Readers of this blog may know that I harbor measured skepticism for HACA even though I recognize that it may be beneficial. From a pragmatic perspective, it makes sense to use it, since the outcome of hypoxic-ischemic encephalopathy (HIE) and ABI (Anoxic Brain Injury) is so dismal. But what did the original two studies actually show?
- The HACA group multicenter trial randomized 273 patients to hypothermia versus control and found that the hypothermia group had higher rates of "favorable neurological outcome" (a cerebral performance category of 1 or 2 - the primary endpoint) with RR of 1.40 and 95% CI 1.08-1.81; moreover, mortality was lower in the hypothermia group, with RR 0.74 and 95% CI 0.58-0.95
- The Bernard et al study randomized 77 patients to hypothermia versus control and found that survival (the primary outcome) was 49% and 26% in the hypothermia and control groups, respectively, with P=0.046