Therapeutic Efficacy of Craniocerebral Hypothermia Helmet Versus Arctic Sun Surface Cooling System in Post-Cardiac Arrest Syndrome: A Prospective Comparative Study.

Abstract

Therapeutic hypothermia is a critical intervention in post-cardiac arrest care, yet the optimal cooling method remains debatable. This prospective, single-center study compared the efficacy of a novel craniocerebral hypothermia helmet with the Arctic Sun 5000 surface cooling system in post-cardiac arrest patients. Thirty-four comatose survivors of cardiac arrest were randomized to receive either craniocerebral hypothermia (n = 17) or peripheral surface cooling (n = 17). Target temperature management (32-34°C) was initiated within 30-120 minutes of return of spontaneous circulation and maintained for 36-48 hours. Craniocerebral hypothermia demonstrated significantly faster cooling initiation (32.9 ± 13.5 vs. 238 ± 25.7 minutes, p < 0.001) compared with peripheral cooling, while both methods achieved similar target temperature maintenance. The craniocerebral group showed better preservation of renal function and electrolyte stability, with significantly lower increases in serum creatinine and urea levels (p < 0.001). Hospital stays were notably shorter in the craniocerebral group (13 ± 7 vs. 24.29 ± 31 days, p < 0.001). While both methods achieved comparable survival rates, the craniocerebral group exhibited a lower incidence of seizures (17.6% vs. 66.6%) and improved neurological outcomes based on Cerebral Performance Category scores though not reaching statistical significance. These findings suggest that craniocerebral hypothermia offers advantages in terms of rapid cooling initiation, physiological stability, and reduced hospital stay, representing a promising alternative for targeted temperature management in post-cardiac arrest care. The enhanced practicality and comparable efficacy of this approach warrant further investigation through larger multicenter trials.