Hypothermic cardiac arrest: prognostic factors for successful resuscitation before rewarming

To indicate factors predicting return of spontaneous circulation in patients with hypothermic cardiac arrest in the pre-rewarming period. A multicenter retrospective study was conducted. We included patients who had suffered cardiac arrest caused by severe accidental hypothermia with a core body temperature of ≤ 28 °C. Patients who had achieved return of spontaneous circulation before commencement of active rewarming at the hospital were compared to those who remained in cardiac arrest. A total of 156 patients suffering hypothermic cardiac arrest were included in the study. In 14 of them (9%) resuscitation was successful before rewarming. Factors associated with return of spontaneous circulation were as follows: witnessed onset of cardiac arrest (p = 0.04); a higher core body temperature (p = 0.005) with a prognostic threshold of 24.6 °C; and a higher arterial oxygen partial pressure (p = 0.04) with a prognostic threshold of 81 mmHg. One patient after successful resuscitation sustained recurrence of cardiac arrest during rewarming. Patients with core body temperature