NHLBI launches temperature regulation study for pediatric cardiac arrest
The National Heart, Lung, and Blood Institute (NHLBI) has launched the first large-scale, multicenter study to investigate the effectiveness of temperature management in infants and children who have had cardiac arrest.
Balintfy: Researchers are starting a new study to see if infants and children who have cardiac arrest—whose hearts stop—can be helped with therapeutic hypothermia.
Pemberton: Therapeutic hypothermia—it's a big word — but really just means body cooling.
Balintfy: Victoria Pemberton is a clinical trials specialists and program officer at the National Heart, Lung and Blood Institute.
Pemberton: We've probably all heard a story of a child who had fallen into an icy pond and who has come out remarkably intact.
Balintfy: Therapeutic hypothermia is cooling done on purpose. She adds that it has been successful in adults after cardiac arrest and in newborns after birth asphyxia, or lack of oxygen. In those cases it improves survival and outcomes; but therapeutic hypothermia has not been studied in infants or children who have had cardiac arrest.
Pemberton: And so I think the next step now is for us to test this treatment in children. Children don't always respond the same way that adults do and so it would really be not ethical or fair to apply this treatment to children where itís never been tested and proven effective.
Balintfy: With $21-million in funding over six years, it is the first large-scale, multicenter study to explore the use of therapeutic hypothermia in infants and children after cardiac arrest. Participants in the study must be older than 48 hours and younger than 18 years and must be enrolled within six hours of suffering cardiac arrest.
Pemberton: So one of the very important parts of this study is to get the therapy instituted very quickly. So from the time that a child has been noted to have cardiac arrest and the heart starts beating again—after CPR or whatever resuscitative measures have been given—there's about six hours before we want to put the child on the cooling mattress and have the cooling blankets on.
Balintfy: Roughly 16-thoudand children suffer cardiac arrest each year in the United States. Cardiac arrest in infants and children has many causes, such as strangulation, drowning, or trauma. It can also be a complication of many medical conditions. Again NHLBIís Pemberton.
Pemberton: Cardiac arrest in children outside of the hospital is a particularly devastating event. Many children do not survive after a cardiac arrest or they survive with really impaired neurologic abilities and cognitive abilities.
Balintfy: Pemberton says it's important for both healthcare providers and the public to know and understand the scope of this new study, called Therapeutic Hypothermia Aafter Pediatric Cardiac Arrest or THAPCA. But she adds of the treatment:
Pemberton: We would like to caution the public against thinking that this is a magic cure or the silver bullet. But we do think that it's a reasonable therapy to consider and to test in this patient population to see if whether it will improve survival and cognitive intactness in children after cardiac arrest.
Balintfy: For more information on THAPCA, visit the website, www.nhlbi.nih.gov. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.