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Invasive resuscitation therapy and moderate cooling after resuscitation both missed the mark in clinical trials, highlighting opportunities for improvement in prehospital and hospital care for out-of-hospital cardiac arrest (OHCA).
A hyperinvasive approach to refractory OHCA featuring early transport to hospital under mechanical CPR, extracorporeal CPR (venoarterial extracorporeal membrane oxygenation [VA ECMO]), and immediate invasive evaluation was not significantly better than standard advanced cardiovascular life support, according to the Prague OHCA study, which had nevertheless been stopped prematurely due to benefit shown in secondary outcomes.
In CAPITAL CHILL, the colder of two target temperatures in therapeutic hypothermia did not improve outcomes for comatose survivors of OHCA, and in fact were associated with harm.