{ "abstract": "Out-of-hospital cardiac arrest remains associated with high mortality and neurological disability. Mild therapeutic hypothermia has been questioned after large trials failed to demonstrate superiority over controlled normothermia with fever prevention. In this expert viewpoint, we argue that these neutral findings should not be interpreted as proof of biological futility in every patient and setting. The clinical effect of hypothermia may depend on patient phenotype, timing of initiation, cooling technique, temperature-control quality, and integration with contemporary post-resuscitation care. This may be particularly important in patients undergoing percutaneous coronary intervention, in whom hypothermia can impair the pharmacokinetics and antiplatelet effects of oral P2Y12 inhibitors. Current evidence does not support routine hypothermia in all comatose survivors. However, uncertainty remains regarding its value in selected patients. Patients with an intermediate degree of ischemic brain injury may represent a plausible target for neuroprotection, but this remains an unproven hypothesis. Future trials should investigate whether injury severity modifies the effects of early, precisely delivered hypothermia, using standardized protocols, active normothermia as the comparator, and prespecified antithrombotic and post-resuscitation strategies.", "abstract_shown": true, "affiliations": [ "Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland", "Staszic Specialist Hospital in Piła, 64-920 Piła, Poland", "Institute of Medical Science, The John Paul II Catholic University of Lublin, 20-037 Lublin, Poland", "Department of Emergency Medical Service, Faculty of Medicine, Silesian Academy in Katowice, 40-752 Katowice, Poland", "Department of Emergency Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland", "Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland", "Modern Medical Technologies Center, 87-100 Toruń, Poland", "Gajda-Med District Hospital, 06-100 Pułtusk, Poland", "First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland", "Department of Cardiology and Electrotherapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia Katowice, 41-800 Zabrze, Poland", "Institute for Heart Diseases, Wroclaw Medical University, 50-556 Wrocław, Poland", "Department and Clinic of Cardiology, University of Medical Sciences, 61-848 Poznań, Poland", "Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland", "Department of Pediatric Cardiac Surgery, University Children’s Hospital, Jagiellonian University Medical College, 30-663 Kraków, Poland", "National Institute of Cardiology, 04-628 Warszawa, Poland", "International Cardiovascular Center MC Medicor, 6310 Izola, Slovenia", "Department of Cardiology, Third Faculty of Medicine Charles University, 100 00 Prague, Czech Republic", "University Hospital Královské Vinohrady, 100 34 Prague, Czech Republic", "Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore and Lifebridge Health System, Baltimore, MD 21215, USA", "CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Seoul 14353, Republic of Korea", "Gwangmyeong and Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea", "National Heart and Lung Institute, Imperial College, London W12 0NN, UK", "Centre for Health Services Research, University of Hertfordshire, Hatfield AL10 9AB, UK", "Teaching-Therapeutical Hospital, Azerbaijan Medical University, AZ 1022 Baku, Azerbaijan", "GREAT Heath Science Network, 00136 Rome, Italy", "Clinic of Cardiovascular Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-08661 Vilnius, Lithuania", "Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, 97080 