Letter by Kohlhauer et al Regarding Article, “Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline: The RINSE Trial (Rapid Infusion of Cold Normal Saline)”
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To the Editor:
We congratulate Bernard and colleagues1 for their remarkable study about the induction of therapeutic hypothermia through a large volume of intra-arrest fluid administration. Conditions of therapeutic hypothermia application have been recently challenged through several clinical trials and probably need to be reconsidered on the basis of experimental evidence.
In this study, intra-arrest cooling through intravenous fluid administration was reported to be independently associated with a decrease in return of spontaneous circulation (ROSC) in patients with initial shockable rhythm compared with standard care. In addition, despite the significantly lower temperature at admission (34.7±1.2°C with intra-arrest cooling versus 35.4±1.3°C with standard care, P …