{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:11:08Z","timestamp":1784304668282,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fonds Erasme pour le Recherche M\u00e9dicale"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Randomized trials have shown that trans-nasal evaporative cooling initiated during CPR (i.e. intra-arrest) effectively lower core body temperature in out-of-hospital cardiac arrest patients. However, these trials may have been underpowered to detect significant differences in neurologic outcome, especially in patients with initial shockable rhythm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a post hoc pooled analysis of individual data from two randomized trials including 851 patients who eventually received the allocated intervention and with available outcome (\u201cas-treated\u201d analysis). Primary outcome was survival with favourable neurological outcome at hospital discharge (Cerebral Performance Category [CPC] of 1\u20132) according to the initial rhythm (shockable vs. non-shockable). Secondary outcomes included complete neurological recovery (CPC 1) at hospital discharge.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the 325 patients with initial shockable rhythms, favourable neurological outcome was observed in 54\/158 (34.2%) patients in the intervention and 40\/167 (24.0%) in the control group (RR 1.43 [confidence intervals, CIs 1.01\u20132.02]). Complete neurological recovery was observed in 40\/158 (25.3%) in the intervention and 27\/167 (16.2%) in the control group (RR 1.57 [CIs 1.01\u20132.42]). Among the 526 patients with initial non-shockable rhythms, favourable neurological outcome was in 10\/259 (3.8%) in the intervention and 13\/267 (4.9%) in the control group (RR 0.88 [CIs 0.52\u20131.29]; <jats:italic>p<\/jats:italic>\u2009=\u20090.67); survival and complete neurological recovery were also similar between groups. No significant benefit was observed for the intervention in the entire population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this pooled analysis of individual data, intra-arrest cooling was associated with a significant increase in favourable neurological outcome in out-of-hospital cardiac arrest patients with initial shockable rhythms. Future studies are needed to confirm the potential benefits of this intervention in this subgroup of patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13054-021-03583-9","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T16:03:26Z","timestamp":1623168206000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Effect of intra-arrest trans-nasal evaporative cooling in out-of-hospital cardiac arrest: a pooled individual participant data analysis"],"prefix":"10.1186","volume":"25","author":[{"given":"Fabio 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