were no differences between the 2 treatment groups in demographic variables , depression , or delays related to the resuscitation . No differences were found in any of the cognitive functions between the 2 groups . 67 % of patients in hypothermia and 44 % patients in normothermia group were cognitively intact or had only very mild impairment . Severe cognitive deficits were found in 15 % and 28 % of patients , respectively . All Q-EEG parameters were better in the hypothermia-treated group , but the differences did not reach statistical significance . The amplitude of P300 potential was significantly higher in hypothermia-reated group . Conclusions — The use of therapeutic hypothermia was not associated with cognitive decline or neurophysiological deficits after out-of-hospital CA AIM Survivors of out-of-hospital cardiac arrest ( OHCA ) may experience psychological distress but the actual prevalence is unknown . The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors . METHODS OHCA-survivors r and omized to targeted temperature of 33 ° C or 36 ° C within the Target Temperature Management trial ( TTM-trial ) attended a follow-up after 6 months that included the question naire Hospital Anxiety and Depression Scale ( HADS ) . A control group with ST-elevation myocardial infa rct ion ( STEMI ) completed the same follow-up . Correlations to variables assumed to be associated with anxiety and depression in OHCA-survivors were tested . RESULTS At follow-up 278 OHCA-survivors and 119 STEMI-controls completed the HADS where 24 % of OHCA-survivors ( 28 % in 33 ° C group/22 % in 36 ° C group , p=0.83 ) and 19 % of the STEMI-controls reported symptoms of anxiety ( OR 1.32 ; 95 % CI ( 0.78 - 2.25 ) , p=0.30 ) . Depressive symptoms were reported by 13 % of OHCA-survivors ( equal in both intervention groups , p=0.96 ) and 8 % of STEMI-controls ( OR 1.76 ; 95 % CI ( 
    Output:
    
There is a considerable incidence of side effects attributed to the procedure , e.g. , from life‐threatening ventricular arrhythmias to self‐limited consequences .
Most studies analyzed in this systematic review indicated that the procedure of TH has not caused severe adverse effects leading to significant alterations in the outcomes following resuscitation from OHCA .