Würzburg, Germany", "Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany", "Department of Life and Health Sciences, Link Campus University, 00165 Rome, Italy", "American Heart of Poland, 64-920 Piła, Poland" ], "article_type": null, "arxiv": null, "author_total": 35, "authors": [ { "affs": [ 0 ], "name": "Julia M. Umińska" }, { "affs": [ 0 ], "name": "Jakub Ratajczak", "orcid": "0000-0002-3059-5338" }, { "affs": [ 0 ], "name": "Piotr Niezgoda", "orcid": "0000-0002-9912-9730" }, { "affs": [ 0 ], "name": "Przemysław Żuratyński", "orcid": "0000-0003-3498-6229" }, { "affs": [ 1 ], "name": "Dawid Mielczarek" }, { "affs": [ 1 ], "name": "Łukasz Pawłowski" }, { "affs": [ 0 ], "name": "Maciej Chudaś" }, { "affs": [ 0 ], "name": "Przemysław Jasiewicz", "orcid": "0009-0001-9039-2516" }, { "affs": [ 2 ], "name": "Łukasz Szarpak", "orcid": "0000-0002-0973-5455" }, { "affs": [ 3 ], "name": "Klaudiusz Nadolny", "orcid": "0000-0003-0355-241X" }, { "affs": [ 4 ], "name": "Jerzy Robert Ładny", "orcid": "0000-0003-4167-1962" }, { "affs": [ 5 ], "name": "Agnieszka Tycińska" }, { "affs": [ 0, 6 ], "name": "Aldona Kubica" }, { "affs": [ 6, 7 ], "name": "Robert Gajda", "orcid": "0000-0002-8305-8130" }, { "affs": [ 8 ], "name": "Miłosz Jaguszewski", "orcid": "0000-0002-2555-593X" }, { "affs": [ 9 ], "name": "Beata Średniawa", "orcid": "0000-0003-1591-3972" }, { "affs": [ 10 ], "name": "Wiktor Kuliczkowski", "orcid": "0000-0001-6284-0820" }, { "affs": [ 11 ], "name": "Maciej Lesiak", "orcid": "0000-0003-2630-5016" }, { "affs": [ 12 ], "name": "Przemysław Trzeciak" }, { "affs": [ 12 ], "name": "Mariusz Gąsior" }, { "affs": [ 13 ], "name": "Tomasz Mroczek" }, { "affs": [ 14 ], "name": "Janina Stępińska" }, { "affs": [ 15 ], "name": "Marko Noč", "orcid": "0000-0003-3303-4306" }, { "affs": [ 16, 17 ], "name": "Zuzana Motovska", "orcid": "0000-0002-5319-473X" }, { "affs": [ 18 ], "name": "Udaya Tantry" }, { "affs": [ 19, 20 ], "name": "Young-Hoon Jeong", "orcid": "0000-0003-0403-3726" }, { "affs": [ 18 ], "name": "Paul A. Gurbel" }, { "affs": [ 21, 22 ], "name": "Diana A. Gorog", "orcid": "0000-0002-9286-1451" }, { "affs": [ 23 ], "name": "Rahima Gabulova", "orcid": "0000-0001-5670-8954" }, { "affs": [ 24 ], "name": "Salvatore Di Somma" }, { "affs": [ 25 ], "name": "Jolita Badariene", "orcid": "0000-0003-1184-9803" }, { "affs": [ 26, 27 ], "name": "Stefan Frantz", "orcid": "0000-0002-0301-6185" }, { "affs": [ 26, 27 ], "name": "Stefan Störk", "orcid": "0000-0002-1771-7249" }, { "affs": [ 0, 28 ], "name": "Eliano P. Navarese" }, { "affs": [ 0, 6, 29 ], "name": "Jacek Kubica", "orcid": "0000-0001-8250-754X" } ], "bibtex": "https://research.draconitic.com/paper/67xatqk1ft8jq.bib", "cited_by": 0, "doi": "10.3390/jcm15218676", "fulltext_url": null, "id": "67xatqk1ft8jq", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/21/8676", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [], "openalex": null, "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-11-06", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/67xatqk1ft8jq.ris", "sources": [ { "first_seen": "2026-11-10T00:21:41Z", "native_id": "10.3390/jcm15218676", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/21/8676" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Rethinking Mild Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Dead End or Missed Opportunity? An Expert Viewpoint", "title_text": "Rethinking Mild Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Dead End or Missed Opportunity? An Expert Viewpoint", "type": "peer-reviewed", "updated_at": "2026-11-10T00:21:41Z", "url": "https://research.draconitic.com/paper/67xatqk1ft8jq", "venue": "Journal of Clinical Medicine", "versions": [] }