Rethinking Mild Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Dead End or Missed Opportunity? An Expert Viewpoint

@article{uminska2026rethinking,
  title = {{Rethinking Mild Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Dead End or Missed Opportunity? An Expert Viewpoint}},
  author = {Julia M. Umińska and Jakub Ratajczak and Piotr Niezgoda and Przemysław Żuratyński and Dawid Mielczarek and Łukasz Pawłowski and Maciej Chudaś and Przemysław Jasiewicz and Łukasz Szarpak and Klaudiusz Nadolny and Jerzy Robert Ładny and Agnieszka Tycińska and Aldona Kubica and Robert Gajda and Miłosz Jaguszewski and Beata Średniawa and Wiktor Kuliczkowski and Maciej Lesiak and Przemysław Trzeciak and Mariusz Gąsior and Tomasz Mroczek and Janina Stępińska and Marko Noč and Zuzana Motovska and Udaya Tantry and Young-Hoon Jeong and Paul A. Gurbel and Diana A. Gorog and Rahima Gabulova and Salvatore Di Somma and Jolita Badariene and Stefan Frantz and Stefan Störk and Eliano P. Navarese and Jacek Kubica},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218676},
  url = {https://www.mdpi.com/2077-0383/15/21/8676},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Rethinking Mild Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: Dead End or Missed Opportunity? An Expert Viewpoint
AU  - Julia M. Umińska
AU  - Jakub Ratajczak
AU  - Piotr Niezgoda
AU  - Przemysław Żuratyński
AU  - Dawid Mielczarek
AU  - Łukasz Pawłowski
AU  - Maciej Chudaś
AU  - Przemysław Jasiewicz
AU  - Łukasz Szarpak
AU  - Klaudiusz Nadolny
AU  - Jerzy Robert Ładny
AU  - Agnieszka Tycińska
AU  - Aldona Kubica
AU  - Robert Gajda
AU  - Miłosz Jaguszewski
AU  - Beata Średniawa
AU  - Wiktor Kuliczkowski
AU  - Maciej Lesiak
AU  - Przemysław Trzeciak
AU  - Mariusz Gąsior
AU  - Tomasz Mroczek
AU  - Janina Stępińska
AU  - Marko Noč
AU  - Zuzana Motovska
AU  - Udaya Tantry
AU  - Young-Hoon Jeong
AU  - Paul A. Gurbel
AU  - Diana A. Gorog
AU  - Rahima Gabulova
AU  - Salvatore Di Somma
AU  - Jolita Badariene
AU  - Stefan Frantz
AU  - Stefan Störk
AU  - Eliano P. Navarese
AU  - Jacek Kubica
PY  - 2026
DA  - 2026/11/06
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218676
UR  - https://www.mdpi.com/2077-0383/15/21/8676
AB  - 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.
SN  - 2077-0383
ER  -